Medicare Reimbursement for CPT 19300

This page covers the Medicare Physician Fee Schedule (PFS) estimate for CPT code 19300, a procedure code whose official descriptor is maintained by the AMA and not reproduced here. It shows the national PFS allowed amount for both non-facility (e.g., office) and facility (e.g., hospital outpatient) settings, along with locality-specific adjustments.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$637.29	$425.86
ALASKA* (AK)	$733.20	$508.03
ALABAMA (AL)	$566.77	$381.77
ARKANSAS (AR)	$557.92	$376.31
ARIZONA (AZ)	$618.33	$413.46
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$804.27	$506.16
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$819.30	$514.42
OXNARD-THOUSAND OAKS-VENTURA (CA)	$704.04	$454.13
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$708.37	$458.25
NAPA (CA)	$763.09	$484.43
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$805.64	$507.53
VALLEJO (CA)	$761.11	$482.45
BAKERSFIELD (CA)	$665.46	$433.74
CHICO (CA)	$662.17	$430.44
FRESNO (CA)	$662.17	$430.44
HANFORD-CORCORAN (CA)	$662.17	$430.44
MADERA (CA)	$662.17	$430.44
MERCED (CA)	$662.17	$430.44
MODESTO (CA)	$662.17	$430.44
REDDING (CA)	$662.17	$430.44
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$675.15	$443.43
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$693.85	$447.96
SALINAS (CA)	$691.29	$446.25
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$824.91	$520.03
SANTA CRUZ-WATSONVILLE (CA)	$713.30	$456.41
SANTA ROSA-PETALUMA (CA)	$720.37	$460.73
STOCKTON (CA)	$662.17	$430.44
VISALIA (CA)	$662.17	$430.44
YUBA CITY (CA)	$662.17	$430.44
EL CENTRO (CA)	$662.37	$430.65
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$707.05	$454.18
SAN LUIS OBISPO-PASO ROBLES (CA)	$680.39	$439.58
SANTA MARIA-SANTA BARBARA (CA)	$693.74	$447.22
REST OF CALIFORNIA (CA)	$662.17	$430.44
COLORADO (CO)	$657.64	$432.68
CONNECTICUT (CT)	$681.87	$454.17
DC + MD/VA SUBURBS (DC)	$726.65	$477.58
DELAWARE (DE)	$628.99	$420.10
FORT LAUDERDALE (FL)	$675.45	$461.28
MIAMI (FL)	$716.46	$496.37
REST OF FLORIDA (FL)	$638.97	$436.84
ATLANTA (GA)	$652.71	$437.90
REST OF GEORGIA (GA)	$599.27	$410.68
HAWAII, GUAM (HI)	$678.34	$437.95
IOWA (IA)	$576.89	$383.43
IDAHO (ID)	$582.08	$387.57
EAST ST. LOUIS (IL)	$644.36	$449.85
SUBURBAN CHICAGO (IL)	$681.14	$464.01
CHICAGO (IL)	$692.96	$480.47
REST OF ILLINOIS (IL)	$623.17	$430.13
INDIANA (IN)	$585.57	$389.58
KANSAS (KS)	$576.55	$385.42
KENTUCKY (KY)	$586.81	$398.85
NEW ORLEANS (LA)	$617.78	$418.82
REST OF LOUISIANA (LA)	$586.85	$399.73
METROPOLITAN BOSTON (MA)	$722.17	$469.72
REST OF MASSACHUSETTS (MA)	$654.32	$431.68
BALTIMORE/SURR. CNTYS (MD)	$680.58	$453.72
REST OF MARYLAND (MD)	$640.79	$426.83
SOUTHERN MAINE (ME)	$618.56	$409.04
REST OF MAINE (ME)	$588.10	$393.59
DETROIT (MI)	$650.18	$446.15
REST OF MICHIGAN (MI)	$605.63	$412.59
MINNESOTA (MN)	$621.13	$403.57
METROPOLITAN ST. LOUIS (MO)	$617.02	$415.75
METROPOLITAN KANSAS CITY (MO)	$610.50	$411.97
REST OF MISSOURI (MO)	$577.75	$395.50
MISSISSIPPI (MS)	$567.82	$385.79
MONTANA** (MT)	$637.21	$425.78
NORTH CAROLINA (NC)	$594.30	$397.04
NORTH DAKOTA** (ND)	$613.28	$401.85
NEBRASKA (NE)	$579.51	$384.37
NEW HAMPSHIRE (NH)	$649.62	$429.52
NORTHERN NJ (NJ)	$718.75	$473.50
REST OF NEW JERSEY (NJ)	$687.12	$456.25
NEW MEXICO (NM)	$610.23	$416.35
NEVADA** (NV)	$630.96	$419.32
MANHATTAN (NY)	$740.71	$495.03
NYC SUBURBS/LONG ISLAND (NY)	$763.11	$511.72
POUGHKPSIE/N NYC SUBURBS (NY)	$693.83	$462.32
QUEENS (NY)	$743.37	$493.46
REST OF NEW YORK (NY)	$604.09	$403.24
OHIO (OH)	$600.74	$407.70
OKLAHOMA (OK)	$582.92	$394.12
PORTLAND (OR)	$676.76	$441.86
REST OF OREGON (OR)	$623.59	$413.01
METROPOLITAN PHILADELPHIA (PA)	$665.58	$445.49
REST OF PENNSYLVANIA (PA)	$600.31	$406.22
PUERTO RICO (PR)	$641.35	$427.59
RHODE ISLAND (RI)	$650.20	$431.79
SOUTH CAROLINA (SC)	$599.01	$403.65
SOUTH DAKOTA** (SD)	$610.45	$399.03
TENNESSEE (TN)	$580.01	$387.82
BRAZORIA (TX)	$625.97	$416.44
DALLAS (TX)	$631.41	$420.83
GALVESTON (TX)	$628.75	$418.81
HOUSTON (TX)	$650.90	$440.95
BEAUMONT (TX)	$596.27	$403.87
FORT WORTH (TX)	$627.70	$419.23
AUSTIN (TX)	$657.61	$433.92
REST OF TEXAS (TX)	$611.75	$411.11
UTAH (UT)	$607.74	$408.99
VIRGINIA (VA)	$618.20	$410.37
VIRGIN ISLANDS (VI)	$641.35	$427.59
VERMONT (VT)	$613.09	$403.77
SEATTLE (KING CNTY) (WA)	$734.76	$475.34
REST OF WASHINGTON (WA)	$652.34	$429.71
WISCONSIN (WI)	$591.52	$388.97
WEST VIRGINIA (WV)	$599.18	$415.45
WYOMING** (WY)	$626.78	$415.35

