Medicare Reimbursement for CPT 19307

CPT 19307 is a procedure code defined by the American Medical Association; the specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjusted for your locality, and compares non-facility (e.g., office) versus facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1126.61	$1126.61
ALASKA* (AK)	$1376.92	$1376.92
ALABAMA (AL)	$1012.26	$1012.26
ARKANSAS (AR)	$998.32	$998.32
ARIZONA (AZ)	$1092.75	$1092.75
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1254.94	$1254.94
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1271.96	$1271.96
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1156.85	$1156.85
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1171.06	$1171.06
NAPA (CA)	$1212.92	$1212.92
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1260.09	$1260.09
VALLEJO (CA)	$1205.51	$1205.51
BAKERSFIELD (CA)	$1115.97	$1115.97
CHICO (CA)	$1103.75	$1103.75
FRESNO (CA)	$1103.75	$1103.75
HANFORD-CORCORAN (CA)	$1103.75	$1103.75
MADERA (CA)	$1103.75	$1103.75
MERCED (CA)	$1103.75	$1103.75
MODESTO (CA)	$1103.75	$1103.75
REDDING (CA)	$1103.75	$1103.75
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1152.30	$1152.30
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1140.98	$1140.98
SALINAS (CA)	$1136.49	$1136.49
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1292.99	$1292.99
SANTA CRUZ-WATSONVILLE (CA)	$1152.44	$1152.44
SANTA ROSA-PETALUMA (CA)	$1162.78	$1162.78
STOCKTON (CA)	$1103.75	$1103.75
VISALIA (CA)	$1103.75	$1103.75
YUBA CITY (CA)	$1103.75	$1103.75
EL CENTRO (CA)	$1104.51	$1104.51
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1151.22	$1151.22
SAN LUIS OBISPO-PASO ROBLES (CA)	$1120.50	$1120.50
SANTA MARIA-SANTA BARBARA (CA)	$1137.46	$1137.46
REST OF CALIFORNIA (CA)	$1103.75	$1103.75
COLORADO (CO)	$1125.43	$1125.43
CONNECTICUT (CT)	$1200.09	$1200.09
DC + MD/VA SUBURBS (DC)	$1244.67	$1244.67
DELAWARE (DE)	$1109.59	$1109.59
FORT LAUDERDALE (FL)	$1253.93	$1253.93
MIAMI (FL)	$1373.93	$1373.93
REST OF FLORIDA (FL)	$1185.58	$1185.58
ATLANTA (GA)	$1165.01	$1165.01
REST OF GEORGIA (GA)	$1113.60	$1113.60
HAWAII, GUAM (HI)	$1116.27	$1116.27
IOWA (IA)	$1002.27	$1002.27
IDAHO (ID)	$1015.72	$1015.72
EAST ST. LOUIS (IL)	$1248.88	$1248.88
SUBURBAN CHICAGO (IL)	$1258.04	$1258.04
CHICAGO (IL)	$1328.60	$1328.60
REST OF ILLINOIS (IL)	$1177.92	$1177.92
INDIANA (IN)	$1020.41	$1020.41
KANSAS (KS)	$1014.18	$1014.18
KENTUCKY (KY)	$1070.52	$1070.52
NEW ORLEANS (LA)	$1124.21	$1124.21
REST OF LOUISIANA (LA)	$1075.47	$1075.47
METROPOLITAN BOSTON (MA)	$1209.54	$1209.54
REST OF MASSACHUSETTS (MA)	$1125.91	$1125.91
BALTIMORE/SURR. CNTYS (MD)	$1200.28	$1200.28
REST OF MARYLAND (MD)	$1124.74	$1124.74
SOUTHERN MAINE (ME)	$1067.28	$1067.28
REST OF MAINE (ME)	$1038.26	$1038.26
DETROIT (MI)	$1216.78	$1216.78
REST OF MICHIGAN (MI)	$1112.25	$1112.25
MINNESOTA (MN)	$1031.39	$1031.39
METROPOLITAN ST. LOUIS (MO)	$1108.22	$1108.22
METROPOLITAN KANSAS CITY (MO)	$1099.38	$1099.38
REST OF MISSOURI (MO)	$1068.93	$1068.93
MISSISSIPPI (MS)	$1032.99	$1032.99
MONTANA** (MT)	$1126.31	$1126.31
NORTH CAROLINA (NC)	$1045.90	$1045.90
NORTH DAKOTA** (ND)	$1036.74	$1036.74
NEBRASKA (NE)	$1002.51	$1002.51
NEW HAMPSHIRE (NH)	$1123.67	$1123.67
NORTHERN NJ (NJ)	$1236.12	$1236.12
REST OF NEW JERSEY (NJ)	$1200.55	$1200.55
NEW MEXICO (NM)	$1124.70	$1124.70
NEVADA** (NV)	$1101.73	$1101.73
MANHATTAN (NY)	$1315.86	$1315.86
NYC SUBURBS/LONG ISLAND (NY)	$1367.38	$1367.38
POUGHKPSIE/N NYC SUBURBS (NY)	$1221.75	$1221.75
QUEENS (NY)	$1301.86	$1301.86
REST OF NEW YORK (NY)	$1062.20	$1062.20
OHIO (OH)	$1093.94	$1093.94
OKLAHOMA (OK)	$1051.20	$1051.20
PORTLAND (OR)	$1140.48	$1140.48
REST OF OREGON (OR)	$1080.12	$1080.12
METROPOLITAN PHILADELPHIA (PA)	$1182.33	$1182.33
REST OF PENNSYLVANIA (PA)	$1086.36	$1086.36
PUERTO RICO (PR)	$1128.63	$1128.63
RHODE ISLAND (RI)	$1134.25	$1134.25
SOUTH CAROLINA (SC)	$1074.32	$1074.32
SOUTH DAKOTA** (SD)	$1026.15	$1026.15
TENNESSEE (TN)	$1021.12	$1021.12
BRAZORIA (TX)	$1094.51	$1094.51
DALLAS (TX)	$1108.84	$1108.84
GALVESTON (TX)	$1102.55	$1102.55
HOUSTON (TX)	$1185.46	$1185.46
BEAUMONT (TX)	$1080.82	$1080.82
FORT WORTH (TX)	$1106.91	$1106.91
AUSTIN (TX)	$1133.12	$1133.12
REST OF TEXAS (TX)	$1092.07	$1092.07
UTAH (UT)	$1087.81	$1087.81
VIRGINIA (VA)	$1075.51	$1075.51
VIRGIN ISLANDS (VI)	$1128.63	$1128.63
VERMONT (VT)	$1047.97	$1047.97
SEATTLE (KING CNTY) (WA)	$1216.62	$1216.62
REST OF WASHINGTON (WA)	$1118.71	$1118.71
WISCONSIN (WI)	$1005.55	$1005.55
WEST VIRGINIA (WV)	$1140.81	$1140.81
WYOMING** (WY)	$1087.27	$1087.27

