Medicare Reimbursement for CPT 19302
This page covers the Medicare Physician Fee Schedule (PFS) allowed amount for this procedure code. It shows the national average along with locality-adjusted estimates, broken out by non-facility and facility settings, since practice expense inputs can differ between them.
Medicare allowed amount (2026)
| Locality | Non-facility | Facility |
|---|---|---|
| National (unadjusted) | $867.42 | $867.42 |
| ALASKA* (AK) | $1061.72 | $1061.72 |
| ALABAMA (AL) | $779.72 | $779.72 |
| ARKANSAS (AR) | $769.02 | $769.02 |
| ARIZONA (AZ) | $841.41 | $841.41 |
| SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA) | $964.08 | $964.08 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA) | $977.05 | $977.05 |
| OXNARD-THOUSAND OAKS-VENTURA (CA) | $889.60 | $889.60 |
| LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA) | $900.62 | $900.62 |
| NAPA (CA) | $932.12 | $932.12 |
| SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA) | $968.06 | $968.06 |
| VALLEJO (CA) | $926.38 | $926.38 |
| BAKERSFIELD (CA) | $858.52 | $858.52 |
| CHICO (CA) | $849.05 | $849.05 |
| FRESNO (CA) | $849.05 | $849.05 |
| HANFORD-CORCORAN (CA) | $849.05 | $849.05 |
| MADERA (CA) | $849.05 | $849.05 |
| MERCED (CA) | $849.05 | $849.05 |
| MODESTO (CA) | $849.05 | $849.05 |
| REDDING (CA) | $849.05 | $849.05 |
| RIVERSIDE-SAN BERNARDINO-ONTARIO (CA) | $886.67 | $886.67 |
| SACRAMENTO-ROSEVILLE-FOLSOM (CA) | $877.44 | $877.44 |
| SALINAS (CA) | $873.99 | $873.99 |
| SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA) | $993.35 | $993.35 |
| SANTA CRUZ-WATSONVILLE (CA) | $885.93 | $885.93 |
| SANTA ROSA-PETALUMA (CA) | $893.86 | $893.86 |
| STOCKTON (CA) | $849.05 | $849.05 |
| VISALIA (CA) | $849.05 | $849.05 |
| YUBA CITY (CA) | $849.05 | $849.05 |
| EL CENTRO (CA) | $849.64 | $849.64 |
| SAN DIEGO-CHULA VISTA-CARLSBAD (CA) | $885.14 | $885.14 |
| SAN LUIS OBISPO-PASO ROBLES (CA) | $861.72 | $861.72 |
| SANTA MARIA-SANTA BARBARA (CA) | $874.68 | $874.68 |
| REST OF CALIFORNIA (CA) | $849.05 | $849.05 |
| COLORADO (CO) | $866.07 | $866.07 |
| CONNECTICUT (CT) | $923.84 | $923.84 |
| DC + MD/VA SUBURBS (DC) | $957.71 | $957.71 |
| DELAWARE (DE) | $854.32 | $854.32 |
| FORT LAUDERDALE (FL) | $965.98 | $965.98 |
| MIAMI (FL) | $1058.76 | $1058.76 |
| REST OF FLORIDA (FL) | $913.43 | $913.43 |
| ATLANTA (GA) | $897.07 | $897.07 |
| REST OF GEORGIA (GA) | $858.11 | $858.11 |
| HAWAII, GUAM (HI) | $858.42 | $858.42 |
| IOWA (IA) | $771.69 | $771.69 |
| IDAHO (ID) | $782.07 | $782.07 |
| EAST ST. LOUIS (IL) | $962.73 | $962.73 |
| SUBURBAN CHICAGO (IL) | $969.07 | $969.07 |
| CHICAGO (IL) | $1023.91 | $1023.91 |
| REST OF ILLINOIS (IL) | $907.80 | $907.80 |
| INDIANA (IN) | $785.66 | $785.66 |
| KANSAS (KS) | $780.99 | $780.99 |
| KENTUCKY (KY) | $824.76 | $824.76 |
| NEW ORLEANS (LA) | $865.98 | $865.98 |
| REST OF LOUISIANA (LA) | $828.62 | $828.62 |
| METROPOLITAN BOSTON (MA) | $930.36 | $930.36 |
| REST OF MASSACHUSETTS (MA) | $866.53 | $866.53 |
| BALTIMORE/SURR. CNTYS (MD) | $924.00 | $924.00 |
| REST OF MARYLAND (MD) | $865.90 | $865.90 |
| SOUTHERN MAINE (ME) | $821.51 | $821.51 |
| REST OF MAINE (ME) | $799.54 | $799.54 |
| DETROIT (MI) | $937.54 | $937.54 |
| REST OF MICHIGAN (MI) | $856.92 | $856.92 |
| MINNESOTA (MN) | $793.43 | $793.43 |
| METROPOLITAN ST. LOUIS (MO) | $853.52 | $853.52 |
| METROPOLITAN KANSAS CITY (MO) | $846.75 | $846.75 |
| REST OF MISSOURI (MO) | $823.72 | $823.72 |
| MISSISSIPPI (MS) | $795.87 | $795.87 |
| MONTANA** (MT) | $867.19 | $867.19 |
| NORTH CAROLINA (NC) | $805.36 | $805.36 |
| NORTH DAKOTA** (ND) | $797.78 | $797.78 |
| NEBRASKA (NE) | $771.82 | $771.82 |
| NEW HAMPSHIRE (NH) | $864.85 | $864.85 |