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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 payment for this code is based on three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for a given locality to reflect local cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Practice expense RVUs differ between non-facility and facility settings because facility settings (like hospitals) typically have the facility itself absorb a portion of the overhead costs, resulting in a lower PFS amount for the same code. These calculations update annually and are subject to any applicable modifiers.

RVUs — work 5.18, practice expense 12.69 (non-facility) / 6.36 (facility), malpractice 1.21 — × 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 annual deductible is met; the beneficiary or secondary insurer is responsible for the remainder.
Actual payment can vary by locality, modifiers appended to the claim, mandatory sequestration reductions, and annual budget-neutrality adjustments.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC).

Frequently asked

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

The facility rate uses lower practice expense RVUs because the facility (such as a hospital) bears a portion of the overhead costs, whereas in a non-facility setting the billing provider absorbs those costs directly.

Does this amount reflect what Medicare will actually pay?

No. It is a PFS-based estimate. Medicare generally pays 80% of the allowed amount after the deductible, and the final payment can be affected by modifiers, place of service, sequestration, and locality-specific adjustments.

Why do GPCIs matter for this code?

GPCIs adjust the work, practice expense, and malpractice RVUs to reflect the relative cost of providing services in a specific geographic locality, so the same code can have different allowed amounts in different areas.

Can I use this estimate for billing or appeals?

This figure is for reference and planning purposes only. For billing accuracy, claims submission, or denial appeals, consult your MAC's current fee schedule and official guidance.

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.