CPT 19112 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 • 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 |
National average reimbursement for CPT 19112 by major payers:
$547.48
$574.16
$575.24
$739.18
| 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 19112 | ||||||
United | 19112 | $1168.00 | 1588603351 - PHYSICIAN'S DAY SURGERY CENTER | 710623198 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $2206.00 | 1326435926 - SELECT PHYSICIANS SURGERY CENTERS | 383935220 - (FL) SELECT PHYSICIANS SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $1227.00 | 1871674481 - CAROLINAS PHYSICIANS NETWORK INC, ATRIUM HEALTH ENDOSCOPY CENTER BALLANTYNE | 561667838 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $2388.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $843.00 | 1285664300 - PHYSICIANS OUTPATIENT SURGERY CENTER, LLC | 311649113 - (OH) PHYSICIANS OUTPATIENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $3019.00 | 1225064736 - NMC SURGERY CENTER, L.P., THE SURGERY CENTER OF NACOGDOCHES | 752793512 - (TX) NMC SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $1647.00 | 1639499627 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC MARIETTA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $2353.00 | 1336142413 - TEXAN AMBULATORY SURGERY CENTER, LP | 331058382 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $787.00 | 1174859516 - HERMITAGE TN ENDOSCOPY ASC, LLC, ASSOCIATED ENDOSCOPY | 270986942 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $940.00 | 1720262405 - BATON ROUGE LA ENDOSCOPY ASC LLC, LOUISIANA ENDOSCOPY CENTER | 261168310 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $1100.00 | 1932155470 - SUSQUEHANNA SURGERY CENTER INC | 233046101 - (PA) SUSQUEHANNA SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $1370.00 | 1639135346 - SURGERY CENTERS OF DES MOINES LTD | 363562598 | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $1559.00 | 1548791593 - BRIDGEWATER AMBULATORY SURGERY CENTER, LLC | 820860675 - (NJ) BRIDGEWATER AMBULATORY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $2388.00 | 1912933680 - SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC | 562422009 - (PA) SOUTHWESTERN AMBULATORY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19112 | $949.00 | 1639176183 - BERKS CENTER FOR DIGESTIVE HEALTH, LP | 233068912 | PA | 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 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 |
|---|---|---|
| 19083-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 Ultrasound Guidance |
| 19101-CPT | Moderate | Biopsy Of Breast Incisional |
| 19105-CPT | High | Ablation Cryosurgical Of Fibroadenoma Including Ultrasound Guidance Each Fibroadenoma |
| 19112-CPT | Moderate | Exc Lactiferous Duct Fistula |
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.
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