Medicare Reimbursement for CPT 19369

CPT 19369 is a procedure code billed under Medicare Part B. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount, both nationally and adjusted by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$1755.89	$1755.89
ALASKA* (AK)	$2216.09	$2216.09
ALABAMA (AL)	$1605.24	$1605.24
ARKANSAS (AR)	$1586.82	$1586.82
ARIZONA (AZ)	$1711.63	$1711.63
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$1967.71	$1967.71
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$1995.18	$1995.18
OXNARD-THOUSAND OAKS-VENTURA (CA)	$1812.37	$1812.37
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$1833.95	$1833.95
NAPA (CA)	$1900.55	$1900.55
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$1974.16	$1974.16
VALLEJO (CA)	$1891.26	$1891.26
BAKERSFIELD (CA)	$1753.54	$1753.54
CHICO (CA)	$1737.65	$1737.65
FRESNO (CA)	$1737.65	$1737.65
HANFORD-CORCORAN (CA)	$1737.65	$1737.65
MADERA (CA)	$1737.65	$1737.65
MERCED (CA)	$1737.65	$1737.65
MODESTO (CA)	$1737.65	$1737.65
REDDING (CA)	$1737.65	$1737.65
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$1798.81	$1798.81
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$1793.64	$1793.64
SALINAS (CA)	$1786.35	$1786.35
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$2021.55	$2021.55
SANTA CRUZ-WATSONVILLE (CA)	$1806.76	$1806.76
SANTA ROSA-PETALUMA (CA)	$1823.04	$1823.04
STOCKTON (CA)	$1737.65	$1737.65
VISALIA (CA)	$1737.65	$1737.65
YUBA CITY (CA)	$1737.65	$1737.65
EL CENTRO (CA)	$1738.60	$1738.60
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$1806.69	$1806.69
SAN LUIS OBISPO-PASO ROBLES (CA)	$1761.15	$1761.15
SANTA MARIA-SANTA BARBARA (CA)	$1787.12	$1787.12
REST OF CALIFORNIA (CA)	$1737.65	$1737.65
COLORADO (CO)	$1761.55	$1761.55
CONNECTICUT (CT)	$1858.20	$1858.20
DC + MD/VA SUBURBS (DC)	$1929.65	$1929.65
DELAWARE (DE)	$1735.27	$1735.27
FORT LAUDERDALE (FL)	$1916.28	$1916.28
MIAMI (FL)	$2068.37	$2068.37
REST OF FLORIDA (FL)	$1827.27	$1827.27
ATLANTA (GA)	$1805.82	$1805.82
REST OF GEORGIA (GA)	$1733.30	$1733.30
HAWAII, GUAM (HI)	$1750.88	$1750.88
IOWA (IA)	$1595.04	$1595.04
IDAHO (ID)	$1612.19	$1612.19
EAST ST. LOUIS (IL)	$1904.54	$1904.54
SUBURBAN CHICAGO (IL)	$1924.24	$1924.24
CHICAGO (IL)	$2011.44	$2011.44
REST OF ILLINOIS (IL)	$1815.16	$1815.16
INDIANA (IN)	$1618.48	$1618.48
KANSAS (KS)	$1609.33	$1609.33
KENTUCKY (KY)	$1679.10	$1679.10
NEW ORLEANS (LA)	$1749.45	$1749.45
REST OF LOUISIANA (LA)	$1685.08	$1685.08
METROPOLITAN BOSTON (MA)	$1882.83	$1882.83
REST OF MASSACHUSETTS (MA)	$1762.65	$1762.65
BALTIMORE/SURR. CNTYS (MD)	$1857.05	$1857.05
REST OF MARYLAND (MD)	$1757.08	$1757.08
SOUTHERN MAINE (ME)	$1680.96	$1680.96
REST OF MAINE (ME)	$1640.46	$1640.46
DETROIT (MI)	$1866.91	$1866.91
REST OF MICHIGAN (MI)	$1732.82	$1732.82
MINNESOTA (MN)	$1638.17	$1638.17
METROPOLITAN ST. LOUIS (MO)	$1730.04	$1730.04
METROPOLITAN KANSAS CITY (MO)	$1718.19	$1718.19
REST OF MISSOURI (MO)	$1675.54	$1675.54
MISSISSIPPI (MS)	$1630.41	$1630.41
MONTANA** (MT)	$1755.51	$1755.51
NORTH CAROLINA (NC)	$1650.79	$1650.79
NORTH DAKOTA** (ND)	$1643.19	$1643.19
NEBRASKA (NE)	$1595.81	$1595.81
NEW HAMPSHIRE (NH)	$1754.57	$1754.57
NORTHERN NJ (NJ)	$1920.46	$1920.46
REST OF NEW JERSEY (NJ)	$1865.35	$1865.35
NEW MEXICO (NM)	$1748.66	$1748.66
NEVADA** (NV)	$1724.75	$1724.75
MANHATTAN (NY)	$2020.85	$2020.85
NYC SUBURBS/LONG ISLAND (NY)	$2087.01	$2087.01
POUGHKPSIE/N NYC SUBURBS (NY)	$1893.53	$1893.53
QUEENS (NY)	$2004.45	$2004.45
REST OF NEW YORK (NY)	$1672.22	$1672.22
OHIO (OH)	$1709.86	$1709.86
OKLAHOMA (OK)	$1655.11	$1655.11
PORTLAND (OR)	$1784.29	$1784.29
REST OF OREGON (OR)	$1697.35	$1697.35
METROPOLITAN PHILADELPHIA (PA)	$1833.26	$1833.26
REST OF PENNSYLVANIA (PA)	$1700.64	$1700.64
PUERTO RICO (PR)	$1759.05	$1759.05
RHODE ISLAND (RI)	$1772.80	$1772.80
SOUTH CAROLINA (SC)	$1685.90	$1685.90
SOUTH DAKOTA** (SD)	$1629.91	$1629.91
TENNESSEE (TN)	$1618.32	$1618.32
BRAZORIA (TX)	$1717.39	$1717.39
DALLAS (TX)	$1735.94	$1735.94
GALVESTON (TX)	$1727.59	$1727.59
HOUSTON (TX)	$1831.55	$1831.55
BEAUMONT (TX)	$1693.24	$1693.24
FORT WORTH (TX)	$1732.94	$1732.94
AUSTIN (TX)	$1767.99	$1767.99
REST OF TEXAS (TX)	$1709.61	$1709.61
UTAH (UT)	$1703.75	$1703.75
VIRGINIA (VA)	$1690.82	$1690.82
VIRGIN ISLANDS (VI)	$1759.05	$1759.05
VERMONT (VT)	$1656.70	$1656.70
SEATTLE (KING CNTY) (WA)	$1896.20	$1896.20
REST OF WASHINGTON (WA)	$1752.76	$1752.76
WISCONSIN (WI)	$1601.65	$1601.65
WEST VIRGINIA (WV)	$1766.07	$1766.07
WYOMING** (WY)	$1706.56	$1706.56

