CPT 19000 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 19000 by major payers:

$123.98

$139.37

$145.73

$172.71
| 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 19000 | ||||||
United | 19000 | $191.75 | 1356505101 - MOUHAMMAD YABRODI | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 19000 | $88.09 | 1962981084 - SAL BLAKE | 350593390 - DEACONESS HOSPITAL INC | KY | Physician Assistant (363A00000X) |
United | 19000 | $191.75 | 1376587345 - DONNA LILLY | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Social Worker (1041C0700X) |
United | 19000 | $88.09 | 1750648317 - DAVID BAUM | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 19000 | $88.09 | 1659963510 - THOMAS HORNYAK | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 19000 | $191.75 | 1649606815 - AMANDA ROMERHAUSEN | 350593390 - DEACONESS HOSPITAL INC | IN | Acute Care Nurse Practitioner (363LA2100X) |
United | 19000 | $88.09 | 1144750092 - KRISTINE HAYS | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 19000 | $144.77 | 1801813266 - GREGG BEAN | 741586031 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 19000 | $88.09 | 1023416252 - JODY SUTTON | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 19000 | $134.25 | 1952309171 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 19000 | $88.09 | 1881447324 - KAYLA BLAKE | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 19000 | $88.09 | 1700393683 - MELISSA HARMON | 350593390 - DEACONESS HOSPITAL INC | KY | Family Nurse Practitioner (363LF0000X) |
United | 19000 | $88.09 | 1275020612 - STACEY KUDER | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Social Worker (1041C0700X) |
United | 19000 | $191.75 | 1801987854 - MICHAEL PETERS | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 19000 | $88.09 | 1720183247 - GINA NIEMEIER | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
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 19000 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19000 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 19000 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 |
|---|---|---|
| 15958-CPT | High | Excision, Trochanteric Pressure Ulcer, In Preparation For Muscle Or Myocutaneous Flap Or Skin Graft Closure; With Ostectomy |
| 17999-CPT | Moderate | Unlisted Procedure, Skin, Mucous Membrane And Subcutaneous Tissue |
| 19000-CPT | Low | Puncture Aspiration Breast Cyst |
| 19001-CPT | Low | Puncture Asp Breast Cyst Ea Add |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19000 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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