19318 Breast reduction
Also known as: reduction mammoplasty, breast reduction
Surgical reduction of breast size by removing excess glandular tissue, fat, and skin. This procedure is performed to alleviate symptoms and improve breast proportions.
In Plain Language
making breasts smaller; reduction of breast size
Clinical Context
Used to treat symptomatic macromastia (abnormally large breasts) causing back pain, neck pain, shoulder grooving, or skin irritation. May be medically necessary or performed for cosmetic reasons.
RVU Breakdown
| Work RVU | 15.63 |
| Total RVU | 15.63 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 15.63, this code ranks in the 74th percentile among Surgery codes — 2.0x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 19318?
CPT 19318 (Breast reduction) is a Surgery code. Surgical reduction of breast size by removing excess glandular tissue, fat, and skin. This procedure is performed to alleviate symptoms and improve breast proportions.
What is the wRVU value for CPT 19318?
The work RVU for CPT 19318 is 15.63. This code is primarily used by Plastic Surgery, General Surgery, Cosmetic Surgery. It has a 90-day global period.
When is CPT 19318 used?
Used to treat symptomatic macromastia (abnormally large breasts) causing back pain, neck pain, shoulder grooving, or skin irritation. May be medically necessary or performed for cosmetic reasons.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.