Medicare Reimbursement for CPT 19380

CPT 19380 is a procedure code billed under Medicare Part B; the official descriptor is licensed by the AMA and is not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) allowed amount for this code, both at the national level and adjusted for locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$735.82	$735.82
ALASKA* (AK)	$906.68	$906.68
ALABAMA (AL)	$668.15	$668.15
ARKANSAS (AR)	$659.80	$659.80
ARIZONA (AZ)	$716.55	$716.55
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$855.49	$855.49
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$868.74	$868.74
OXNARD-THOUSAND OAKS-VENTURA (CA)	$775.45	$775.45
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$783.29	$783.29
NAPA (CA)	$821.60	$821.60
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$857.82	$857.82
VALLEJO (CA)	$818.24	$818.24
BAKERSFIELD (CA)	$745.11	$745.11
CHICO (CA)	$739.38	$739.38
FRESNO (CA)	$739.38	$739.38
HANFORD-CORCORAN (CA)	$739.38	$739.38
MADERA (CA)	$739.38	$739.38
MERCED (CA)	$739.38	$739.38
MODESTO (CA)	$739.38	$739.38
REDDING (CA)	$739.38	$739.38
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$761.45	$761.45
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$766.63	$766.63
SALINAS (CA)	$763.60	$763.60
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$878.26	$878.26
SANTA CRUZ-WATSONVILLE (CA)	$776.97	$776.97
SANTA ROSA-PETALUMA (CA)	$784.19	$784.19
STOCKTON (CA)	$739.38	$739.38
VISALIA (CA)	$739.38	$739.38
YUBA CITY (CA)	$739.38	$739.38
EL CENTRO (CA)	$739.72	$739.72
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$774.88	$774.88
SAN LUIS OBISPO-PASO ROBLES (CA)	$752.44	$752.44
SANTA MARIA-SANTA BARBARA (CA)	$764.64	$764.64
REST OF CALIFORNIA (CA)	$739.38	$739.38
COLORADO (CO)	$744.62	$744.62
CONNECTICUT (CT)	$780.85	$780.85
DC + MD/VA SUBURBS (DC)	$817.24	$817.24
DELAWARE (DE)	$727.08	$727.08
FORT LAUDERDALE (FL)	$795.09	$795.09
MIAMI (FL)	$852.96	$852.96
REST OF FLORIDA (FL)	$756.90	$756.90
ATLANTA (GA)	$755.53	$755.53
REST OF GEORGIA (GA)	$716.18	$716.18
HAWAII, GUAM (HI)	$748.59	$748.59
IOWA (IA)	$668.73	$668.73
IDAHO (ID)	$675.45	$675.45
EAST ST. LOUIS (IL)	$780.96	$780.96
SUBURBAN CHICAGO (IL)	$799.43	$799.43
CHICAGO (IL)	$828.56	$828.56
REST OF ILLINOIS (IL)	$747.96	$747.96
INDIANA (IN)	$678.46	$678.46
KANSAS (KS)	$672.71	$672.71
KENTUCKY (KY)	$696.30	$696.30
NEW ORLEANS (LA)	$727.22	$727.22
REST OF LOUISIANA (LA)	$698.03	$698.03
METROPOLITAN BOSTON (MA)	$802.10	$802.10
REST OF MASSACHUSETTS (MA)	$743.83	$743.83
BALTIMORE/SURR. CNTYS (MD)	$780.03	$780.03
REST OF MARYLAND (MD)	$737.49	$737.49
SOUTHERN MAINE (ME)	$707.82	$707.82
REST OF MAINE (ME)	$685.65	$685.65
DETROIT (MI)	$772.17	$772.17
REST OF MICHIGAN (MI)	$718.24	$718.24
MINNESOTA (MN)	$696.42	$696.42
METROPOLITAN ST. LOUIS (MO)	$721.39	$721.39
METROPOLITAN KANSAS CITY (MO)	$715.73	$715.73
REST OF MISSOURI (MO)	$692.14	$692.14
MISSISSIPPI (MS)	$675.75	$675.75
MONTANA** (MT)	$735.68	$735.68
NORTH CAROLINA (NC)	$690.76	$690.76
NORTH DAKOTA** (ND)	$695.15	$695.15
NEBRASKA (NE)	$669.85	$669.85
NEW HAMPSHIRE (NH)	$739.71	$739.71
NORTHERN NJ (NJ)	$811.97	$811.97
REST OF NEW JERSEY (NJ)	$784.95	$784.95
NEW MEXICO (NM)	$724.38	$724.38
NEVADA** (NV)	$724.69	$724.69
MANHATTAN (NY)	$848.41	$848.41
NYC SUBURBS/LONG ISLAND (NY)	$875.16	$875.16
POUGHKPSIE/N NYC SUBURBS (NY)	$795.41	$795.41
QUEENS (NY)	$844.62	$844.62
REST OF NEW YORK (NY)	$700.30	$700.30
OHIO (OH)	$709.96	$709.96
OKLAHOMA (OK)	$688.07	$688.07
PORTLAND (OR)	$757.81	$757.81
REST OF OREGON (OR)	$714.27	$714.27
METROPOLITAN PHILADELPHIA (PA)	$768.03	$768.03
REST OF PENNSYLVANIA (PA)	$707.16	$707.16
PUERTO RICO (PR)	$738.13	$738.13
RHODE ISLAND (RI)	$745.36	$745.36
SOUTH CAROLINA (SC)	$702.48	$702.48
SOUTH DAKOTA** (SD)	$690.36	$690.36
TENNESSEE (TN)	$676.49	$676.49
BRAZORIA (TX)	$720.94	$720.94
DALLAS (TX)	$728.16	$728.16
GALVESTON (TX)	$724.83	$724.83
HOUSTON (TX)	$762.35	$762.35
BEAUMONT (TX)	$703.64	$703.64
FORT WORTH (TX)	$726.01	$726.01
AUSTIN (TX)	$746.35	$746.35
REST OF TEXAS (TX)	$713.70	$713.70
UTAH (UT)	$710.62	$710.62
VIRGINIA (VA)	$710.53	$710.53
VIRGIN ISLANDS (VI)	$738.13	$738.13
VERMONT (VT)	$698.96	$698.96
SEATTLE (KING CNTY) (WA)	$810.40	$810.40
REST OF WASHINGTON (WA)	$740.28	$740.28
WISCONSIN (WI)	$675.69	$675.69
WEST VIRGINIA (WV)	$725.56	$725.56
WYOMING** (WY)	$718.02	$718.02

