Medicare Reimbursement for CPT 19306

CPT 19306 is a surgical procedure code defined by the American Medical Association; the descriptor itself is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code nationally and, where available, by locality, comparing non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1177.05	$1177.05
ALASKA* (AK)	$1429.23	$1429.23
ALABAMA (AL)	$1054.91	$1054.91
ARKANSAS (AR)	$1040.00	$1040.00
ARIZONA (AZ)	$1141.01	$1141.01
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1318.00	$1318.00
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1336.15	$1336.15
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1212.01	$1212.01
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1226.60	$1226.60
NAPA (CA)	$1272.80	$1272.80
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1323.38	$1323.38
VALLEJO (CA)	$1265.05	$1265.05
BAKERSFIELD (CA)	$1167.63	$1167.63
CHICO (CA)	$1154.92	$1154.92
FRESNO (CA)	$1154.92	$1154.92
HANFORD-CORCORAN (CA)	$1154.92	$1154.92
MADERA (CA)	$1154.92	$1154.92
MERCED (CA)	$1154.92	$1154.92
MODESTO (CA)	$1154.92	$1154.92
REDDING (CA)	$1154.92	$1154.92
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1205.59	$1205.59
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1194.85	$1194.85
SALINAS (CA)	$1190.19	$1190.19
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1358.11	$1358.11
SANTA CRUZ-WATSONVILLE (CA)	$1208.28	$1208.28
SANTA ROSA-PETALUMA (CA)	$1219.16	$1219.16
STOCKTON (CA)	$1154.92	$1154.92
VISALIA (CA)	$1154.92	$1154.92
YUBA CITY (CA)	$1154.92	$1154.92
EL CENTRO (CA)	$1155.71	$1155.71
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1206.40	$1206.40
SAN LUIS OBISPO-PASO ROBLES (CA)	$1173.35	$1173.35
SANTA MARIA-SANTA BARBARA (CA)	$1191.41	$1191.41
REST OF CALIFORNIA (CA)	$1154.92	$1154.92
COLORADO (CO)	$1176.96	$1176.96
CONNECTICUT (CT)	$1255.03	$1255.03
DC + MD/VA SUBURBS (DC)	$1303.07	$1303.07
DELAWARE (DE)	$1158.90	$1158.90
FORT LAUDERDALE (FL)	$1310.27	$1310.27
MIAMI (FL)	$1436.18	$1436.18
REST OF FLORIDA (FL)	$1237.66	$1237.66
ATLANTA (GA)	$1217.43	$1217.43
REST OF GEORGIA (GA)	$1161.10	$1161.10
HAWAII, GUAM (HI)	$1169.24	$1169.24
IOWA (IA)	$1045.36	$1045.36
IDAHO (ID)	$1059.51	$1059.51
EAST ST. LOUIS (IL)	$1302.96	$1302.96
SUBURBAN CHICAGO (IL)	$1314.72	$1314.72
CHICAGO (IL)	$1387.92	$1387.92
REST OF ILLINOIS (IL)	$1228.71	$1228.71
INDIANA (IN)	$1064.56	$1064.56
KANSAS (KS)	$1057.55	$1057.55
KENTUCKY (KY)	$1116.05	$1116.05
NEW ORLEANS (LA)	$1173.25	$1173.25
REST OF LOUISIANA (LA)	$1121.13	$1121.13
METROPOLITAN BOSTON (MA)	$1267.02	$1267.02
REST OF MASSACHUSETTS (MA)	$1177.14	$1177.14
BALTIMORE/SURR. CNTYS (MD)	$1255.22	$1255.22
REST OF MARYLAND (MD)	$1175.14	$1175.14
SOUTHERN MAINE (ME)	$1114.89	$1114.89
REST OF MAINE (ME)	$1083.05	$1083.05
DETROIT (MI)	$1270.43	$1270.43
REST OF MICHIGAN (MI)	$1160.15	$1160.15
MINNESOTA (MN)	$1078.25	$1078.25
METROPOLITAN ST. LOUIS (MO)	$1156.79	$1156.79
METROPOLITAN KANSAS CITY (MO)	$1147.27	$1147.27
REST OF MISSOURI (MO)	$1113.80	$1113.80
MISSISSIPPI (MS)	$1076.25	$1076.25
MONTANA** (MT)	$1176.73	$1176.73
NORTH CAROLINA (NC)	$1091.30	$1091.30
NORTH DAKOTA** (ND)	$1083.20	$1083.20
NEBRASKA (NE)	$1045.78	$1045.78
NEW HAMPSHIRE (NH)	$1174.87	$1174.87
NORTHERN NJ (NJ)	$1293.56	$1293.56
REST OF NEW JERSEY (NJ)	$1255.42	$1255.42
