Medicare Reimbursement for CPT 19120

CPT 19120 is a procedure code defined by the American Medical Association; the specific clinical description is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for 2026, both at the national level and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$573.16	$407.82
ALASKA* (AK)	$669.36	$493.27
ALABAMA (AL)	$510.64	$365.97
ARKANSAS (AR)	$502.86	$360.84
ARIZONA (AZ)	$555.89	$395.68
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$699.74	$466.62
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$711.90	$473.49
OXNARD-THOUSAND OAKS-VENTURA (CA)	$620.72	$425.30
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$625.55	$429.95
NAPA (CA)	$667.05	$449.14
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$701.39	$468.27
VALLEJO (CA)	$664.68	$446.77
BAKERSFIELD (CA)	$589.76	$408.55
CHICO (CA)	$585.84	$404.63
FRESNO (CA)	$585.84	$404.63
HANFORD-CORCORAN (CA)	$585.84	$404.63
MADERA (CA)	$585.84	$404.63
MERCED (CA)	$585.84	$404.63
MODESTO (CA)	$585.84	$404.63
REDDING (CA)	$585.84	$404.63
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$601.38	$420.17
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$611.74	$419.46
SALINAS (CA)	$609.45	$417.83
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$718.63	$480.22
SANTA CRUZ-WATSONVILLE (CA)	$626.12	$425.23
SANTA ROSA-PETALUMA (CA)	$632.17	$429.14
STOCKTON (CA)	$585.84	$404.63
VISALIA (CA)	$585.84	$404.63
YUBA CITY (CA)	$585.84	$404.63
EL CENTRO (CA)	$586.08	$404.87
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$621.83	$424.09
SAN LUIS OBISPO-PASO ROBLES (CA)	$600.11	$411.80
SANTA MARIA-SANTA BARBARA (CA)	$611.20	$418.42
REST OF CALIFORNIA (CA)	$585.84	$404.63
COLORADO (CO)	$586.11	$410.20
CONNECTICUT (CT)	$612.75	$434.68
DC + MD/VA SUBURBS (DC)	$648.14	$453.37
DELAWARE (DE)	$565.25	$401.90
FORT LAUDERDALE (FL)	$616.61	$449.12
MIAMI (FL)	$660.82	$488.71
REST OF FLORIDA (FL)	$582.91	$424.85
ATLANTA (GA)	$588.78	$420.80
REST OF GEORGIA (GA)	$546.60	$399.12
HAWAII, GUAM (HI)	$598.25	$410.27
IOWA (IA)	$515.73	$364.45
IDAHO (ID)	$521.08	$368.97
EAST ST. LOUIS (IL)	$595.71	$443.60
SUBURBAN CHICAGO (IL)	$620.86	$451.06
CHICAGO (IL)	$638.89	$472.73
REST OF ILLINOIS (IL)	$571.54	$420.59
INDIANA (IN)	$524.03	$370.76
KANSAS (KS)	$517.27	$367.80
KENTUCKY (KY)	$532.19	$385.21
NEW ORLEANS (LA)	$560.16	$404.58
REST OF LOUISIANA (LA)	$532.94	$386.62
METROPOLITAN BOSTON (MA)	$640.14	$442.73
REST OF MASSACHUSETTS (MA)	$584.01	$409.91
BALTIMORE/SURR. CNTYS (MD)	$611.96	$434.55
REST OF MARYLAND (MD)	$575.10	$407.78
SOUTHERN MAINE (ME)	$552.30	$388.45
REST OF MAINE (ME)	$528.29	$376.18
DETROIT (MI)	$594.76	$435.22
REST OF MICHIGAN (MI)	$550.52	$399.57
MINNESOTA (MN)	$548.69	$378.56
METROPOLITAN ST. LOUIS (MO)	$557.32	$399.92
METROPOLITAN KANSAS CITY (MO)	$551.79	$396.54
REST OF MISSOURI (MO)	$526.08	$383.57
MISSISSIPPI (MS)	$514.37	$372.02
MONTANA** (MT)	$573.06	$407.73
NORTH CAROLINA (NC)	$533.43	$379.17
NORTH DAKOTA** (ND)	$544.39	$379.06
NEBRASKA (NE)	$517.47	$364.87
NEW HAMPSHIRE (NH)	$580.72	$408.60
NORTHERN NJ (NJ)	$641.72	$449.93
REST OF NEW JERSEY (NJ)	$616.11	$435.57
