Medicare Reimbursement for CPT 19305

CPT 19305 is a surgical procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1096.55	$1096.55
ALASKA* (AK)	$1339.75	$1339.75
ALABAMA (AL)	$985.23	$985.23
ARKANSAS (AR)	$971.65	$971.65
ARIZONA (AZ)	$1063.61	$1063.61
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1222.63	$1222.63
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1239.26	$1239.26
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1126.61	$1126.61
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1140.39	$1140.39
NAPA (CA)	$1181.52	$1181.52
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1227.62	$1227.62
VALLEJO (CA)	$1174.34	$1174.34
BAKERSFIELD (CA)	$1086.64	$1086.64
CHICO (CA)	$1074.80	$1074.80
FRESNO (CA)	$1074.80	$1074.80
HANFORD-CORCORAN (CA)	$1074.80	$1074.80
MADERA (CA)	$1074.80	$1074.80
MERCED (CA)	$1074.80	$1074.80
MODESTO (CA)	$1074.80	$1074.80
REDDING (CA)	$1074.80	$1074.80
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1121.85	$1121.85
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1111.16	$1111.16
SALINAS (CA)	$1106.79	$1106.79
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1259.64	$1259.64
SANTA CRUZ-WATSONVILLE (CA)	$1122.46	$1122.46
SANTA ROSA-PETALUMA (CA)	$1132.54	$1132.54
STOCKTON (CA)	$1074.80	$1074.80
VISALIA (CA)	$1074.80	$1074.80
YUBA CITY (CA)	$1074.80	$1074.80
EL CENTRO (CA)	$1075.53	$1075.53
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1121.21	$1121.21
SAN LUIS OBISPO-PASO ROBLES (CA)	$1091.20	$1091.20
SANTA MARIA-SANTA BARBARA (CA)	$1107.75	$1107.75
REST OF CALIFORNIA (CA)	$1074.80	$1074.80
COLORADO (CO)	$1095.67	$1095.67
CONNECTICUT (CT)	$1168.08	$1168.08
DC + MD/VA SUBURBS (DC)	$1211.71	$1211.71
DELAWARE (DE)	$1080.01	$1080.01
FORT LAUDERDALE (FL)	$1219.99	$1219.99
MIAMI (FL)	$1336.39	$1336.39
REST OF FLORIDA (FL)	$1153.52	$1153.52
ATLANTA (GA)	$1133.83	$1133.83
REST OF GEORGIA (GA)	$1083.51	$1083.51
HAWAII, GUAM (HI)	$1087.08	$1087.08
IOWA (IA)	$975.71	$975.71
IDAHO (ID)	$988.76	$988.76
EAST ST. LOUIS (IL)	$1214.72	$1214.72
SUBURBAN CHICAGO (IL)	$1224.03	$1224.03
CHICAGO (IL)	$1292.32	$1292.32
REST OF ILLINOIS (IL)	$1145.92	$1145.92
INDIANA (IN)	$993.34	$993.34
KANSAS (KS)	$987.21	$987.21
KENTUCKY (KY)	$1041.75	$1041.75
NEW ORLEANS (LA)	$1093.99	$1093.99
REST OF LOUISIANA (LA)	$1046.53	$1046.53
METROPOLITAN BOSTON (MA)	$1177.73	$1177.73
REST OF MASSACHUSETTS (MA)	$1096.10	$1096.10
BALTIMORE/SURR. CNTYS (MD)	$1168.24	$1168.24
REST OF MARYLAND (MD)	$1094.79	$1094.79
SOUTHERN MAINE (ME)	$1039.01	$1039.01
REST OF MAINE (ME)	$1010.61	$1010.61
DETROIT (MI)	$1183.79	$1183.79
REST OF MICHIGAN (MI)	$1082.28	$1082.28
MINNESOTA (MN)	$1004.39	$1004.39
METROPOLITAN ST. LOUIS (MO)	$1078.54	$1078.54
METROPOLITAN KANSAS CITY (MO)	$1069.91	$1069.91
REST OF MISSOURI (MO)	$1040.10	$1040.10
MISSISSIPPI (MS)	$1005.26	$1005.26
MONTANA** (MT)	$1096.26	$1096.26
NORTH CAROLINA (NC)	$1018.06	$1018.06
NORTH DAKOTA** (ND)	$1009.45	$1009.45
NEBRASKA (NE)	$975.98	$975.98
NEW HAMPSHIRE (NH)	$1093.86	$1093.86
NORTHERN NJ (NJ)	$1203.37	$1203.37
REST OF NEW JERSEY (NJ)	$1168.61	$1168.61
NEW MEXICO (NM)	$1094.36	$1094.36
NEVADA** (NV)	$1072.45	$1072.45
MANHATTAN (NY)	$1280.65	$1280.65
NYC SUBURBS/LONG ISLAND (NY)	$1330.69	$1330.69
POUGHKPSIE/N NYC SUBURBS (NY)	$1189.16	$1189.16
QUEENS (NY)	$1267.17	$1267.17
REST OF NEW YORK (NY)	$1033.93	$1033.93
OHIO (OH)	$1064.54	$1064.54
OKLAHOMA (OK)	$1023.04	$1023.04
PORTLAND (OR)	$1110.45	$1110.45
REST OF OREGON (OR)	$1051.48	$1051.48
METROPOLITAN PHILADELPHIA (PA)	$1150.72	$1150.72
REST OF PENNSYLVANIA (PA)	$1057.21	$1057.21
PUERTO RICO (PR)	$1098.55	$1098.55
RHODE ISLAND (RI)	$1104.10	$1104.10
SOUTH CAROLINA (SC)	$1045.57	$1045.57
SOUTH DAKOTA** (SD)	$999.19	$999.19
TENNESSEE (TN)	$993.95	$993.95
BRAZORIA (TX)	$1065.41	$1065.41
DALLAS (TX)	$1079.32	$1079.32
GALVESTON (TX)	$1073.21	$1073.21
HOUSTON (TX)	$1153.56	$1153.56
BEAUMONT (TX)	$1051.81	$1051.81
FORT WORTH (TX)	$1077.41	$1077.41
AUSTIN (TX)	$1103.10	$1103.10
REST OF TEXAS (TX)	$1062.88	$1062.88
UTAH (UT)	$1058.71	$1058.71
VIRGINIA (VA)	$1046.96	$1046.96
VIRGIN ISLANDS (VI)	$1098.55	$1098.55
VERMONT (VT)	$1020.30	$1020.30
SEATTLE (KING CNTY) (WA)	$1184.73	$1184.73
REST OF WASHINGTON (WA)	$1089.11	$1089.11
WISCONSIN (WI)	$979.06	$979.06
WEST VIRGINIA (WV)	$1109.78	$1109.78
WYOMING** (WY)	$1058.43	$1058.43

