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See a sample rate comparisonHealthcare 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 |
| Medicare Fee Schedule | View Medicare rates for 19000 |
| Medicaid Fee Schedule | View Medicaid rates for 19000 |
National average reimbursement for CPT 19000 by major payers:

$123.98

$139.37

$145.73

$84.28
Choose a payer to see a sample of rates for CPT 19000.
Deaconess Hospital Inc
Deaconess Hospital Inc
Town Center Orthopaedic Associates, P.C.
Sports Physical Therapy Occupationa Therapy And Rehabilitation Service
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 |
|---|---|---|
| 19000-CPT | Low | Puncture Aspiration Breast Cyst |
| 19001-CPT | Low | Puncture Aspiration Of Cyst Of, Puncture Aspiration Of Cyst Of Breast Each Additional Cyst (List Separately In Addition To Code Forprimary Procedure) |
| 19081-CPT | Moderate | Bx Breast 1st Lesion Strtctc, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous First Lesion Including Stereotactic Guidance |
| 19082-CPT | Moderate | Bx Breast Add Lesion Strtctc, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous Each Additional Lesion Including Stereotactic Guidance List Separately In Addition To Code For Primary Procedure |
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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