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See a sample rate comparisonCPT 19110 Fee Schedule
Last Verified: September 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.
Nipple Exploration With Or Wi, Nipple Exploration With Or Without Excision Of A Solitarylactiferous Duct Or A Papilloma Lactiferous Duct
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19110 |
| Medicaid Fee Schedule | View Medicaid rates for 19110 |
National average reimbursement for CPT 19110 by major payers:
$614.19
$608.08
$636.67
$568.49
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CPT 19110
5 of 25 sample ratesHigher to lower in this preview
Port Warwick Surgery Center, LLC
Port Warwick Surgery Center LLC
$5,447.00Published rateCentrum Surgery Center Ltd
$2,119.00Published rateGreat South Bay Endoscopy Center, LLC
Great South Bay Endoscopy Center LLC
$1,304.00Published rateArizona Eye Institute & Cosmetic Laser Center LLC
Arizona Eye Institute Cosmetic Laser Center LLC
$979.00Published ratePamela Binns-Turner
Deaconess Hospital Inc
$386.32Published rate
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See a sample payer proposalCPT 19110 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19110 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 19110 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 |
|---|---|---|
| 19083-CPT | Moderate | Bx Breast 1st Lesion Us Imag, 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 Ultrasound Guidance |
| 19110-CPT | Moderate | Nipple Exploration With Or Wi, Nipple Exploration With Or Without Excision Of A Solitarylactiferous Duct Or A Papilloma Lactiferous Duct |
| 19112-CPT | Moderate | Repair Milk Duct Passage, Surgery To Remove A Fistula (Abnormal Passage) From A Milk Duct. The Procedure May Remove Part Of The Duct. |
| 19120-CPT | Moderate | Removal Of Breast Lesion, Excision Of Cyst Fibroadenoma Or Other Benign Or Malignant Tumor Aberrant Breast Tissue Duct Lesion Nipple Or Areolar Lesion Except 19300 Open Male Or Female 1 Or More Lesions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19110 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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