Medicare Reimbursement for CPT 19350

CPT 19350 is a physician procedure code reported under the Medicare Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code nationally and adjusted by 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)	$893.81	$615.91
ALASKA* (AK)	$1052.26	$756.30
ALABAMA (AL)	$801.92	$558.76
ARKANSAS (AR)	$790.41	$551.70
ARIZONA (AZ)	$868.99	$599.71
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1111.90	$720.06
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1132.11	$731.39
OXNARD-THOUSAND OAKS-VENTURA (CA)	$979.62	$651.15
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$986.31	$657.56
NAPA (CA)	$1057.22	$690.96
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1113.79	$721.96
VALLEJO (CA)	$1054.49	$688.23
BAKERSFIELD (CA)	$929.61	$625.04
CHICO (CA)	$924.95	$620.37
FRESNO (CA)	$924.95	$620.37
HANFORD-CORCORAN (CA)	$924.95	$620.37
MADERA (CA)	$924.95	$620.37
MERCED (CA)	$924.95	$620.37
MODESTO (CA)	$924.95	$620.37
REDDING (CA)	$924.95	$620.37
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$942.92	$638.35
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$966.86	$643.66
SALINAS (CA)	$963.21	$641.13
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1139.86	$739.14
SANTA CRUZ-WATSONVILLE (CA)	$990.56	$652.92
SANTA ROSA-PETALUMA (CA)	$1000.27	$659.01
STOCKTON (CA)	$924.95	$620.37
VISALIA (CA)	$924.95	$620.37
YUBA CITY (CA)	$924.95	$620.37
EL CENTRO (CA)	$925.22	$620.65
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$983.28	$650.92
SAN LUIS OBISPO-PASO ROBLES (CA)	$948.23	$631.70
SANTA MARIA-SANTA BARBARA (CA)	$966.11	$642.08
REST OF CALIFORNIA (CA)	$924.95	$620.37
COLORADO (CO)	$919.80	$624.12
CONNECTICUT (CT)	$953.14	$653.85
DC + MD/VA SUBURBS (DC)	$1012.50	$685.14
DELAWARE (DE)	$883.16	$608.60
FORT LAUDERDALE (FL)	$945.92	$664.41
MIAMI (FL)	$1001.29	$712.00
REST OF FLORIDA (FL)	$898.04	$632.37
ATLANTA (GA)	$914.57	$632.23
REST OF GEORGIA (GA)	$846.04	$598.16
HAWAII, GUAM (HI)	$944.50	$628.53
IOWA (IA)	$814.15	$559.88
IDAHO (ID)	$821.10	$565.43
EAST ST. LOUIS (IL)	$907.05	$651.39
SUBURBAN CHICAGO (IL)	$953.56	$668.17
CHICAGO (IL)	$970.83	$691.54
REST OF ILLINOIS (IL)	$878.11	$624.39
INDIANA (IN)	$825.61	$568.00
KANSAS (KS)	$814.16	$562.95
KENTUCKY (KY)	$828.97	$581.92
NEW ORLEANS (LA)	$869.45	$607.95
REST OF LOUISIANA (LA)	$829.20	$583.26
METROPOLITAN BOSTON (MA)	$1004.87	$673.06
REST OF MASSACHUSETTS (MA)	$915.93	$623.30
BALTIMORE/SURR. CNTYS (MD)	$951.30	$653.12
REST OF MARYLAND (MD)	$898.70	$617.47
SOUTHERN MAINE (ME)	$868.35	$592.96
REST OF MAINE (ME)	$829.41	$573.75
DETROIT (MI)	$913.12	$644.95
REST OF MICHIGAN (MI)	$853.90	$600.18
MINNESOTA (MN)	$870.24	$584.29
METROPOLITAN ST. LOUIS (MO)	$867.93	$603.37
METROPOLITAN KANSAS CITY (MO)	$859.50	$598.55
REST OF MISSOURI (MO)	$817.64	$578.09
MISSISSIPPI (MS)	$803.99	$564.72
MONTANA** (MT)	$893.70	$615.80
NORTH CAROLINA (NC)	$837.40	$578.12
NORTH DAKOTA** (ND)	$860.68	$582.78
NEBRASKA (NE)	$817.42	$560.93
NEW HAMPSHIRE (NH)	$909.03	$619.75
NORTHERN NJ (NJ)	$1002.92	$680.56
REST OF NEW JERSEY (NJ)	$960.89	$657.43
NEW MEXICO (NM)	$860.08	$605.25
NEVADA** (NV)	$885.03	$606.86
MANHATTAN (NY)	$1033.19	$710.27
NYC SUBURBS/LONG ISLAND (NY)	$1062.92	$732.51
POUGHKPSIE/N NYC SUBURBS (NY)	$970.30	$666.01
QUEENS (NY)	$1035.99	$707.51
REST OF NEW YORK (NY)	$850.17	$586.17
OHIO (OH)	$847.15	$593.43
OKLAHOMA (OK)	$823.44	$575.28
PORTLAND (OR)	$944.37	$635.63
REST OF OREGON (OR)	$875.08	$598.29
METROPOLITAN PHILADELPHIA (PA)	$932.11	$642.82
REST OF PENNSYLVANIA (PA)	$846.34	$591.24
PUERTO RICO (PR)	$898.93	$617.97
RHODE ISLAND (RI)	$911.29	$624.22
SOUTH CAROLINA (SC)	$844.29	$587.52
SOUTH DAKOTA** (SD)	$856.77	$578.88
TENNESSEE (TN)	$818.71	$566.11
BRAZORIA (TX)	$879.04	$603.64
DALLAS (TX)	$886.39	$609.61
GALVESTON (TX)	$882.80	$606.85
HOUSTON (TX)	$913.36	$637.41
BEAUMONT (TX)	$841.12	$588.23
FORT WORTH (TX)	$881.70	$607.70
AUSTIN (TX)	$919.45	$625.43
REST OF TEXAS (TX)	$860.78	$597.06
UTAH (UT)	$855.63	$594.41
VIRGINIA (VA)	$868.20	$595.03
VIRGIN ISLANDS (VI)	$898.93	$617.97
VERMONT (VT)	$860.84	$585.72
SEATTLE (KING CNTY) (WA)	$1021.33	$680.36
REST OF WASHINGTON (WA)	$913.03	$620.40
WISCONSIN (WI)	$832.47	$566.24
WEST VIRGINIA (WV)	$846.92	$605.43
WYOMING** (WY)	$879.31	$601.41

