CPT 19285 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 19285 by major payers:
$467.04
$599.59
$575.48
$707.38
| 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 19285 | ||||||
United | 19285 | $848.00 | 1710268412 - AMIN JIMINIAN WILMOT | 350593390 - DEACONESS HOSPITAL INC | FL | Hospitalist Physician (208M00000X) |
United | 19285 | $300.00 | 1306043617 - UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19285 | $2285.00 | 1205018439 - LAKE POINTE OPERATING COMPANY, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER LAKE POINTE | 260194016 - (TX) LAKE POINTE OPERATING COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $1767.00 | 1114473329 - EMERUS BHS SA THOUSAND OAKS LLC, BAPTIST NEIGHBORHOOD HOSPITAL SHAVANO PARK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $658.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19285 | $2071.00 | 1659352987 - USMD HOSPITAL AT ARLINGTON, L.P. | 731662763 - (TX) USMD HOSPITAL AT ARLINGTON, LP | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $1086.00 | 1043218365 - HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. MARY, BAYOU BEND HEALTH SYSTEM | 726008504 - (LA) HOSPITAL SERVICE DISTRICT NO 1 OF THE PARISH OF ST MARY | LA | Critical Access Hospital (282NC0060X) |
United | 19285 | $2500.00 | 1992707228 - SHANNON MEDICAL CENTER | 752559845 - (TX) SHANNON MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $716.28 | 1679522932 - RICARDO RODRIGUEZ | 721460193 - (LA) BATON ROUGE ORTHOPAEDIC CLINIC, LLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 19285 | $766.00 | 1740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL | 752302928 | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $1767.00 | 1275235426 - EMERUS BHS SA THOUSAND OAKS LLC | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $2749.00 | 1942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $501.23 | 1942231865 - GEORGE WILLIAMS | 461116776 - (LA) OPELOUSAS GENERAL HEALTH SYSTEM PHYSICIAN PRACTICES | LA | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 19285 | $984.00 | 1184042822 - WOODLANDS SPECIALTY HOSPITAL | 462263738 - (TX) WOODLANDS SPECIALTY HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 19285 | $315.00 | 1235706888 - SOUTHERN SURGICAL CENTER, LLC | 844035828 - (LA) SOUTHERN SURGICAL CENTER LLC | LA | 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 19285 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19285 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 19285 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 19285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19285 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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