Medicare Reimbursement for CPT 19328

CPT 19328 is a procedure code used for physician billing under Medicare Part B. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for your locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$513.37	$513.37
ALASKA* (AK)	$628.04	$628.04
ALABAMA (AL)	$465.02	$465.02
ARKANSAS (AR)	$459.04	$459.04
ARIZONA (AZ)	$499.68	$499.68
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$601.52	$601.52
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$611.02	$611.02
OXNARD-THOUSAND OAKS-VENTURA (CA)	$543.37	$543.37
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$548.66	$548.66
NAPA (CA)	$577.00	$577.00
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$603.11	$603.11
VALLEJO (CA)	$574.71	$574.71
BAKERSFIELD (CA)	$521.24	$521.24
CHICO (CA)	$517.34	$517.34
FRESNO (CA)	$517.34	$517.34
HANFORD-CORCORAN (CA)	$517.34	$517.34
MADERA (CA)	$517.34	$517.34
MERCED (CA)	$517.34	$517.34
MODESTO (CA)	$517.34	$517.34
REDDING (CA)	$517.34	$517.34
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$532.40	$532.40
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$536.98	$536.98
SALINAS (CA)	$534.87	$534.87
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$617.52	$617.52
SANTA CRUZ-WATSONVILLE (CA)	$545.02	$545.02
SANTA ROSA-PETALUMA (CA)	$550.11	$550.11
STOCKTON (CA)	$517.34	$517.34
VISALIA (CA)	$517.34	$517.34
YUBA CITY (CA)	$517.34	$517.34
EL CENTRO (CA)	$517.57	$517.57
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$543.21	$543.21
SAN LUIS OBISPO-PASO ROBLES (CA)	$526.99	$526.99
SANTA MARIA-SANTA BARBARA (CA)	$535.71	$535.71
REST OF CALIFORNIA (CA)	$517.34	$517.34
COLORADO (CO)	$520.40	$520.40
CONNECTICUT (CT)	$545.32	$545.32
DC + MD/VA SUBURBS (DC)	$571.69	$571.69
DELAWARE (DE)	$507.17	$507.17
FORT LAUDERDALE (FL)	$554.07	$554.07
MIAMI (FL)	$594.07	$594.07
REST OF FLORIDA (FL)	$527.02	$527.02
ATLANTA (GA)	$527.09	$527.09
REST OF GEORGIA (GA)	$498.11	$498.11
HAWAII, GUAM (HI)	$524.44	$524.44
IOWA (IA)	$466.10	$466.10
IDAHO (ID)	$470.77	$470.77
EAST ST. LOUIS (IL)	$542.83	$542.83
SUBURBAN CHICAGO (IL)	$557.23	$557.23
CHICAGO (IL)	$576.75	$576.75
REST OF ILLINOIS (IL)	$520.17	$520.17
INDIANA (IN)	$472.95	$472.95
KANSAS (KS)	$468.63	$468.63
KENTUCKY (KY)	$484.48	$484.48
NEW ORLEANS (LA)	$506.49	$506.49
REST OF LOUISIANA (LA)	$485.60	$485.60
METROPOLITAN BOSTON (MA)	$561.70	$561.70
REST OF MASSACHUSETTS (MA)	$519.65	$519.65
BALTIMORE/SURR. CNTYS (MD)	$544.71	$544.71
REST OF MARYLAND (MD)	$514.65	$514.65
SOUTHERN MAINE (ME)	$494.10	$494.10
REST OF MAINE (ME)	$477.74	$477.74
DETROIT (MI)	$537.59	$537.59
REST OF MICHIGAN (MI)	$499.88	$499.88
MINNESOTA (MN)	$486.96	$486.96
METROPOLITAN ST. LOUIS (MO)	$502.69	$502.69
METROPOLITAN KANSAS CITY (MO)	$498.60	$498.60
REST OF MISSOURI (MO)	$481.18	$481.18
MISSISSIPPI (MS)	$469.97	$469.97
MONTANA** (MT)	$513.28	$513.28
NORTH CAROLINA (NC)	$481.45	$481.45
NORTH DAKOTA** (ND)	$485.60	$485.60
NEBRASKA (NE)	$467.00	$467.00
NEW HAMPSHIRE (NH)	$516.73	$516.73
NORTHERN NJ (NJ)	$567.72	$567.72
REST OF NEW JERSEY (NJ)	$548.24	$548.24
NEW MEXICO (NM)	$504.14	$504.14
NEVADA** (NV)	$505.79	$505.79
MANHATTAN (NY)	$592.63	$592.63
NYC SUBURBS/LONG ISLAND (NY)	$611.37	$611.37
POUGHKPSIE/N NYC SUBURBS (NY)	$555.41	$555.41
QUEENS (NY)	$590.39	$590.39
REST OF NEW YORK (NY)	$488.26	$488.26
OHIO (OH)	$494.22	$494.22
OKLAHOMA (OK)	$478.93	$478.93
PORTLAND (OR)	$530.19	$530.19
REST OF OREGON (OR)	$498.59	$498.59
METROPOLITAN PHILADELPHIA (PA)	$535.96	$535.96
REST OF PENNSYLVANIA (PA)	$492.39	$492.39
PUERTO RICO (PR)	$515.14	$515.14
RHODE ISLAND (RI)	$520.33	$520.33
SOUTH CAROLINA (SC)	$489.30	$489.30
SOUTH DAKOTA** (SD)	$482.32	$482.32
TENNESSEE (TN)	$471.30	$471.30
BRAZORIA (TX)	$503.00	$503.00
DALLAS (TX)	$508.01	$508.01
GALVESTON (TX)	$505.69	$505.69
HOUSTON (TX)	$531.32	$531.32
BEAUMONT (TX)	$489.85	$489.85
FORT WORTH (TX)	$506.38	$506.38
AUSTIN (TX)	$521.54	$521.54
REST OF TEXAS (TX)	$497.39	$497.39
UTAH (UT)	$495.13	$495.13
VIRGINIA (VA)	$495.81	$495.81
VIRGIN ISLANDS (VI)	$515.14	$515.14
VERMONT (VT)	$488.03	$488.03
SEATTLE (KING CNTY) (WA)	$567.87	$567.87
REST OF WASHINGTON (WA)	$517.24	$517.24
WISCONSIN (WI)	$471.59	$471.59
WEST VIRGINIA (WV)	$504.12	$504.12
WYOMING** (WY)	$501.21	$501.21

