Medicare Reimbursement for CPT 19370

CPT 19370 is a procedure code billed to Medicare under the Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and adjusted for your locality, broken out by non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$615.91	$615.91
ALASKA* (AK)	$757.00	$757.00
ALABAMA (AL)	$558.91	$558.91
ARKANSAS (AR)	$551.87	$551.87
ARIZONA (AZ)	$599.74	$599.74
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$719.10	$719.10
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$730.37	$730.37
OXNARD-THOUSAND OAKS-VENTURA (CA)	$650.66	$650.66
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$657.10	$657.10
NAPA (CA)	$690.18	$690.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$721.01	$721.01
VALLEJO (CA)	$687.43	$687.43
BAKERSFIELD (CA)	$624.72	$624.72
CHICO (CA)	$620.03	$620.03
FRESNO (CA)	$620.03	$620.03
HANFORD-CORCORAN (CA)	$620.03	$620.03
MADERA (CA)	$620.03	$620.03
MERCED (CA)	$620.03	$620.03
MODESTO (CA)	$620.03	$620.03
REDDING (CA)	$620.03	$620.03
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$638.11	$638.11
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$643.20	$643.20
SALINAS (CA)	$640.66	$640.66
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$738.17	$738.17
SANTA CRUZ-WATSONVILLE (CA)	$652.30	$652.30
SANTA ROSA-PETALUMA (CA)	$658.39	$658.39
STOCKTON (CA)	$620.03	$620.03
VISALIA (CA)	$620.03	$620.03
YUBA CITY (CA)	$620.03	$620.03
EL CENTRO (CA)	$620.31	$620.31
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$650.36	$650.36
SAN LUIS OBISPO-PASO ROBLES (CA)	$631.26	$631.26
SANTA MARIA-SANTA BARBARA (CA)	$641.60	$641.60
REST OF CALIFORNIA (CA)	$620.03	$620.03
COLORADO (CO)	$623.92	$623.92
CONNECTICUT (CT)	$653.78	$653.78
DC + MD/VA SUBURBS (DC)	$684.87	$684.87
DELAWARE (DE)	$608.60	$608.60
FORT LAUDERDALE (FL)	$664.65	$664.65
MIAMI (FL)	$712.42	$712.42
REST OF FLORIDA (FL)	$632.65	$632.65
ATLANTA (GA)	$632.27	$632.27
REST OF GEORGIA (GA)	$598.48	$598.48
HAWAII, GUAM (HI)	$628.07	$628.07
IOWA (IA)	$559.87	$559.87
IDAHO (ID)	$565.45	$565.45
EAST ST. LOUIS (IL)	$651.92	$651.92
SUBURBAN CHICAGO (IL)	$668.37	$668.37
CHICAGO (IL)	$691.98	$691.98
REST OF ILLINOIS (IL)	$624.78	$624.78
INDIANA (IN)	$568.00	$568.00
KANSAS (KS)	$563.01	$563.01
KENTUCKY (KY)	$582.15	$582.15
NEW ORLEANS (LA)	$608.13	$608.13
REST OF LOUISIANA (LA)	$583.52	$583.52
METROPOLITAN BOSTON (MA)	$672.65	$672.65
REST OF MASSACHUSETTS (MA)	$623.14	$623.14
BALTIMORE/SURR. CNTYS (MD)	$653.06	$653.06
REST OF MARYLAND (MD)	$617.43	$617.43
SOUTHERN MAINE (ME)	$592.86	$592.86
REST OF MAINE (ME)	$573.81	$573.81
DETROIT (MI)	$645.26	$645.26
REST OF MICHIGAN (MI)	$600.43	$600.43
MINNESOTA (MN)	$583.98	$583.98
METROPOLITAN ST. LOUIS (MO)	$603.49	$603.49
METROPOLITAN KANSAS CITY (MO)	$598.69	$598.69
REST OF MISSOURI (MO)	$578.41	$578.41
MISSISSIPPI (MS)	$564.96	$564.96
MONTANA** (MT)	$615.80	$615.80
NORTH CAROLINA (NC)	$578.16	$578.16
NORTH DAKOTA** (ND)	$582.58	$582.58
NEBRASKA (NE)	$560.90	$560.90
NEW HAMPSHIRE (NH)	$619.61	$619.61
NORTHERN NJ (NJ)	$680.33	$680.33
REST OF NEW JERSEY (NJ)	$657.33	$657.33
NEW MEXICO (NM)	$605.51	$605.51
NEVADA** (NV)	$606.80	$606.80
MANHATTAN (NY)	$710.22	$710.22
NYC SUBURBS/LONG ISLAND (NY)	$732.48	$732.48
POUGHKPSIE/N NYC SUBURBS (NY)	$665.95	$665.95
QUEENS (NY)	$707.36	$707.36
REST OF NEW YORK (NY)	$586.19	$586.19
OHIO (OH)	$593.64	$593.64
OKLAHOMA (OK)	$575.45	$575.45
PORTLAND (OR)	$635.32	$635.32
REST OF OREGON (OR)	$598.20	$598.20
METROPOLITAN PHILADELPHIA (PA)	$642.83	$642.83
REST OF PENNSYLVANIA (PA)	$591.41	$591.41
PUERTO RICO (PR)	$617.94	$617.94
RHODE ISLAND (RI)	$624.15	$624.15
SOUTH CAROLINA (SC)	$587.64	$587.64
SOUTH DAKOTA** (SD)	$578.65	$578.65
TENNESSEE (TN)	$566.16	$566.16
BRAZORIA (TX)	$603.61	$603.61
DALLAS (TX)	$609.59	$609.59
GALVESTON (TX)	$606.82	$606.82
HOUSTON (TX)	$637.57	$637.57
BEAUMONT (TX)	$588.42	$588.42
FORT WORTH (TX)	$607.70	$607.70
AUSTIN (TX)	$625.26	$625.26
REST OF TEXAS (TX)	$597.15	$597.15
UTAH (UT)	$594.52	$594.52
VIRGINIA (VA)	$594.97	$594.97
VIRGIN ISLANDS (VI)	$617.94	$617.94
VERMONT (VT)	$585.58	$585.58
SEATTLE (KING CNTY) (WA)	$679.87	$679.87
REST OF WASHINGTON (WA)	$620.23	$620.23
WISCONSIN (WI)	$566.11	$566.11
WEST VIRGINIA (WV)	$605.88	$605.88
WYOMING** (WY)	$601.32	$601.32

