Medicare Reimbursement for CPT 19357

CPT code 19357 is a procedure code defined by the American Medical Association; its specific clinical descriptor is not reproduced here due to licensing restrictions. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, with both non-facility and facility rate variants where applicable.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1072.84	$1072.84
ALASKA* (AK)	$1306.11	$1306.11
ALABAMA (AL)	$971.07	$971.07
ARKANSAS (AR)	$958.46	$958.46
ARIZONA (AZ)	$1044.30	$1044.30
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1270.97	$1270.97
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1291.63	$1291.63
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1142.88	$1142.88
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1153.38	$1153.38
NAPA (CA)	$1217.17	$1217.17
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1274.06	$1274.06
VALLEJO (CA)	$1212.71	$1212.71
BAKERSFIELD (CA)	$1094.37	$1094.37
CHICO (CA)	$1086.77	$1086.77
FRESNO (CA)	$1086.77	$1086.77
HANFORD-CORCORAN (CA)	$1086.77	$1086.77
MADERA (CA)	$1086.77	$1086.77
MERCED (CA)	$1086.77	$1086.77
MODESTO (CA)	$1086.77	$1086.77
REDDING (CA)	$1086.77	$1086.77
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1116.05	$1116.05
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1129.37	$1129.37
SALINAS (CA)	$1124.95	$1124.95
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1304.26	$1304.26
SANTA CRUZ-WATSONVILLE (CA)	$1148.05	$1148.05
SANTA ROSA-PETALUMA (CA)	$1158.88	$1158.88
STOCKTON (CA)	$1086.77	$1086.77
VISALIA (CA)	$1086.77	$1086.77
YUBA CITY (CA)	$1086.77	$1086.77
EL CENTRO (CA)	$1087.23	$1087.23
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1143.47	$1143.47
SAN LUIS OBISPO-PASO ROBLES (CA)	$1108.21	$1108.21
SANTA MARIA-SANTA BARBARA (CA)	$1127.00	$1127.00
REST OF CALIFORNIA (CA)	$1086.77	$1086.77
COLORADO (CO)	$1090.66	$1090.66
CONNECTICUT (CT)	$1139.98	$1139.98
DC + MD/VA SUBURBS (DC)	$1197.97	$1197.97
DELAWARE (DE)	$1060.09	$1060.09
FORT LAUDERDALE (FL)	$1152.73	$1152.73
MIAMI (FL)	$1232.19	$1232.19
REST OF FLORIDA (FL)	$1096.59	$1096.59
ATLANTA (GA)	$1100.53	$1100.53
REST OF GEORGIA (GA)	$1036.42	$1036.42
HAWAII, GUAM (HI)	$1102.91	$1102.91
IOWA (IA)	$975.67	$975.67
IDAHO (ID)	$985.06	$985.06
EAST ST. LOUIS (IL)	$1125.07	$1125.07
SUBURBAN CHICAGO (IL)	$1159.82	$1159.82
CHICAGO (IL)	$1196.36	$1196.36
REST OF ILLINOIS (IL)	$1080.60	$1080.60
INDIANA (IN)	$989.74	$989.74
KANSAS (KS)	$979.90	$979.90
KENTUCKY (KY)	$1009.76	$1009.76
NEW ORLEANS (LA)	$1055.77	$1055.77
REST OF LOUISIANA (LA)	$1011.67	$1011.67
METROPOLITAN BOSTON (MA)	$1179.40	$1179.40
REST OF MASSACHUSETTS (MA)	$1088.56	$1088.56
BALTIMORE/SURR. CNTYS (MD)	$1138.50	$1138.50
REST OF MARYLAND (MD)	$1076.20	$1076.20
SOUTHERN MAINE (ME)	$1034.83	$1034.83
REST OF MAINE (ME)	$998.60	$998.60
DETROIT (MI)	$1117.71	$1117.71
REST OF MICHIGAN (MI)	$1041.17	$1041.17
MINNESOTA (MN)	$1023.34	$1023.34
METROPOLITAN ST. LOUIS (MO)	$1049.08	$1049.08
METROPOLITAN KANSAS CITY (MO)	$1040.33	$1040.33
REST OF MISSOURI (MO)	$1001.66	$1001.66
MISSISSIPPI (MS)	$979.81	$979.81
MONTANA** (MT)	$1072.66	$1072.66
NORTH CAROLINA (NC)	$1006.63	$1006.63
NORTH DAKOTA** (ND)	$1018.87	$1018.87
NEBRASKA (NE)	$977.93	$977.93
NEW HAMPSHIRE (NH)	$1081.93	$1081.93
NORTHERN NJ (NJ)	$1189.25	$1189.25
REST OF NEW JERSEY (NJ)	$1146.86	$1146.86
NEW MEXICO (NM)	$1049.71	$1049.71
NEVADA** (NV)	$1058.16	$1058.16
MANHATTAN (NY)	$1237.79	$1237.79
NYC SUBURBS/LONG ISLAND (NY)	$1275.88	$1275.88
POUGHKPSIE/N NYC SUBURBS (NY)	$1161.04	$1161.04
QUEENS (NY)	$1234.68	$1234.68
REST OF NEW YORK (NY)	$1020.92	$1020.92
OHIO (OH)	$1030.18	$1030.18
OKLAHOMA (OK)	$999.22	$999.22
PORTLAND (OR)	$1112.67	$1112.67
REST OF OREGON (OR)	$1043.86	$1043.86
METROPOLITAN PHILADELPHIA (PA)	$1119.52	$1119.52
REST OF PENNSYLVANIA (PA)	$1026.95	$1026.95
PUERTO RICO (PR)	$1076.96	$1076.96
RHODE ISLAND (RI)	$1088.66	$1088.66
SOUTH CAROLINA (SC)	$1021.31	$1021.31
SOUTH DAKOTA** (SD)	$1012.51	$1012.51
TENNESSEE (TN)	$985.39	$985.39
BRAZORIA (TX)	$1052.23	$1052.23
DALLAS (TX)	$1062.29	$1062.29
GALVESTON (TX)	$1057.59	$1057.59
HOUSTON (TX)	$1107.37	$1107.37
BEAUMONT (TX)	$1021.51	$1021.51
FORT WORTH (TX)	$1058.49	$1058.49
AUSTIN (TX)	$1092.37	$1092.37
REST OF TEXAS (TX)	$1038.59	$1038.59
UTAH (UT)	$1033.65	$1033.65
VIRGINIA (VA)	$1037.65	$1037.65
VIRGIN ISLANDS (VI)	$1076.96	$1076.96
VERMONT (VT)	$1022.97	$1022.97
SEATTLE (KING CNTY) (WA)	$1193.58	$1193.58
REST OF WASHINGTON (WA)	$1083.84	$1083.84
WISCONSIN (WI)	$989.02	$989.02
WEST VIRGINIA (WV)	$1046.67	$1046.67
WYOMING** (WY)	$1049.22	$1049.22

