Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 19112 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.
Repair Milk Duct Passage, Surgery To Remove A Fistula (Abnormal Passage) From A Milk Duct. The Procedure May Remove Part Of The 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19112 |
| Medicaid Fee Schedule | View Medicaid rates for 19112 |
National average reimbursement for CPT 19112 by major payers:
$547.48
$574.16
$575.24
$521.32
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 19112.
CPT 19112
5 of 25 sample ratesHigher to lower in this preview
Nmc Surgery Center, L.P., The Surgery Center Of Nacogdoches
Nmc Surgery Center Lp
$3,019.00Published rateUpper Bay Surgery Center, LLC
$2,307.00Published rateSurgery Centers Of Des Moines Ltd
$1,370.00Published rateNiagara Health Center, Inc
Niagara Health Center
$1,000.00Published rateHermitage Tn Endoscopy Asc, LLC, Associated Endoscopy
$787.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 19112 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19112 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 19112 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 |
|---|---|---|
| 19101-CPT | Moderate | Breast Biopsy, A Procedure To Remove A Sample Of Tissue From A Breast For Testing. Ultrasound (Sound Wave Images) May Be Used To Help Locate The Tissue To Be Sampled. The Sample May Be Taken In Surgery Or With A Needle. |
| 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. |
| 19294-CPT | Moderate | Preparation Of Tumor Cavity W, Preparation Of Tumor Cavity With Placement Of A Radiation Therapy Applicator For Intraoperative Radiation Therapy (Iort) Concurrent With Partial Mastectomy (List Separately In Addition To Code For Primary Procedure) Tery Disease Data Preparation And Transmission A |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19112. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19112 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 19112) and we'll show you how you compare in 15 minutes or less.