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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 each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the provider's locality to reflect regional cost differences, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Practice expense RVUs typically differ between non-facility and facility settings because facility settings assume the hospital or facility absorbs certain overhead costs, which can result in a lower facility-based PE RVU and allowed amount compared to non-facility.

RVUs — work 17.54, practice expense 11.66 (non-facility) / 11.66 (facility), malpractice 4.53 — × 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 insurer is responsible for the remainder.
Actual payment can vary based on modifiers, place of service, sequestration reductions, and annual budget-neutrality adjustments.
Rates differ by locality due to GPCI adjustments — the amount shown may not match your specific Medicare Administrative Contractor (MAC) locality.
Always verify current rates and coverage policy with your MAC before billing or appealing a denial.

Frequently asked

Why is the facility amount different from the non-facility amount?

Facility and non-facility rates differ because the practice expense RVU component changes based on site of service — non-facility settings (like a physician's office) generally include more overhead costs in the RVU than facility settings (like a hospital), where the facility bills separately for overhead.

Why might the amount I was paid differ from the amount shown here?

Actual payments can be affected by your specific locality GPCIs, applied modifiers, secondary payer coordination, sequestration cuts, and whether the deductible has been met. This page shows a national estimate and locality-adjusted estimate, not a final remittance amount.

Does Medicare pay the full allowed amount shown?

No. Medicare Part B typically pays 80% of the PFS allowed amount after the annual deductible is met; the beneficiary or a supplemental payer is generally responsible for the remaining 20% coinsurance.

Will this amount change next year?

Yes. The Medicare conversion factor, RVUs, and GPCIs are updated annually (and sometimes mid-year), which can increase or decrease the allowed amount from one year to the next.

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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.