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 |
| Medicare Fee Schedule | View Medicare rates for 19281 |
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 | $550.00 | 1386177376 - EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC | 820817194 - (AR) EXECUTIVE SURGERY CENTER OF LITTLE ROCK LLC | AR | 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 | $1528.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $1913.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $947.00 | 1104341353 - BANNER PEORIA SURGERY CENTER LLC | 901182685 - (AZ) BANNER PEORIA SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $1258.00 | 1770929044 - SURGCENTER OF PALM BEACH GARDENS, SURGCENTER OF PALM BEACH GARDENS, LLC | 462315994 - (FL) SURGCENTER OF PALM BEACH GARDENS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $424.00 | 1538153887 - KANSAS ENDOSCOPY LLC | 200282684 - (KS) KANSAS ENDOSCOPY LLC | KS | 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 | $686.00 | 1487629986 - SAN LUIS OBISPO CA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF THE CENTRAL COAST | 201965605 - (CA) SAN LUIS OBISPO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $1022.00 | 1497724942 - PARK VENTURA ENDOSCOPY CENTER, LLC, DIGESTIVE HEALTH CENTER OF PLANO | 412059014 - (TX) PARK VENTURA ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $875.00 | 1952776098 - BAYTOWN ASC, LP, BAYTOWN HEART & VASCULAR SURGERY CENTER | 474501044 - (TX) BAYTOWN ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $461.00 | 1669954707 - CARDIOVASCULAR SURGICAL SUITES LLC | 831614285 - (FL) CARDIOVASCULAR SURGICAL SUITES L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $1664.00 | 1073505038 - PALMETTO SURGERY CENTER LLC | 582333248 - (SC) PALMETTO SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19281 | $939.00 | 1679728901 - ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | 263777820 - (NJ) ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | NJ | 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 | 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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