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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 each code. Each RVU component is adjusted by the Geographic Practice Cost Index (GPCI) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Practice-expense RVUs (and therefore the final amount) can differ between non-facility settings, such as a physician's office, and facility settings, such as a hospital, because the resources the practice must supply differ. For this code, the practice-expense RVU is the same in both settings, so the non-facility and facility amounts shown are equal.

RVUs — work 8.94, practice expense 7.82 (non-facility) / 7.82 (facility), malpractice 1.68 — × 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 beneficiary or secondary payer is generally responsible for the rest.
Modifiers, multiple-procedure reductions, sequestration, and other claim-specific adjustments can change the actual paid amount.
Amounts shown use the national conversion factor and may differ once localized by GPCI, and are subject to annual budget-neutrality adjustments.
Always confirm the final allowed amount and coverage rules with your Medicare Administrative Contractor (MAC).

Frequently asked

Why do the non-facility and facility amounts look the same for this code?

The practice-expense RVU used in this calculation is identical for both settings, so the resulting PFS amount comes out the same in this case.

Why does the amount differ by locality?

Each locality has its own GPCI values for work, practice expense, and malpractice, which adjust the RVUs to reflect local cost-of-practice differences before the conversion factor is applied.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before the standard 80/20 cost-sharing split, deductible status, and any claim-level adjustments like modifiers or sequestration.

Where can I verify this amount for my specific claim?

Check your MAC's published fee schedule for your locality or consult CMS's Physician Fee Schedule Look-Up Tool for the current year.

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.