Medicare Reimbursement for CPT 19282

CPT 19282 is a physician procedure code (descriptor not shown here due to AMA licensing restrictions). This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code nationally and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$164.67	$41.42
ALASKA* (AK)	$188.24	$56.97
ALABAMA (AL)	$147.35	$39.51
ARKANSAS (AR)	$145.14	$39.27
ARIZONA (AZ)	$160.27	$40.85
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$219.24	$45.46
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$223.79	$46.06
OXNARD-THOUSAND OAKS-VENTURA (CA)	$188.10	$42.42
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$188.77	$42.96
NAPA (CA)	$206.52	$44.08
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$219.33	$45.55
VALLEJO (CA)	$206.39	$43.95
BAKERSFIELD (CA)	$176.65	$41.57
CHICO (CA)	$176.39	$41.31
FRESNO (CA)	$176.39	$41.31
HANFORD-CORCORAN (CA)	$176.39	$41.31
MADERA (CA)	$176.39	$41.31
MERCED (CA)	$176.39	$41.31
MODESTO (CA)	$176.39	$41.31
REDDING (CA)	$176.39	$41.31
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$177.27	$42.19
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$185.67	$42.34
SALINAS (CA)	$184.99	$42.15
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$224.16	$46.44
SANTA CRUZ-WATSONVILLE (CA)	$191.91	$42.16
SANTA ROSA-PETALUMA (CA)	$193.88	$42.53
STOCKTON (CA)	$176.39	$41.31
VISALIA (CA)	$176.39	$41.31
YUBA CITY (CA)	$176.39	$41.31
EL CENTRO (CA)	$176.41	$41.32
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$189.76	$42.35
SAN LUIS OBISPO-PASO ROBLES (CA)	$181.95	$41.57
SANTA MARIA-SANTA BARBARA (CA)	$185.80	$42.09
REST OF CALIFORNIA (CA)	$176.39	$41.31
COLORADO (CO)	$172.75	$41.61
CONNECTICUT (CT)	$175.84	$43.10
DC + MD/VA SUBURBS (DC)	$189.74	$44.56
DELAWARE (DE)	$163.01	$41.24
FORT LAUDERDALE (FL)	$168.51	$43.65
MIAMI (FL)	$174.05	$45.75
REST OF FLORIDA (FL)	$160.32	$42.50
ATLANTA (GA)	$167.37	$42.15
REST OF GEORGIA (GA)	$151.22	$41.28
HAWAII, GUAM (HI)	$181.25	$41.12
IOWA (IA)	$152.07	$39.29
IDAHO (ID)	$152.92	$39.53
EAST ST. LOUIS (IL)	$157.03	$43.65
SUBURBAN CHICAGO (IL)	$170.45	$43.87
CHICAGO (IL)	$169.00	$45.14
REST OF ILLINOIS (IL)	$154.93	$42.40
INDIANA (IN)	$153.86	$39.60
KANSAS (KS)	$150.93	$39.51
KENTUCKY (KY)	$150.09	$40.52
NEW ORLEANS (LA)	$157.40	$41.43
REST OF LOUISIANA (LA)	$149.69	$40.61
METROPOLITAN BOSTON (MA)	$190.79	$43.63
REST OF MASSACHUSETTS (MA)	$171.50	$41.72
BALTIMORE/SURR. CNTYS (MD)	$175.26	$43.01
REST OF MARYLAND (MD)	$166.33	$41.60
SOUTHERN MAINE (ME)	$162.52	$40.38
REST OF MAINE (ME)	$153.32	$39.93
DETROIT (MI)	$161.98	$43.04
REST OF MICHIGAN (MI)	$153.77	$41.24
MINNESOTA (MN)	$166.53	$39.71
METROPOLITAN ST. LOUIS (MO)	$158.47	$41.13
METROPOLITAN KANSAS CITY (MO)	$156.72	$40.99
REST OF MISSOURI (MO)	$146.76	$40.52
MISSISSIPPI (MS)	$146.00	$39.88
MONTANA** (MT)	$164.66	$41.41
NORTH CAROLINA (NC)	$155.04	$40.05
NORTH DAKOTA** (ND)	$163.08	$39.83
NEBRASKA (NE)	$153.05	$39.29
NEW HAMPSHIRE (NH)	$169.63	$41.33
NORTHERN NJ (NJ)	$187.59	$44.62
REST OF NEW JERSEY (NJ)	$178.13	$43.54
NEW MEXICO (NM)	$154.47	$41.46
NEVADA** (NV)	$164.35	$40.98
MANHATTAN (NY)	$189.27	$46.05
NYC SUBURBS/LONG ISLAND (NY)	$193.48	$46.94
POUGHKPSIE/N NYC SUBURBS (NY)	$178.98	$44.02
QUEENS (NY)	$191.47	$45.79
REST OF NEW YORK (NY)	$157.41	$40.32
OHIO (OH)	$153.44	$40.92
OKLAHOMA (OK)	$150.24	$40.18
PORTLAND (OR)	$178.85	$41.92
REST OF OREGON (OR)	$163.36	$40.60
METROPOLITAN PHILADELPHIA (PA)	$171.07	$42.77
REST OF PENNSYLVANIA (PA)	$153.92	$40.78
PUERTO RICO (PR)	$166.05	$41.44
RHODE ISLAND (RI)	$169.27	$41.95
SOUTH CAROLINA (SC)	$154.44	$40.56
SOUTH DAKOTA** (SD)	$162.89	$39.64
TENNESSEE (TN)	$151.67	$39.63
BRAZORIA (TX)	$163.18	$41.04
DALLAS (TX)	$164.06	$41.31
GALVESTON (TX)	$163.56	$41.18
HOUSTON (TX)	$165.03	$42.64
BEAUMONT (TX)	$152.84	$40.69
FORT WORTH (TX)	$162.81	$41.28
AUSTIN (TX)	$171.92	$41.53
REST OF TEXAS (TX)	$157.81	$40.85
UTAH (UT)	$156.64	$40.78
VIRGINIA (VA)	$161.68	$40.53
VIRGIN ISLANDS (VI)	$166.05	$41.44
VERMONT (VT)	$162.05	$40.04
SEATTLE (KING CNTY) (WA)	$195.16	$43.93
REST OF WASHINGTON (WA)	$171.30	$41.52
WISCONSIN (WI)	$157.39	$39.32
WEST VIRGINIA (WV)	$148.88	$41.78
WYOMING** (WY)	$163.97	$40.72

