Medicare Reimbursement for CPT 19298

This page covers Medicare Physician Fee Schedule (PFS) estimates for this procedure code (CPT descriptors are proprietary to the AMA and are not reproduced here). It shows the national PFS allowed amount as well as how the amount can vary by locality, and it distinguishes between non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$851.39	$263.53
ALASKA* (AK)	$980.69	$354.62
ALABAMA (AL)	$763.85	$249.47
ARKANSAS (AR)	$752.71	$247.74
ARIZONA (AZ)	$829.14	$259.51
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1126.96	$298.08
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1150.14	$302.45
OXNARD-THOUSAND OAKS-VENTURA (CA)	$969.27	$274.42
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$972.96	$277.52
NAPA (CA)	$1062.44	$287.65
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1127.46	$298.58
VALLEJO (CA)	$1061.72	$286.93
BAKERSFIELD (CA)	$911.54	$267.25
CHICO (CA)	$910.09	$265.80
FRESNO (CA)	$910.09	$265.80
HANFORD-CORCORAN (CA)	$910.09	$265.80
MADERA (CA)	$910.09	$265.80
MERCED (CA)	$910.09	$265.80
MODESTO (CA)	$910.09	$265.80
REDDING (CA)	$910.09	$265.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$914.94	$270.65
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$957.15	$273.48
SALINAS (CA)	$953.62	$272.29
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1152.18	$304.49
SANTA CRUZ-WATSONVILLE (CA)	$988.11	$273.86
SANTA ROSA-PETALUMA (CA)	$998.23	$276.35
STOCKTON (CA)	$910.09	$265.80
VISALIA (CA)	$910.09	$265.80
YUBA CITY (CA)	$910.09	$265.80
EL CENTRO (CA)	$910.16	$265.87
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$977.54	$274.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$938.01	$268.44
SANTA MARIA-SANTA BARBARA (CA)	$957.60	$272.16
REST OF CALIFORNIA (CA)	$910.09	$265.80
COLORADO (CO)	$891.98	$266.50
CONNECTICUT (CT)	$908.22	$275.10
DC + MD/VA SUBURBS (DC)	$978.75	$286.25
DELAWARE (DE)	$843.05	$262.25
FORT LAUDERDALE (FL)	$871.70	$276.21
MIAMI (FL)	$900.48	$288.52
REST OF FLORIDA (FL)	$830.21	$268.22
ATLANTA (GA)	$865.29	$268.03
REST OF GEORGIA (GA)	$784.08	$259.72
HAWAII, GUAM (HI)	$934.16	$265.77
IOWA (IA)	$787.34	$249.45
IDAHO (ID)	$791.70	$250.87
EAST ST. LOUIS (IL)	$814.35	$273.52
SUBURBAN CHICAGO (IL)	$881.58	$277.85
CHICAGO (IL)	$874.98	$284.18
REST OF ILLINOIS (IL)	$803.17	$266.46
INDIANA (IN)	$796.44	$251.49
KANSAS (KS)	$781.77	$250.34
KENTUCKY (KY)	$778.07	$255.46
NEW ORLEANS (LA)	$815.08	$261.91
REST OF LOUISIANA (LA)	$776.10	$255.85
METROPOLITAN BOSTON (MA)	$983.42	$281.52
REST OF MASSACHUSETTS (MA)	$885.82	$266.81
BALTIMORE/SURR. CNTYS (MD)	$905.27	$274.50
REST OF MARYLAND (MD)	$859.85	$264.94
SOUTHERN MAINE (ME)	$840.12	$257.56
REST OF MAINE (ME)	$793.89	$253.06
DETROIT (MI)	$838.74	$271.46
REST OF MICHIGAN (MI)	$796.79	$260.08
MINNESOTA (MN)	$859.87	$254.97
METROPOLITAN ST. LOUIS (MO)	$820.25	$260.61
METROPOLITAN KANSAS CITY (MO)	$811.44	$259.45
REST OF MISSOURI (MO)	$761.40	$254.67
MISSISSIPPI (MS)	$757.30	$251.15
MONTANA** (MT)	$851.36	$263.50
NORTH CAROLINA (NC)	$802.58	$254.11
NORTH DAKOTA** (ND)	$842.66	$254.80
NEBRASKA (NE)	$792.25	$249.66
NEW HAMPSHIRE (NH)	$876.17	$264.22
NORTHERN NJ (NJ)	$968.08	$286.17
REST OF NEW JERSEY (NJ)	$920.05	$278.11
NEW MEXICO (NM)	$800.45	$261.39
NEVADA** (NV)	$849.58	$261.14
MANHATTAN (NY)	$977.18	$294.09
NYC SUBURBS/LONG ISLAND (NY)	$998.70	$299.74
POUGHKPSIE/N NYC SUBURBS (NY)	$924.59	$280.89
QUEENS (NY)	$988.05	$293.21
REST OF NEW YORK (NY)	$814.56	$256.10
OHIO (OH)	$795.02	$258.30
OKLAHOMA (OK)	$778.64	$253.68
PORTLAND (OR)	$922.70	$269.59
REST OF OREGON (OR)	$844.43	$258.92
METROPOLITAN PHILADELPHIA (PA)	$884.22	$272.26
REST OF PENNSYLVANIA (PA)	$797.34	$257.69
PUERTO RICO (PR)	$858.31	$263.99
RHODE ISLAND (RI)	$874.79	$267.53
SOUTH CAROLINA (SC)	$799.84	$256.66
SOUTH DAKOTA** (SD)	$841.63	$253.77
TENNESSEE (TN)	$785.50	$251.14
BRAZORIA (TX)	$843.81	$261.25
DALLAS (TX)	$848.39	$262.89
GALVESTON (TX)	$845.81	$262.07
HOUSTON (TX)	$853.87	$270.13
BEAUMONT (TX)	$791.91	$256.96
FORT WORTH (TX)	$842.09	$262.46
AUSTIN (TX)	$887.75	$265.80
REST OF TEXAS (TX)	$816.85	$258.97
UTAH (UT)	$810.93	$258.35
VIRGINIA (VA)	$836.03	$258.17
VIRGIN ISLANDS (VI)	$858.31	$263.99
VERMONT (VT)	$837.64	$255.66
SEATTLE (KING CNTY) (WA)	$1005.46	$284.16
REST OF WASHINGTON (WA)	$884.73	$265.71
WISCONSIN (WI)	$813.95	$250.78
WEST VIRGINIA (WV)	$772.66	$261.82
WYOMING** (WY)	$847.57	$259.71

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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 — assigned to the code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings use different practice-expense RVUs because overhead costs differ when the service is performed in a physician office versus a hospital or ambulatory surgical center, which is why the two allowed amounts differ.

RVUs — work 5.61, practice expense 19.44 (non-facility) / 1.84 (facility), malpractice 0.44 — × 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 payer is responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates mean amounts change each year.
Always verify the current allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The practice-expense RVU is lower in the facility setting because the facility (not the billing physician) absorbs certain overhead costs like equipment and supplies, so the physician-side payment is reduced accordingly.

Does this amount apply to every state the same way?

No. The underlying RVUs are adjusted by locality-specific GPCIs, so the final allowed amount can vary from the national figure depending on where the service was rendered.

Will Medicare pay the full listed amount?

No. Medicare generally reimburses 80% of the allowed amount after the patient's deductible is met; the remaining 20% is typically billed to the patient or a secondary payer.

Why might my remittance advice show a different amount than this estimate?

Differences can result from modifiers, multiple-procedure payment reductions, sequestration, incorrect place-of-service coding, or mid-year/annual fee schedule updates.

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.