CPT 15819 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15819 |
National average reimbursement for CPT 15819 by major payers:
$1,020.32
$993.18
$777.28
$1,576.89
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15819 | ||||||
United | 15819 | $536.00 | 1447366224 - WEST MICHIGAN SURGERY CENTER, LLC | 371509502 - (MI) MICHIGAN PRIMARY CARE PARTNERS PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $550.00 | 1194987222 - ADVANCED SURGERY CENTER OF PALM BEACH COUNTY, LLC, ADVANCED SURGERY CENTER | 262830080 - (FL) ADVANCED SURGERY CENTER OF PALM BEACH COUNTY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $643.00 | 1801349386 - INTERVENTIONAL PAIN MANAGEMENT, LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $525.00 | 1477572675 - MOOTHEDATH A MENON, WIKA ENDOSCOPY CENTER | 363164643 - (CA) M.A. MENON, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $1528.00 | 1376906354 - PREMIER AT EXTON SURGERY CENTER, LLC | 474302293 - (PA) PREMIER AT EXTON SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $1500.00 | 1750567442 - IRELAND GROVE CENTER FOR SURGERY LLC. | 202687982 - (IL) IRELAND GROVE CENTER FOR SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $1233.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $622.00 | 1396983847 - EYE SURGERY CENTER LLC, THE EYE SURGERY CENTER | 263915695 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $1558.00 | 1902204654 - DENVER SURGICENTER, LLC | 472340660 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $803.00 | 1447949706 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT BOCA RATON RESEARCH PARK | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $2279.00 | 1083656318 - SURGERY CENTER OF OVERLAND PARK LP | 201011611 - (KS) SURGERY CENTER OF OVERLAND PARK LP | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $590.00 | 1699328146 - ALLIANCE SURGERY CENTER, LLC | 824278461 - (MI) ALLIANCE SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $2782.00 | 1205327277 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $839.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15819 | $410.00 | 1114984523 - AUGUSTA UROLOGY SURGICENTER, LLC | 582360326 - (GA) AUGUSTA UROLOGY SURGICENTER, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15819 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15819 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 15819 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 15731-CPT | High | Foreheard Flap W/Preservation Of Vascular Pedicle |
| 15733-CPT | High | Muscle, Myocutaneous, Or Fasciocutaneous Flap; Head And Neck With Named Vascular Pedicle (Ie, Buccinators, Genioglossus, Temporalis, Masseter, Sternocleidomastoid, Levator Scapulae) |
| 15734-CPT | High | Muscle Myo/Fasciocutaneous Flap Trunk |
| 15819-CPT | High | Cervicoplasty |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15819. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15819 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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