2025 CPT code 19340
(Active) Effective Date: N/A Revision Date: N/A Surgery - Repair and/or Reconstruction Procedures on the Breast Surgical Procedures on the Integumentary System Feed
Immediate insertion of a breast implant following a mastectomy.
Modifiers 50 (bilateral procedure) and others may be applicable depending on the specific circumstances of the procedure.
Medical necessity for code 19340 is established when immediate breast reconstruction is medically appropriate given the patient’s clinical condition. Factors considered can include the patient’s overall health and surgical risk, the type of mastectomy, and the patient's personal preferences.
The surgeon is responsible for creating the pocket for the implant, inserting the implant, and closing the incision.Anesthesiology services may also be involved.
- Surgical Procedures on the Integumentary System
- Surgical Procedures on the Integumentary System > Surgical Procedures on the Breast > Repair and/or Reconstruction Procedures on the Breast
In simple words: The doctor puts in a breast implant at the same time as removing the breast (mastectomy). This is done to rebuild the breast.
This CPT code describes the immediate insertion of a breast implant during the same operative session as a mastectomy.The procedure involves creating a pocket and inserting the implant (saline or silicone gel filled) to reconstruct the breast. This code is used when there is no delay between the mastectomy and the implant placement, and a tissue expander was not used as part of a staged reconstruction.The code also applies to the replacement of an existing implant with a new one in cases where there was no delay in initial implant reconstruction. Removal of the previous implant is included.
Example 1: A patient undergoes a mastectomy for breast cancer.During the same surgical procedure, the surgeon inserts a breast implant for immediate reconstruction. The implant is placed subpectorally., A patient has a mastectomy and requires immediate breast reconstruction. A silicone gel-filled implant is inserted submuscularly to restore breast volume and shape., A patient had a breast implant placed after a prior mastectomy. Due to complications, the implant needs to be removed and replaced during the same procedure. The original implant insertion was considered immediate reconstruction.
Operative report detailing the mastectomy and implant placement, including implant type, location (subpectoral or subglandular), and any complications.Preoperative and postoperative imaging (if applicable). Pathology report confirming the diagnosis of cancer (if applicable). Consent form signed by the patient.
** This code should only be used when the implant placement is performed during the same operative session as the mastectomy and a tissue expander was not used.The removal of a prior implant, if part of the replacement procedure, is included in the code. Always refer to the most recent CPT manual for the most accurate and up-to-date information.
- Revenue Code: P1A (MAJOR PROCEDURE - BREAST)
- RVU: This information is not available in the provided text and would require access to a specific fee schedule or payment system.RVUs vary based on geographic location and payer.
- Global Days: The global period for this procedure would need to be determined based on the specific payer and their guidelines.There is no explicit global period stated for this code.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a complete procedure code.
- Fee Schedule: This information is not available in the provided text and would require access to a specific fee schedule or payment system.
- Specialties:Surgical Oncology, Plastic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center