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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 Physician Fee Schedule assigns each code three Relative Value Units (RVUs) — for physician work, practice expense, and malpractice risk. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, then the 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 and facility settings because overhead costs vary depending on where the service is performed. The resulting allowed amount represents the full Medicare-approved payment before cost-sharing is applied.

RVUs — work 7.25, practice expense 6.72 (non-facility) / 6.72 (facility), malpractice 1.4 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This amount is an estimate, 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 rest.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual payment.
Annual budget-neutrality adjustments and conversion factor updates may cause amounts to differ from prior years.
Always verify current rates and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why does the facility amount differ from the non-facility amount?

Practice expense RVUs are typically lower in facility settings because the facility, rather than the physician's practice, absorbs certain overhead and equipment costs.

Does this amount reflect what the patient will owe?

No. This is the total Medicare-allowed amount. After the deductible, Medicare generally pays 80%, and the patient or secondary payer is responsible for the remaining 20%, unless other coverage applies.

Will this amount be the same in every state?

No. The national amount is adjusted using locality-specific GPCIs, so the actual allowed amount can vary based on where the service is performed.

Can modifiers change this reimbursement figure?

Yes. Modifiers such as those indicating bilateral procedures, reduced services, or multiple procedures can increase or decrease the final payment relative to the base allowed amount shown here.

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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.