Data Platform
Sign InTry for Free

CPT 19020 Fee Schedule

Last Verified: January 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.

Mastotomy W Explor/Drain Abscess
Key FactDetail
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 LevelModerate
Medicare Fee ScheduleView Medicare rates for 19020

National average reimbursement for CPT 19020 by major payers:

bcbs

$558.88

uhc

$585.82

aetna

$616.25

cigna

$744.71

Preview provider-level rates for...
For billing codeCPT 19020
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 19020

United
19020$3500.001295702942 - GRAPEVINE SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - SOUTHLAKE752854711 - (TX) GRAPEVINE SURGICARE PARTNERS LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$3993.001699738112 - NORTH AUSTIN SURGERY CENTER, L.P.200648730 - (TX) NORTH AUSTIN SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$870.001497728984 - MOUNT DORA OPHTHALMOLOGY ASC LLC, MID FLORIDA SURGERY CENTER621795778 - (FL) MOUNT DORA OPHTHALMOLOGY ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1380.001659409241 - EYE SURGERY CENTER, LOREN BARRUS & PAUL SCHULTZ PTRS931126853 - (OR) EYE SURGERY CENTERORAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$4825.001063641801 - PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC, NOVANT HEALTH HUNTERSVILLE OUTPATIENT SURGERY262422926 - (NC) PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1044.001316533474 - SANDHILLS ENDOSCOPY CENTER851392224 - (SC) SANDHILLS ENDOSCOPY CENTERSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1400.001154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1325.001003062274 - ADVANCED SURGICAL CARE OF BATON ROUGE,LLC261476056 - (LA) ADVANCED SURGICAL CARE OF BATON ROUGELLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1803.001396782553 - SSM ST. JOSEPH SURGERY CENTER, LLC, THE SURGERY CENTER AT ST. JOSEPH MEDICAL PARK431822767 - (MO) SSM ST JOSEPH SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$3608.001902134372 - METRO SPECIALTY SURGERY CENTER, LLC270426722 - (IN) METRO SPECIALTY SURGERY CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$1072.001023169380 - JCMG SURGERY CENTER, INC.431809950 - (MO) JCMG SURGERY CENTER INCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$817.601801904867 - LORI MUNSIE350593390 - DEACONESS HOSPITAL INCINObstetrics & Gynecology Physician (207V00000X)
United
19020$3427.001003138736 - NEWPORT SURGICAL PARTNERS LLC, NEWPORT PLAZA SURGICAL CENTER392060266CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$3099.001750517561 - CANON CITY CO MULTI SPECIALTY ASC LLC, ARKANSAS VALLEY SURGERY CENTER264730485 - (CO) CANON CITY CO MULTI SPECIALTY ASC LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
19020$507.001629133442 - ARIZONA SURGICAL ARTS, INC.860607769 - (AZ) ARIZONA SURGICAL ARTS INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 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.

CodeComplexityDescription
17999-CPTModerateUnlisted Procedure, Skin, Mucous Membrane And Subcutaneous Tissue
19000-CPTLowPuncture Aspiration Breast Cyst
19001-CPTLowPuncture Asp Breast Cyst Ea Add
19020-CPTModerateMastotomy W Explor/Drain Abscess

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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 19020) and we'll show you how you compare in 15 minutes or less.