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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 payment is built from three Relative Value Units (RVUs): physician work, practice expense, and malpractice. Each RVU component is adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual conversion factor to produce the allowed amount. Non-facility and facility rates can differ because practice-expense RVUs are typically lower when the procedure is performed in a facility (e.g., hospital) setting, since the facility absorbs certain overhead costs. For this code, the non-facility and facility amounts shown are the same, indicating the practice-expense RVU did not differ between settings for this code in this year's fee schedule.

RVUs — work 30.53, practice expense 16.36 (non-facility) / 16.36 (facility), malpractice 5.68 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, based on the national Medicare Physician Fee Schedule; actual payment may differ.
Medicare typically pays 80% of the allowed amount after the patient meets the annual Part B deductible; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, place-of-service codes, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
Locality-adjusted amounts vary by Medicare Administrative Contractor (MAC) jurisdiction; always confirm current rates with your MAC or the official CMS PFS lookup tool.
This code's descriptor is licensed by the AMA and is not reproduced here; consult your CPT codebook for the official description.

Frequently asked

Why do the non-facility and facility amounts for CPT 19369 look the same?

When the practice-expense RVU is identical in both settings for a given code, the calculated non-facility and facility allowed amounts will match. This varies by code and year.

Will my locality's payment match the national amount shown?

Not necessarily. The national figure uses standard GPCI inputs; actual payment in your area depends on locality-specific GPIs applied to the work, practice expense, and malpractice RVUs.

Does this amount reflect what Medicare will actually pay me?

No. This is an estimated allowed amount before deductible and coinsurance. Medicare generally pays 80% of the allowed amount, with patient responsibility for the rest, and additional adjustments (e.g., sequestration) may apply.

Where can I find the official CPT descriptor for 19369?

The CPT code set is maintained and licensed by the American Medical Association (AMA). Refer to your licensed CPT codebook or AMA resources for the official descriptor.

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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.