CPT 19001 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 19001 by major payers:
$37.07
$35.86
$36.29
$44.90
| 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 19001 | ||||||
United | 19001 | $226.00 | 1417114117 - HOSP OF THE UNIV OF PA SPU | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $104.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $390.00 | 1518969773 - ARIZONA SKIN CANCER SURGERY CENTER, P.C. | 562365590 - (AZ) ARIZONA SKIN CANCER SURGERY CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $89.00 | 1275802183 - PRECISION VISION SURGERY CENTER, LLC | 731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $125.00 | 1043560295 - CENTENNIAL SPECIALTY SURGERY CENTER INC | 454699837 - (NV) CENTENNIAL SPECIALTY SURGERY CENTER INC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $507.00 | 1306353586 - SDG CASTLE ROCK ENDOSCOPY CENTER | 823765778 - (CO) SDG CASTLE ROCK ENDOSCOPY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $237.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $188.00 | 1023734084 - WEST GEORGIA SURGERY CENTER, LLC | 833671516 - (GA) TANNER MEDICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $574.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $566.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $280.00 | 1952363368 - GOLDEN TRIANGLE SURGICENTER LP | 330529450 - (CA) GOLDEN TRIANGLE SURGICENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $531.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $150.00 | 1518052380 - CUKROWSKI SURGERY CENTER PC, EAST MICHIGAN SURGERY CENTER | 203478646 - (MI) CUKROWSKI EYE CENTER PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $200.00 | 1407327356 - ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC, SURGERY CENTER OF BEVERLY HILLS LLC | 832822673 - (CA) ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19001 | $574.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | 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 19001 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19001 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 19001 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 19001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19001 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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