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CPT 19325 · Surgery

Breast augmentation w/implt

Breast augmentation with implant placement costs range from $569 to $9,569 depending on your facility type, with potential differences of $9,000 making bill verification essential before scheduling.

By Michael Glenn , Healthcare Data Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.

Medicare + CMS benchmark data
Publicly available pricing
Updated 2026-04-03
Rate comparison — Breast augmentation w/implt
Non-facility$99Medicare facility$569ASC rate$3.2KHospital outpatient$9.6K$9.5K difference between lowest and highest rate
$569
Medicare facility rate
$99
Non-facility rate
$3,174
ASC rate
$6,395
ASC vs hospital gap

Code 19325 covers surgical breast enlargement using silicone or saline implants placed either above or below the chest muscle. This elective procedure is typically sought by women wanting to increase breast size for cosmetic reasons. Since breast augmentation is considered cosmetic surgery, it's generally not covered by insurance plans, requiring patients to pay out-of-pocket costs that can vary significantly between providers.

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The $6,395 gap between ASC and hospital outpatient for Breast augmentation w/implt is one of the most common billing discrepancies we identify.
Compare by care setting
The same procedure costs different amounts depending on where you receive care.
$9,569
Hospital Outpatient rate for Breast augmentation w/implt
Medicare facility benchmark: $569
Regional rate comparison — Breast augmentation w/implt
Top 5 lowest and highest localities by Medicare facility rate
National avg $569REST OF ILLINOIS, IL$657DETROIT, MI$692QUEENS, NY$699MIAMI, FL$866CHICAGO, IL$817NYC SUBURBS/LONG ISLAND, NY$779

Facility rate

$569

National Medicare benchmark

Non-facility rate

$99

Office setting benchmark

Data sources

4

24 data points

Key insights for CPT 19325

ASC vs hospital outpatient savings

$6,395

Having this done at an ambulatory surgery center costs $3,174 vs $9,569 at a hospital outpatient

Facility vs office setting

$470 difference

Non-facility setting is less expensive for this procedure

What this procedure costs across different settings

The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.

SettingMedicare ratevs lowest
Facility (physician office)$569+475%
Non-facility (office)$99Lowest
Outpatient (APC)$9,569+9566%
Ambulatory surgery (ASC)$3,174+3106%

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About this data

Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).

This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.

Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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