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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 this procedure code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) values specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility amounts differ because the practice-expense RVU is lower when the service is performed in a facility setting, since the facility absorbs certain overhead costs. The resulting figure represents the total allowed amount before any patient cost-sharing is applied.

RVUs — work 8.88, practice expense 16.21 (non-facility) / 7.89 (facility), malpractice 1.67 — × 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 Part B deductible; the patient or secondary insurer is responsible for the remainder.
Modifiers, place-of-service codes, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why is the non-facility amount different from the facility amount for CPT 19350?

The non-facility amount includes a higher practice-expense RVU because it accounts for the overhead costs (staff, supplies, equipment) of performing the service in a non-facility setting like a physician's office. In a facility setting, Medicare assumes the facility bears those costs, so the practice-expense RVU — and therefore the total allowed amount — is lower.

Why does the Medicare amount for CPT 19350 vary by locality?

Each locality has its own Geographic Practice Cost Index (GPCI) values for work, practice expense, and malpractice, reflecting differences in regional costs. These GPCIs adjust the base RVUs before they're multiplied by the conversion factor, which changes the final allowed amount from one area to another.

Does this amount reflect what Medicare will actually pay?

No. This is an estimated allowed amount based on standard PFS inputs. Actual payment can differ due to modifiers, sequestration, secondary payer rules, and annual updates to RVUs or the conversion factor.

Where can billers confirm the exact rate for their locality?

Billers should confirm current, locality-specific rates and any applicable policy edits with their Medicare Administrative Contractor (MAC), since official MAC fee schedules are the authoritative source for payment.

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.