| NORTHERN NJ (NJ) | $951.23 | $951.23 |
| REST OF NEW JERSEY (NJ) | $924.12 | $924.12 |
| NEW MEXICO (NM) | $866.53 | $866.53 |
| NEVADA** (NV) | $848.14 | $848.14 |
| MANHATTAN (NY) | $1013.00 | $1013.00 |
| NYC SUBURBS/LONG ISLAND (NY) | $1052.73 | $1052.73 |
| POUGHKPSIE/N NYC SUBURBS (NY) | $940.53 | $940.53 |
| QUEENS (NY) | $1002.01 | $1002.01 |
| REST OF NEW YORK (NY) | $817.87 | $817.87 |
| OHIO (OH) | $842.73 | $842.73 |
| OKLAHOMA (OK) | $809.76 | $809.76 |
| PORTLAND (OR) | $877.40 | $877.40 |
| REST OF OREGON (OR) | $831.42 | $831.42 |
| METROPOLITAN PHILADELPHIA (PA) | $910.33 | $910.33 |
| REST OF PENNSYLVANIA (PA) | $836.82 | $836.82 |
| PUERTO RICO (PR) | $868.90 | $868.90 |
| RHODE ISLAND (RI) | $873.14 | $873.14 |
| SOUTH CAROLINA (SC) | $827.45 | $827.45 |
| SOUTH DAKOTA** (SD) | $789.58 | $789.58 |
| TENNESSEE (TN) | $786.33 | $786.33 |
| BRAZORIA (TX) | $842.62 | $842.62 |
| DALLAS (TX) | $853.70 | $853.70 |
| GALVESTON (TX) | $848.84 | $848.84 |
| HOUSTON (TX) | $913.09 | $913.09 |
| BEAUMONT (TX) | $832.58 | $832.58 |
| FORT WORTH (TX) | $852.27 | $852.27 |
| AUSTIN (TX) | $872.05 | $872.05 |
| REST OF TEXAS (TX) | $841.02 | $841.02 |
| UTAH (UT) | $837.79 | $837.79 |
| VIRGINIA (VA) | $827.95 | $827.95 |
| VIRGIN ISLANDS (VI) | $868.90 | $868.90 |
| VERMONT (VT) | $806.56 | $806.56 |
| SEATTLE (KING CNTY) (WA) | $935.62 | $935.62 |
| REST OF WASHINGTON (WA) | $860.94 | $860.94 |
| WISCONSIN (WI) | $773.92 | $773.92 |
| WEST VIRGINIA (WV) | $879.36 | $879.36 |
| WYOMING** (WY) | $836.94 | $836.94 |
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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 the Geographic Practice Cost Index (GPCI) for the specific locality where the service is furnished, reflecting local cost-of-living and practice-cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Non-facility (e.g., office) and facility (e.g., hospital) settings can have different practice-expense RVUs, which is why the two settings may show different allowed amounts for the same code.
RVUs — work 13.64, practice expense 8.82 (non-facility) / 8.82 (facility), malpractice 3.51 — × 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 generally responsible for the remainder.
- Modifiers, place-of-service rules, multiple-procedure reductions, and sequestration can change the actual paid amount.
- Conversion factors and RVUs are updated annually and can change due to budget-neutrality adjustments.
- Always verify the current allowed amount with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.
Frequently asked
Why does the amount differ between non-facility and facility settings?
The practice-expense RVU component is calculated differently depending on where the service is performed, since overhead costs (e.g., supplies, staff time) vary between an office and a facility like a hospital.
Why does the amount change by locality?
Each Medicare locality has its own Geographic Practice Cost Index (GPCI) values, which adjust the work, practice-expense, and malpractice RVUs to reflect regional cost differences before the conversion factor is applied.
Is this the amount my practice will actually be paid?
No. This is an estimated PFS allowed amount. Actual reimbursement depends on the patient's deductible status, applicable modifiers, secondary payer coordination, sequestration, and MAC-specific adjustments.
Why might this estimate differ from what my MAC paid?
PFS amounts are recalculated annually and can also be affected by claim-specific factors such as bundling edits, multiple-procedure discounts, or incorrect locality assignment on the claim.
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.
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