Medicare Reimbursement for CPT 19030

CPT 19030 is a procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare allowed amount for this code, nationally and adjusted by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$159.32	$64.13
ALASKA* (AK)	$188.75	$87.37
ALABAMA (AL)	$144.08	$60.79
ARKANSAS (AR)	$142.15	$60.38
ARIZONA (AZ)	$155.36	$63.12
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$204.03	$69.81
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$207.98	$70.72
OXNARD-THOUSAND OAKS-VENTURA (CA)	$177.85	$65.34
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$178.81	$66.20
NAPA (CA)	$193.24	$67.77
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$204.20	$69.98
VALLEJO (CA)	$192.99	$67.53
BAKERSFIELD (CA)	$168.35	$64.01
CHICO (CA)	$167.88	$63.55
FRESNO (CA)	$167.88	$63.55
HANFORD-CORCORAN (CA)	$167.88	$63.55
MADERA (CA)	$167.88	$63.55
MERCED (CA)	$167.88	$63.55
MODESTO (CA)	$167.88	$63.55
REDDING (CA)	$167.88	$63.55
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$169.52	$65.19
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$175.83	$65.12
SALINAS (CA)	$175.16	$64.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$208.68	$71.41
SANTA CRUZ-WATSONVILLE (CA)	$180.52	$64.86
SANTA ROSA-PETALUMA (CA)	$182.33	$65.43
STOCKTON (CA)	$167.88	$63.55
VISALIA (CA)	$167.88	$63.55
YUBA CITY (CA)	$167.88	$63.55
EL CENTRO (CA)	$167.90	$63.57
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$179.01	$65.16
SAN LUIS OBISPO-PASO ROBLES (CA)	$172.38	$63.95
SANTA MARIA-SANTA BARBARA (CA)	$175.75	$64.75
REST OF CALIFORNIA (CA)	$167.88	$63.55
COLORADO (CO)	$165.51	$64.23
CONNECTICUT (CT)	$169.42	$66.90
DC + MD/VA SUBURBS (DC)	$181.18	$69.05
DELAWARE (DE)	$157.81	$63.76
FORT LAUDERDALE (FL)	$164.73	$68.30
MIAMI (FL)	$171.27	$72.17
REST OF FLORIDA (FL)	$157.24	$66.24
ATLANTA (GA)	$162.15	$65.44
REST OF GEORGIA (GA)	$148.99	$64.08
HAWAII, GUAM (HI)	$171.54	$63.30
IOWA (IA)	$147.41	$60.31
IDAHO (ID)	$148.32	$60.74
EAST ST. LOUIS (IL)	$156.04	$68.46
SUBURBAN CHICAGO (IL)	$166.36	$68.60
CHICAGO (IL)	$166.68	$71.01
REST OF ILLINOIS (IL)	$153.05	$66.14
INDIANA (IN)	$149.12	$60.87
KANSAS (KS)	$146.80	$60.75
KENTUCKY (KY)	$147.29	$62.67
NEW ORLEANS (LA)	$153.84	$64.26
REST OF LOUISIANA (LA)	$147.09	$62.84
METROPOLITAN BOSTON (MA)	$181.09	$67.43
REST OF MASSACHUSETTS (MA)	$164.64	$64.40
BALTIMORE/SURR. CNTYS (MD)	$168.94	$66.80
REST OF MARYLAND (MD)	$160.66	$64.33
SOUTHERN MAINE (ME)	$156.53	$62.20
REST OF MAINE (ME)	$149.06	$61.49
DETROIT (MI)	$159.10	$67.24
REST OF MICHIGAN (MI)	$150.87	$63.96
MINNESOTA (MN)	$158.83	$60.87
METROPOLITAN ST. LOUIS (MO)	$154.31	$63.69
METROPOLITAN KANSAS CITY (MO)	$152.83	$63.44
REST OF MISSOURI (MO)	$144.76	$62.71
MISSISSIPPI (MS)	$143.48	$61.52
MONTANA** (MT)	$159.31	$64.12
NORTH CAROLINA (NC)	$150.51	$61.69
NORTH DAKOTA** (ND)	$156.35	$61.15
NEBRASKA (NE)	$148.16	$60.29
NEW HAMPSHIRE (NH)	$162.98	$63.89
NORTHERN NJ (NJ)	$179.53	$69.10
REST OF NEW JERSEY (NJ)	$171.42	$67.47
NEW MEXICO (NM)	$151.65	$64.36
NEVADA** (NV)	$158.59	$63.30
MANHATTAN (NY)	$182.38	$71.77
NYC SUBURBS/LONG ISLAND (NY)	$186.56	$73.38
POUGHKPSIE/N NYC SUBURBS (NY)	$172.55	$68.31
QUEENS (NY)	$183.75	$71.23
REST OF NEW YORK (NY)	$152.61	$62.17
OHIO (OH)	$150.27	$63.36
OKLAHOMA (OK)	$147.02	$62.01
PORTLAND (OR)	$170.44	$64.68
REST OF OREGON (OR)	$157.42	$62.60
METROPOLITAN PHILADELPHIA (PA)	$165.47	$66.38
REST OF PENNSYLVANIA (PA)	$150.47	$63.09
PUERTO RICO (PR)	$160.40	$64.16
RHODE ISLAND (RI)	$163.18	$64.84
SOUTH CAROLINA (SC)	$150.63	$62.67
SOUTH DAKOTA** (SD)	$156.00	$60.80
TENNESSEE (TN)	$147.49	$60.96
BRAZORIA (TX)	$157.68	$63.34
DALLAS (TX)	$158.64	$63.83
GALVESTON (TX)	$158.13	$63.60
HOUSTON (TX)	$160.87	$66.35
BEAUMONT (TX)	$149.56	$62.93
FORT WORTH (TX)	$157.66	$63.80
AUSTIN (TX)	$164.91	$64.20
REST OF TEXAS (TX)	$153.50	$63.17
UTAH (UT)	$152.54	$63.06
VIRGINIA (VA)	$156.07	$62.50
VIRGIN ISLANDS (VI)	$160.40	$64.16
VERMONT (VT)	$155.80	$61.56
SEATTLE (KING CNTY) (WA)	$184.63	$67.82
REST OF WASHINGTON (WA)	$164.31	$64.07
WISCONSIN (WI)	$151.46	$60.27
WEST VIRGINIA (WV)	$147.79	$65.06
WYOMING** (WY)	$158.02	$62.83