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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 — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed. These locality-adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Because practice-expense RVUs differ depending on where the service is furnished, the non-facility (e.g., physician office) and facility (e.g., hospital) amounts can differ; for this code they happen to use the same practice-expense RVU, so the national rates shown are equal. Actual locality-specific results will vary based on each area's GPCI values.

RVUs — work 17.02, practice expense 11.42 (non-facility) / 11.42 (facility), malpractice 4.39 — × 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 the annual Part B deductible; the patient or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Always verify the current rate and any applicable edits with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why are the non-facility and facility amounts the same for this code?

Both settings use the same practice-expense RVU for this code, so the locality-adjusted totals come out equal. For many other codes, these amounts differ because facility settings typically have lower practice-expense RVUs.

Does this amount reflect what Medicare will actually pay?

No. It's an estimated allowed amount based on national RVUs and the conversion factor. Medicare generally pays 80% of the allowed amount after the deductible, and the final payment can be affected by locality adjustments, modifiers, and other factors.

Why isn't the CPT code description shown?

CPT code descriptors are copyrighted by the American Medical Association (AMA) and cannot be republished here. Refer to your CPT codebook or EHR for the official descriptor.

How do I find the amount for my specific locality?

Use the locality-specific figures on this page, which apply the GPCI adjustments for that area to the RVUs and conversion factor shown.

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.