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units per patient per day — Date of Service Edit: Clinical. 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 — assigned to the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor (a dollar figure set by CMS each year) to produce the allowed amount. Non-facility (e.g., office) and facility (e.g., hospital) settings use different practice-expense RVUs because overhead costs differ, which is why the two amounts shown differ.

RVUs — work 0.98, practice expense 3.87 (non-facility) / 0.18 (facility), malpractice 0.08 — × 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 their annual deductible; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates can shift amounts from one year to the next.
Always confirm actual payment with your Medicare Administrative Contractor (MAC), as local policies and claim-specific factors apply.

Frequently asked

Why is the facility amount lower than the non-facility amount for this code?

In a facility setting, Medicare assumes the hospital or facility is absorbing certain overhead and equipment costs, so the practice-expense RVU used in the calculation is lower than in a non-facility (e.g., office) setting.

Does this amount reflect what the practice will actually be paid?

No. It reflects the Medicare-allowed amount before the patient's deductible and coinsurance are applied, and before any modifier-driven or claim-specific adjustments.

Why might this amount differ from what we see on an actual remittance?

Locality-specific GPCIs, applied modifiers, secondary payer coordination, sequestration, and timing of annual fee schedule updates can all cause the paid amount to differ from a general estimate.

Can I use this figure to bill the patient directly?

No. This figure is an informational estimate of the Medicare allowed amount and should not be used as a basis for patient billing without verifying actual coverage and payment details with your MAC.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

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.