Medicare Reimbursement for CPT Code 19283

CPT code 19283 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) 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)	$250.17	$84.17
ALASKA* (AK)	$291.16	$114.37
ALABAMA (AL)	$224.88	$79.62
ARKANSAS (AR)	$221.67	$79.07
ARIZONA (AZ)	$243.64	$82.79
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$325.32	$91.25
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$331.80	$92.42
OXNARD-THOUSAND OAKS-VENTURA (CA)	$281.75	$85.54
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$283.07	$86.68
NAPA (CA)	$307.44	$88.65
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$325.56	$91.49
VALLEJO (CA)	$307.09	$88.30
BAKERSFIELD (CA)	$265.76	$83.82
CHICO (CA)	$265.12	$83.18
FRESNO (CA)	$265.12	$83.18
HANFORD-CORCORAN (CA)	$265.12	$83.18
MADERA (CA)	$265.12	$83.18
MERCED (CA)	$265.12	$83.18
MODESTO (CA)	$265.12	$83.18
REDDING (CA)	$265.12	$83.18
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$267.40	$85.47
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$278.28	$85.22
SALINAS (CA)	$277.24	$84.85
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$332.77	$93.39
SANTA CRUZ-WATSONVILLE (CA)	$286.56	$84.87
SANTA ROSA-PETALUMA (CA)	$289.46	$85.61
STOCKTON (CA)	$265.12	$83.18
VISALIA (CA)	$265.12	$83.18
YUBA CITY (CA)	$265.12	$83.18
EL CENTRO (CA)	$265.15	$83.21
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$283.81	$85.27
SAN LUIS OBISPO-PASO ROBLES (CA)	$272.77	$83.69
SANTA MARIA-SANTA BARBARA (CA)	$278.29	$84.74
REST OF CALIFORNIA (CA)	$265.12	$83.18
COLORADO (CO)	$260.81	$84.19
CONNECTICUT (CT)	$266.66	$87.87
DC + MD/VA SUBURBS (DC)	$286.17	$90.62
DELAWARE (DE)	$247.65	$83.64
FORT LAUDERDALE (FL)	$258.15	$89.99
MIAMI (FL)	$268.20	$95.39
REST OF FLORIDA (FL)	$245.87	$87.17
ATLANTA (GA)	$254.63	$85.97
REST OF GEORGIA (GA)	$232.29	$84.22
HAWAII, GUAM (HI)	$271.61	$82.86
IOWA (IA)	$230.81	$78.92
IDAHO (ID)	$232.23	$79.51
EAST ST. LOUIS (IL)	$243.04	$90.32
SUBURBAN CHICAGO (IL)	$260.85	$90.37
CHICAGO (IL)	$260.60	$93.77
REST OF ILLINOIS (IL)	$238.63	$87.07
INDIANA (IN)	$233.57	$79.69
KANSAS (KS)	$229.60	$79.54
KENTUCKY (KY)	$229.82	$82.24
NEW ORLEANS (LA)	$240.62	$84.41
REST OF LOUISIANA (LA)	$229.41	$82.49
METROPOLITAN BOSTON (MA)	$286.61	$88.40
REST OF MASSACHUSETTS (MA)	$259.23	$84.43
BALTIMORE/SURR. CNTYS (MD)	$265.87	$87.75
REST OF MARYLAND (MD)	$252.39	$84.39
SOUTHERN MAINE (ME)	$245.98	$81.47
REST OF MAINE (ME)	$233.28	$80.56
DETROIT (MI)	$248.75	$88.56
REST OF MICHIGAN (MI)	$235.59	$84.03
MINNESOTA (MN)	$250.40	$79.58
METROPOLITAN ST. LOUIS (MO)	$241.64	$83.61
METROPOLITAN KANSAS CITY (MO)	$239.15	$83.28
REST OF MISSOURI (MO)	$225.42	$82.33
MISSISSIPPI (MS)	$223.60	$80.67
MONTANA** (MT)	$250.16	$84.16
NORTH CAROLINA (NC)	$235.71	$80.83
NORTH DAKOTA** (ND)	$246.01	$80.00
NEBRASKA (NE)	$232.10	$78.88
NEW HAMPSHIRE (NH)	$256.60	$83.79
NORTHERN NJ (NJ)	$283.24	$90.67
REST OF NEW JERSEY (NJ)	$269.84	$88.56
NEW MEXICO (NM)	$236.81	$84.58
NEVADA** (NV)	$249.18	$83.01
MANHATTAN (NY)	$287.29	$94.40
NYC SUBURBS/LONG ISLAND (NY)	$294.00	$96.62
POUGHKPSIE/N NYC SUBURBS (NY)	$271.49	$89.72
QUEENS (NY)	$289.84	$93.63
REST OF NEW YORK (NY)	$239.19	$81.49
OHIO (OH)	$234.74	$83.18
OKLAHOMA (OK)	$229.56	$81.32
PORTLAND (OR)	$269.18	$84.75
REST OF OREGON (OR)	$247.38	$82.04
METROPOLITAN PHILADELPHIA (PA)	$260.00	$87.19
REST OF PENNSYLVANIA (PA)	$235.19	$82.80
PUERTO RICO (PR)	$252.03	$84.20
RHODE ISLAND (RI)	$256.53	$85.05
SOUTH CAROLINA (SC)	$235.59	$82.20
SOUTH DAKOTA** (SD)	$245.52	$79.51
TENNESSEE (TN)	$230.72	$79.83
BRAZORIA (TX)	$247.55	$83.04
DALLAS (TX)	$249.05	$83.71
GALVESTON (TX)	$248.24	$83.40
HOUSTON (TX)	$252.08	$87.24
BEAUMONT (TX)	$233.65	$82.59
FORT WORTH (TX)	$247.36	$83.68
AUSTIN (TX)	$259.83	$84.20
REST OF TEXAS (TX)	$240.41	$82.88
UTAH (UT)	$238.78	$82.73
VIRGINIA (VA)	$245.08	$81.90
VIRGIN ISLANDS (VI)	$252.03	$84.20
VERMONT (VT)	$244.93	$80.59
SEATTLE (KING CNTY) (WA)	$292.56	$88.87
REST OF WASHINGTON (WA)	$258.78	$83.98
WISCONSIN (WI)	$237.84	$78.81
WEST VIRGINIA (WV)	$229.87	$85.62
WYOMING** (WY)	$248.35	$82.35

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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) assigned to the code: physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital outpatient) settings use different practice-expense RVUs, which is why the two allowed amounts differ — non-facility rates typically include more overhead since the practice bears those costs directly.

RVUs — work 1.95, practice expense 5.33 (non-facility) / 0.36 (facility), malpractice 0.21 — × 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 deductible; the patient or secondary payer is responsible for the rest.
Actual payment can vary by locality, applicable modifiers, claim-level adjustments, sequestration, and annual budget-neutrality adjustments to RVUs or the conversion factor.
Always verify current rates and coverage policy 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 billing physician/practice) incurs most of the overhead costs, such as equipment and supplies, when the service is performed there.

Does this amount apply in every state or region?

No. The national amount shown is a baseline; actual payment is adjusted by locality-specific GPCI values, so the real allowed amount can be higher or lower depending on where the service is billed.

Will modifiers change this amount?

Yes. Modifiers such as bilateral, multiple procedure, or assistant-at-surgery modifiers can increase or decrease the allowed amount from the base rate shown here.

Is this the amount the patient will owe?

Not directly. Medicare generally pays 80% of the allowed amount after the deductible is met; the patient's actual out-of-pocket cost depends on their deductible status, secondary coverage, and any applicable coinsurance.

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.