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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) — work, practice expense (PE), and malpractice (MP) — that reflect the physician effort, overhead costs, and liability risk associated with the service. Each RVU component is adjusted by a locality-specific Geographic Practice Cost Index (GPCI) to account for regional cost differences, then the adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility rates can differ because the PE RVU is typically lower in a facility setting, where the facility (not the physician's office) bears certain overhead costs. For this code, the practice-expense RVU is the same in both settings, so the non-facility and facility national amounts shown are equal.

RVUs — work 10.89, practice expense 9.09 (non-facility) / 9.09 (facility), malpractice 2.05 — × 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 generally responsible for the rest.
Actual payment varies by locality GPCI, applicable modifiers, place of service, sequestration, and annual budget-neutrality adjustments to the conversion factor.
Fee schedule amounts are subject to mid-year or annual revisions; always confirm the current rate with your Medicare Administrative Contractor (MAC).
This page does not include bundling edits, multiple-procedure reductions, or other claim-adjudication adjustments that can change the final paid amount.

Frequently asked

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

The practice-expense RVU used in the formula is identical for non-facility and facility settings for this particular code, so the calculated allowed amount comes out the same in both settings.

Does this amount reflect what Medicare will actually pay?

No. It reflects the Medicare-allowed amount before the patient's deductible and coinsurance are applied, and before locality, modifier, or sequestration adjustments are factored in for a specific claim.

Why can the amount change during the year?

CMS can issue mid-year corrections, and the conversion factor and RVUs are subject to budget-neutrality adjustments and annual rulemaking, which can shift the allowed amount from one update to the next.

Where can I verify the exact rate for my location?

Your Medicare Administrative Contractor (MAC) publishes locality-specific fee schedules, which apply the GPCI adjustments for your specific geographic area.

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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.