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit per patient per day — Date of Service Edit: Policy. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare PFS amounts are built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is billed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility and facility settings because overhead costs (equipment, supplies, staff time) are assumed to be lower when the service is performed in a facility that bills separately for those costs. This is why the same code can show two different allowed amounts depending on place of service.

RVUs — work 1.49, practice expense 3.13 (non-facility) / 0.28 (facility), malpractice 0.15 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the patient meets the annual Part B deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Locality-specific GPCIs mean the amount can vary significantly from the national figure shown here.
Always confirm current rates and edits with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the facility amount lower than the non-facility amount?

The facility rate uses a lower practice-expense RVU because the facility (not the physician's office) is assumed to bear most of the overhead costs, such as equipment and supplies, and bills for those separately.

Does this figure reflect what the patient will actually owe?

No. This reflects the Medicare-allowed amount before the standard 80/20 split and deductible are applied, and before any secondary insurance or modifier adjustments.

Why might my local Medicare payment differ from the national rate shown?

Payments are adjusted by Geographic Practice Cost Indices (GPCIs) that reflect local differences in wages, rent, and malpractice costs, so localities with higher costs typically see higher allowed amounts than the national average.

Will this amount change next year?

Yes. CMS updates the conversion factor and may revise RVUs annually, and budget-neutrality adjustments can shift amounts even when RVUs stay the same.

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.