Medicare Reimbursement for CPT 19361

CPT 19361 is a surgical procedure code reported to Medicare and other payers; the exact service it describes is defined by the AMA's CPT codebook. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code at the national level and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital) settings. For this particular code, the practice-expense component does not differ between settings, so the non-facility and facility allowed amounts are the same.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1382.13	$1382.13
ALASKA* (AK)	$1729.30	$1729.30
ALABAMA (AL)	$1260.20	$1260.20
ARKANSAS (AR)	$1245.24	$1245.24
ARIZONA (AZ)	$1346.68	$1346.68
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1567.99	$1567.99
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1590.68	$1590.68
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1436.40	$1436.40
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1452.65	$1452.65
NAPA (CA)	$1511.56	$1511.56
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1572.86	$1572.86
VALLEJO (CA)	$1504.54	$1504.54
BAKERSFIELD (CA)	$1386.44	$1386.44
CHICO (CA)	$1374.46	$1374.46
FRESNO (CA)	$1374.46	$1374.46
HANFORD-CORCORAN (CA)	$1374.46	$1374.46
MADERA (CA)	$1374.46	$1374.46
MERCED (CA)	$1374.46	$1374.46
MODESTO (CA)	$1374.46	$1374.46
REDDING (CA)	$1374.46	$1374.46
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1420.65	$1420.65
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1420.94	$1420.94
SALINAS (CA)	$1415.23	$1415.23
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$1610.60	$1610.60
SANTA CRUZ-WATSONVILLE (CA)	$1434.38	$1434.38
SANTA ROSA-PETALUMA (CA)	$1447.45	$1447.45
STOCKTON (CA)	$1374.46	$1374.46
VISALIA (CA)	$1374.46	$1374.46
YUBA CITY (CA)	$1374.46	$1374.46
EL CENTRO (CA)	$1375.18	$1375.18
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1433.01	$1433.01
SAN LUIS OBISPO-PASO ROBLES (CA)	$1395.01	$1395.01
SANTA MARIA-SANTA BARBARA (CA)	$1416.29	$1416.29
REST OF CALIFORNIA (CA)	$1374.46	$1374.46
COLORADO (CO)	$1390.47	$1390.47
CONNECTICUT (CT)	$1464.24	$1464.24
DC + MD/VA SUBURBS (DC)	$1524.49	$1524.49
DELAWARE (DE)	$1365.73	$1365.73
FORT LAUDERDALE (FL)	$1504.12	$1504.12
MIAMI (FL)	$1620.82	$1620.82
REST OF FLORIDA (FL)	$1433.17	$1433.17
ATLANTA (GA)	$1420.86	$1420.86
REST OF GEORGIA (GA)	$1358.02	$1358.02
HAWAII, GUAM (HI)	$1387.29	$1387.29
IOWA (IA)	$1255.10	$1255.10
IDAHO (ID)	$1268.38	$1268.38
EAST ST. LOUIS (IL)	$1489.19	$1489.19
SUBURBAN CHICAGO (IL)	$1510.98	$1510.98
CHICAGO (IL)	$1575.41	$1575.41
REST OF ILLINOIS (IL)	$1421.22	$1421.22
INDIANA (IN)	$1273.59	$1273.59
KANSAS (KS)	$1265.17	$1265.17
KENTUCKY (KY)	$1316.90	$1316.90
NEW ORLEANS (LA)	$1373.42	$1373.42
REST OF LOUISIANA (LA)	$1321.14	$1321.14
METROPOLITAN BOSTON (MA)	$1490.29	$1490.29
REST OF MASSACHUSETTS (MA)	$1390.55	$1390.55
BALTIMORE/SURR. CNTYS (MD)	$1463.15	$1463.15
REST OF MARYLAND (MD)	$1383.72	$1383.72
SOUTHERN MAINE (ME)	$1324.95	$1324.95
REST OF MAINE (ME)	$1289.73	$1289.73
DETROIT (MI)	$1463.70	$1463.70
REST OF MICHIGAN (MI)	$1359.03	$1359.03
MINNESOTA (MN)	$1295.11	$1295.11
METROPOLITAN ST. LOUIS (MO)	$1359.47	$1359.47
METROPOLITAN KANSAS CITY (MO)	$1349.68	$1349.68
REST OF MISSOURI (MO)	$1312.44	$1312.44
MISSISSIPPI (MS)	$1278.29	$1278.29
MONTANA** (MT)	$1381.84	$1381.84
NORTH CAROLINA (NC)	$1298.38	$1298.38
NORTH DAKOTA** (ND)	$1297.02	$1297.02
NEBRASKA (NE)	$1256.20	$1256.20
NEW HAMPSHIRE (NH)	$1383.81	$1383.81
NORTHERN NJ (NJ)	$1516.28	$1516.28
REST OF NEW JERSEY (NJ)	$1470.44	$1470.44
NEW MEXICO (NM)	$1371.26	$1371.26
NEVADA** (NV)	$1358.68	$1358.68
MANHATTAN (NY)	$1592.22	$1592.22
NYC SUBURBS/LONG ISLAND (NY)	$1643.96	$1643.96
POUGHKPSIE/N NYC SUBURBS (NY)	$1491.87	$1491.87
QUEENS (NY)	$1581.15	$1581.15
REST OF NEW YORK (NY)	$1315.67	$1315.67
OHIO (OH)	$1341.69	$1341.69
OKLAHOMA (OK)	$1299.03	$1299.03
PORTLAND (OR)	$1410.68	$1410.68
REST OF OREGON (OR)	$1337.66	$1337.66
METROPOLITAN PHILADELPHIA (PA)	$1443.08	$1443.08
REST OF PENNSYLVANIA (PA)	$1335.06	$1335.06
PUERTO RICO (PR)	$1385.24	$1385.24
RHODE ISLAND (RI)	$1396.88	$1396.88
SOUTH CAROLINA (SC)	$1324.31	$1324.31
SOUTH DAKOTA** (SD)	$1286.98	$1286.98
TENNESSEE (TN)	$1272.29	$1272.29
BRAZORIA (TX)	$1352.39	$1352.39
DALLAS (TX)	$1366.72	$1366.72
GALVESTON (TX)	$1360.22	$1360.22
HOUSTON (TX)	$1438.75	$1438.75
BEAUMONT (TX)	$1328.94	$1328.94
FORT WORTH (TX)	$1363.80	$1363.80
AUSTIN (TX)	$1395.04	$1395.04
REST OF TEXAS (TX)	$1343.85	$1343.85
UTAH (UT)	$1338.84	$1338.84
VIRGINIA (VA)	$1331.88	$1331.88
VIRGIN ISLANDS (VI)	$1385.24	$1385.24
VERMONT (VT)	$1306.56	$1306.56
SEATTLE (KING CNTY) (WA)	$1502.45	$1502.45
REST OF WASHINGTON (WA)	$1383.11	$1383.11
WISCONSIN (WI)	$1262.90	$1262.90
WEST VIRGINIA (WV)	$1381.27	$1381.27
WYOMING** (WY)	$1344.87	$1344.87