NEW MEXICO (NM)	$555.34	$403.73
NEVADA** (NV)	$565.40	$399.90
MANHATTAN (NY)	$667.66	$475.54
NYC SUBURBS/LONG ISLAND (NY)	$689.75	$493.17
POUGHKPSIE/N NYC SUBURBS (NY)	$623.54	$442.50
QUEENS (NY)	$667.33	$471.90
REST OF NEW YORK (NY)	$542.18	$385.11
OHIO (OH)	$544.66	$393.71
OKLAHOMA (OK)	$526.83	$379.19
PORTLAND (OR)	$600.70	$417.01
REST OF OREGON (OR)	$557.45	$392.77
METROPOLITAN PHILADELPHIA (PA)	$599.59	$427.47
REST OF PENNSYLVANIA (PA)	$543.27	$391.49
PUERTO RICO (PR)	$576.09	$408.93
RHODE ISLAND (RI)	$582.55	$411.76
SOUTH CAROLINA (SC)	$540.66	$387.89
SOUTH DAKOTA** (SD)	$541.00	$375.67
TENNESSEE (TN)	$520.52	$370.23
BRAZORIA (TX)	$561.06	$397.21
DALLAS (TX)	$566.69	$402.02
GALVESTON (TX)	$564.05	$399.87
HOUSTON (TX)	$590.59	$426.41
BEAUMONT (TX)	$539.84	$389.39
FORT WORTH (TX)	$564.00	$400.98
AUSTIN (TX)	$587.28	$412.36
REST OF TEXAS (TX)	$551.53	$394.63
UTAH (UT)	$548.30	$392.88
VIRGINIA (VA)	$553.28	$390.75
VIRGIN ISLANDS (VI)	$576.09	$408.93
VERMONT (VT)	$545.91	$382.23
SEATTLE (KING CNTY) (WA)	$649.30	$446.43
REST OF WASHINGTON (WA)	$581.69	$407.59
WISCONSIN (WI)	$525.70	$367.31
WEST VIRGINIA (WV)	$550.54	$406.87
WYOMING** (WY)	$560.57	$395.23

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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's PFS amount is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Non-facility rates (e.g., office settings) typically include higher practice-expense RVUs than facility rates (e.g., hospital outpatient), since facility overhead is billed separately by the facility.

RVUs — work 5.77, practice expense 9.94 (non-facility) / 4.99 (facility), malpractice 1.45 — × 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 annual Part B deductible is met; the patient or secondary insurer is responsible for the rest.
Actual payment varies by locality GPCI values, applicable modifiers, sequestration, and annual budget-neutrality adjustments.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the allowed amount differ between non-facility and facility settings?

The practice-expense RVU component differs because non-facility settings (like a physician's office) bear the full overhead cost, while in facility settings the facility bills separately for overhead, resulting in a lower physician-side practice-expense RVU.

Does this amount reflect what the patient will actually owe?

No. The figures shown are the Medicare-allowed amount before the standard 80/20 split, deductible status, secondary insurance, and any applicable modifiers or adjustments are applied.

Why might my locality's payment differ from the national figure?

Local GPCI values adjust the work, practice-expense, and malpractice RVUs to reflect regional cost-of-living and practice-cost differences, so the same code can pay differently across Medicare localities.

Why isn't the CPT code description shown here?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so this page references the code generically rather than reproducing the official descriptor.

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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.