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See a sample rate comparisonCPT 19020 Fee Schedule
Last Verified: October 2026
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.
Drain Infected Breast Tissue, Surgical Drainage Of An Infected Area (Abscess) In Breast Tissue. Samples May Be Examined To Determine The Cause Of Infection. The Wound May Be Stitched Closed Or Packed With Gauze To Encourage Full Drainage.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19020 |
| Medicaid Fee Schedule | View Medicaid rates for 19020 |
National average reimbursement for CPT 19020 by major payers:
$558.88
$585.82
$616.25
$506.26
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CPT 19020
5 of 25 sample ratesHigher to lower in this preview
Presbyterian Sameday Surgery Center At Huntersville LLC, Novant Health Huntersville Outpatient Surgery
Presbyterian Sameday Surgery Center At Huntersville LLC
$4,825.00Published rateCanon City Co Multi Specialty Asc LLC, Arkansas Valley Surgery Center
Canon City Co Multi Specialty Asc LLC
$3,099.00Published rateSsm St. Joseph Surgery Center, LLC, The Surgery Center At St. Joseph Medical Park
Ssm St Joseph Surgery Center LLC
$1,803.00Published rateIpm Surgery Centers LLC, Spinalcare Surgicenter
Ipm Surgery Centers, Inc
$1,200.00Published rateArizona Surgical Arts, Inc.
Arizona Surgical Arts Inc
$507.00Published rate
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See a sample payer proposalCPT 19020 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19020 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 19020 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) |
| 19020-CPT | Moderate | Drain Infected Breast Tissue, Surgical Drainage Of An Infected Area (Abscess) In Breast Tissue. Samples May Be Examined To Determine The Cause Of Infection. The Wound May Be Stitched Closed Or Packed With Gauze To Encourage Full Drainage. |
| 19030-CPT | Moderate | Inject Dye For Breast Imaging, A Contrast Solution Such As Salt Water Or Dye Is Injected Into A Breast Duct To Prepare For An Imaging Procedure. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19020 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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