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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 allowed amount is built from three Relative Value Units (RVUs) assigned to the code: 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 performed, to reflect regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility rates apply when the service is performed in a physician's office or similar setting, while facility rates apply in hospitals or ambulatory surgical centers, where practice-expense RVUs are typically lower because the facility bears some overhead costs.

RVUs — work 14.47, practice expense 14.93 (non-facility) / 14.93 (facility), malpractice 2.72 — × 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 annual Part B deductible is met; the patient or secondary payer is responsible for the remainder.
Modifiers, place of service, sequestration, and annual budget-neutrality adjustments can change the final paid amount.
Rates vary by locality based on GPCI adjustments and may differ from the national figures shown here.
Always verify current rates and coverage policy with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the amount shown differ from what I was actually paid?

Actual payment depends on your specific locality's GPCIs, any applicable modifiers, sequestration reductions, and the patient's deductible/coinsurance status, none of which are reflected in a single national estimate.

Is the facility rate always lower than the non-facility rate?

Not necessarily. Facility rates generally use lower practice-expense RVUs because overhead costs are borne by the facility, but the exact relationship depends on the code and year.

Does this page tell me what the patient will owe?

No. This page reflects the Medicare-allowed amount only. Patient responsibility depends on deductible status, coinsurance, and any secondary insurance.

Why can't you show the CPT code description?

CPT code descriptors are copyrighted and licensed by the American Medical Association, so we reference the code generically rather than reproducing the official text.

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.