CPT 19281 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 |
National average reimbursement for CPT 19281 by major payers:
$285.34
$317.22
$325.97
$416.83
| 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 19281 | ||||||
United | 19281 | $1276.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $1276.00 | 1538609011 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY - SOUTHSIDE | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $477.00 | 1558511881 - ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION, OPHTHALMOLOGY MEDICAL CENTER | 953875237 - (CA) ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $985.00 | 1366065674 - SOUTH DENVER SURGICAL SERVICES LLC, SOUTH DENVER UROLOGY CENTER | 850873977 - (CO) SOUTH DENVER SURGICAL SERVICES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $840.00 | 1568918746 - ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY, LLC | 812594417 - (FL) ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $600.00 | 1184784209 - AMERICAN SURGICAL CENTERS II, LLC, AMERICAN SURGICAL CENTERS | 383486345 - (MI) AMERICAN SURGICAL CENTERS II LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $580.00 | 1457826125 - CENTRAL OREGON SURGICAL INSTITUTE, LLC | 830651822 - (OR) CENTRAL OREGON SURGICAL INSTITUTE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $767.00 | 1336103001 - PERKINS PLAZA AMBULATORY SURGERY CENTER LLC, LAKE SURGERY CENTER | 481264699 - (LA) LAKE ASC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $789.00 | 1750668190 - ELKHART DAY SURGERY, LLC, INSIGHT SURGERY CENTER | 800712220 - (IN) ELKHART DAY SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $780.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $788.00 | 1073713004 - ADVANCED EYE SURGERY CENTER | 205045500 - (CA) ADVANCED EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $2701.00 | 1528339447 - CP SURGERY CENTER, LLC | 800776412 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $480.00 | 1801993217 - EYE PHYSICIANS OF SUSSEX COUNTY, EYE PHYSICIANS OF SUSSEX COUNTY SURGICAL SUITE | 222172159 - (NJ) EYE PHYSICIANS OF SUSSEX COUNTY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $461.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $578.00 | 1093764045 - GASTROENTEROLOGY OF INDIANAPOLIS PC, DIGESTIVE HEALTH CENTER | 351641181 - (IN) GASTROENTEROLOGY OF INDIANAPOLIS, P . C. | IN | 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 19281 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19281 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 19281 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 |
|---|---|---|
| 19281-CPT | Moderate | Placement Of Breast Localization Device(S) (Eg, Clip, Metallic Pellet, Wire/Needle, Radioactive Seeds), Percutaneous; First Lesion, Including Mammographic Guidance |
| 19282-CPT | Moderate | Placement Of Breast Localization Device(S) (Eg, Clip, Metallic Pellet, Wire/Needle, Radioactive Seeds), Percutaneous; Each Additional Lesion, Including Mammographic Guidance (List Separately In Addition To Code For Primary Procedure) |
| 19283-CPT | Moderate | Placement Of Breast Localization Device(S) (Eg, Clip, Metallic Pellet, Wire/Needle, Radioactive Seeds), Percutaneous; First Lesion, Including Stereotactic Guidance |
| 19285-CPT | Moderate | Placement Of Breast Localization Device(S) (Eg, Clip, Metallic Pellet, Wire/Needle, Radioactive Seeds), Percutaneous; First Lesion, Including Ultrasound Guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19281. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19281 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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