CPT 19081 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19081 |
National average reimbursement for CPT 19081 by major payers:
$630.76
$827.99
$779.44
$966.91
| 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 19081 | ||||||
United | 19081 | $1397.00 | 1245233220 - NORTHRIDGE SURGERY CENTER, LP, NORTHRIDGE SURGERY CENTER | 690003768 - (TN) NORTHRIDGE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $852.00 | 1003079187 - WASC LLC | 205816792 - (OH) WOOSTER AMBULATORY SURGERY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $1000.00 | 1487604500 - CYPRESSWOOD SURGERY CENTER LLC, LEGENT SURGERY CENTER CYPRESSWOOD | 680600120 - (TX) CYPRESSWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $1188.00 | 1598927147 - MORTON PLANT MEASE HEALTH SERVICES INC, BARDMOOR OUTPATIENT CENTER | 204385452 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $700.00 | 1659378800 - CITYVIEW SURGERY CENTER LLC, CITYVIEW SURGERY CENTER | 113711239 - (TX) CITYVIEW SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $1179.00 | 1942851639 - NORTHERN MICHIGAN SURGICAL SUITES, LLC | 830670803 - (MI) NORTHERN MICHIGAN SURGICAL SUITES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $707.00 | 1194790592 - UPMC HAMOT SURGERY CENTER, LLC | 251863661 - (PA) UPMC HAMOT SURGERY CENTER, L.L.C. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $840.00 | 1184682445 - PORTSMOUTH SURGERY CENTER | 743085624 - (OH) PORTSMOUTH SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $581.00 | 1497751747 - MID-ATLANTIC ENDOSCOPY CENTER, LLC, MID-ATLANTIC GASTROINTESTINAL CENTER II | 233096335 - (DE) MIDATLANTIC ENDOSCOPY CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $2817.00 | 1407165772 - MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY, LLC, MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY | 273520409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $1358.00 | 1891717195 - CENTER FOR PAIN MANAGEMENT LLC, TUCSON UROLOGIC SURGERY CENTER | 830962530 - (AZ) CENTER FOR PAIN MANAGEMENT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $342.00 | 1356654610 - ENDO-SURGICAL CENTER OF FLORIDA | 272047909 - (FL) ENDOSURGICAL CENTER OF FLORIDA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $2538.00 | 1215990627 - WESTSIDE SURGERY CENTER LLC, WESTSIDE SURGERY CENTER LTD | 593026856 - (FL) WESTSIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $565.00 | 1306134838 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19081 | $632.00 | 1699012682 - FSC INVESTMENTS, LLC, FLORISSANT SURGERY CENTER | 453808874 - (MO) FSC INVESTMENTS LLC | MO | 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 19081 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19081 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 19081 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 |
|---|---|---|
| 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 |
| 19081-CPT | Moderate | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19081. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19081 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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