NEW MEXICO (NM)	$1173.23	$1173.23
NEVADA** (NV)	$1151.09	$1151.09
MANHATTAN (NY)	$1376.84	$1376.84
NYC SUBURBS/LONG ISLAND (NY)	$1431.23	$1431.23
POUGHKPSIE/N NYC SUBURBS (NY)	$1277.51	$1277.51
QUEENS (NY)	$1362.66	$1362.66
REST OF NEW YORK (NY)	$1108.70	$1108.70
OHIO (OH)	$1141.03	$1141.03
OKLAHOMA (OK)	$1095.96	$1095.96
PORTLAND (OR)	$1193.62	$1193.62
REST OF OREGON (OR)	$1128.41	$1128.41
METROPOLITAN PHILADELPHIA (PA)	$1235.74	$1235.74
REST OF PENNSYLVANIA (PA)	$1133.22	$1133.22
PUERTO RICO (PR)	$1179.39	$1179.39
RHODE ISLAND (RI)	$1185.35	$1185.35
SOUTH CAROLINA (SC)	$1120.78	$1120.78
SOUTH DAKOTA** (SD)	$1072.14	$1072.14
TENNESSEE (TN)	$1064.90	$1064.90
BRAZORIA (TX)	$1143.16	$1143.16
DALLAS (TX)	$1158.21	$1158.21
GALVESTON (TX)	$1151.60	$1151.60
HOUSTON (TX)	$1238.18	$1238.18
BEAUMONT (TX)	$1127.26	$1127.26
FORT WORTH (TX)	$1155.98	$1155.98
AUSTIN (TX)	$1185.07	$1185.07
REST OF TEXAS (TX)	$1139.87	$1139.87
UTAH (UT)	$1135.22	$1135.22
VIRGINIA (VA)	$1123.31	$1123.31
VIRGIN ISLANDS (VI)	$1179.39	$1179.39
VERMONT (VT)	$1094.72	$1094.72
SEATTLE (KING CNTY) (WA)	$1274.94	$1274.94
REST OF WASHINGTON (WA)	$1169.68	$1169.68
WISCONSIN (WI)	$1049.72	$1049.72
WEST VIRGINIA (WV)	$1189.00	$1189.00
WYOMING** (WY)	$1135.97	$1135.97

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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 furnished. The geographically adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice-expense RVUs typically differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which is why the same code can show two different allowed amounts depending on place of service. For this code, work, practice-expense, and malpractice RVUs are identical across settings in the data shown, but locality GPCIs will still change the final dollar figure from one area to another.

RVUs — work 17.68, practice expense 12.83 (non-facility) / 12.83 (facility), malpractice 4.73 — × 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 Part B deductible is met; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, and sequestration can change the actual paid amount.
Annual budget-neutrality adjustments and conversion factor updates mean amounts can change year to year.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the allowed amount differ by locality?

Medicare adjusts the work, practice-expense, and malpractice RVUs using locality-specific GPCIs to reflect regional differences in costs, then applies the national conversion factor.

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

When the practice-expense RVU is identical in both settings, as shown here, the total RVUs and resulting allowed amount will match regardless of place of service.

Does this amount include what the patient owes?

No. The figure shown is the total Medicare-allowed amount; Medicare generally pays 80% after the deductible, with the patient or secondary insurance covering the rest.

Can billed charges differ from the Medicare allowed amount?

Yes. Providers may bill more than the Medicare allowed amount, but for participating providers, Medicare's allowed amount is generally the maximum reimbursable under the fee schedule, subject to applicable rules.

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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.