CPT 19499 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | High |
| Medicare Fee Schedule | View Medicare rates for 19499 |
National average reimbursement for CPT 19499 by major payers:
$1,061.60
$275.15
$320.43
$1,432.92
| 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 19499 | ||||||
United | 19499 | $700.00 | 1710952882 - ADVANCED DERMATOLOGY AND SKIN SURGERY, PLLC | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1700.00 | 1790799047 - WATSONVILLE SURGEONS GROUP LLC, CENTRAL COAST SURGERY CENTER | 770549602 - (CA) WATSONVILLE SURGEON'S GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $2388.00 | 1790252864 - TREASURE COAST ASC, LLC, TREASURE COAST CENTER FOR SURGERY | 384092821 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1348.00 | 1922093293 - LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC | 352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLAN | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1138.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1115.00 | 1073505616 - THIBODAUX LASER AND SURGERY CENTER, LLC | 364463537 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1002.00 | 1316290380 - ATHENS SURGERY CENTER LLC, THE SURGERY CENTER OF ATHENS | 800812776 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $3086.00 | 1851369284 - FREMONT AMBULATORY SURGERY CENTER, LP | 943235450 - (CA) FREMONT AMBULATORY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1685.00 | 1508934373 - CENTERS FOR PAIN SOLUTIONS,LLC | 20522938 - (NH) CENTERS FOR PAIN SOLUTIONSLLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $7336.00 | 1497244149 - HOSPITAL FOR SPECIAL SURGERY WEST SIDE AMBULATORY SURGERY CENTER, LLC, HSS WEST SIDE ASC, LLC | 814351390 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $2353.00 | 1336142413 - TEXAN AMBULATORY SURGERY CENTER, LP | 331058382 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1658.00 | 1194716191 - AMBULATORY SURGICAL CENTER OF UNION COUNTY, LLC | 223740023 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1701.00 | 1376230722 - UCHEALTH AMBULATORY SURGERY CENTERS, UCHEALTH EASTVIEW SURGERY CENTER | 383984888 - (CO) UCHEALTH AMBULATORY SURGERY CENTERS | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $1275.00 | 1770603706 - BIRMINGHAM AMBULATORY SURGICAL CENTER, PLLC, TRUVISTA SURGERY CENTER | 202208179 - (MI) BIRMINGHAM AMBULATORY SURGICAL | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19499 | $989.00 | 1255342366 - MILLMAN-DERR CENTER FOR EYE CARE, P.C., MD SURGICENTER | 382184165 - (MI) MILLMAN-DERR CENTER FOR EYE CARE, P.C. | 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 19499 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19499 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 19499 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 |
|---|---|---|
| 11400-CPT | Low | Excision Benign Lesion Including Margins Except Skin Tag (Unless Listed Elsewhere) Trunk Arms Or Legs; Excised Diameter 0.5 Cm Or Less (Desc Rev 1/1/03) |
| 11970-CPT | Moderate | Replacement Of Tissue Expander With Permanent Implant (Desc Rvsd 1/1/21) |
| 13101-CPT | Moderate | Rep Complex Trunk 2.5-7.5cm |
| 19499-CPT | High | Surgery-Intergumentary System |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19499 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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