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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 the code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific Medicare locality where the service is furnished, reflecting local cost-of-living and practice-cost differences. The geographically adjusted RVUs are summed and then multiplied by the annual Medicare conversion factor (a dollar figure CMS updates each year) to produce the allowed amount. Non-facility and facility rates can differ when the practice-expense RVU changes based on where the service is performed, since Medicare assumes different overhead costs in each setting.

RVUs — work 22.78, practice expense 14.31 (non-facility) / 14.31 (facility), malpractice 4.29 — × 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 generally responsible for the remainder.
Modifiers, place of service, multiple-procedure reductions, and sequestration can change the actual paid amount.
CMS applies annual budget-neutrality adjustments and conversion factor updates that can shift amounts from year to year.
Local Medicare Administrative Contractor (MAC) policies and coverage determinations may affect whether and how this code is paid.
Verify current rates and coverage rules with your MAC before billing or appealing a claim.

Frequently asked

Why is the non-facility amount the same as the facility amount for this code?

When the practice-expense RVU assigned to a code is identical for both settings, the geographically adjusted totals — and therefore the final allowed amounts — come out the same, even though Medicare calculates them separately.

Why does the allowed amount vary by locality?

Each Medicare locality has its own Geographic Practice Cost Index (GPCI) values, which adjust the work, practice-expense, and malpractice RVUs to reflect local cost differences before the conversion factor is applied.

Does this amount reflect what the practice will actually be paid?

No. It reflects the Medicare-allowed amount before patient responsibility, deductibles, modifiers, sequestration, and any claim-specific adjustments are applied.

Where can I find the official CPT descriptor for this code?

CPT code descriptors are copyrighted by the American Medical Association; check your licensed CPT codebook or AMA resources for the official language.

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.