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CPT code 19000: Breast aspiration, first cyst2026 Medicare rate & RVUs in Washington, DC area

Reports needle aspiration of a breast cyst, typically to relieve symptoms or evaluate a fluid-filled lesion without taking a core tissue sample.

CMS RVU26DEffective Oct 1, 2026One payment locality5.9K Medicare services in 2024

In Washington, DC area, Medicare pays $109.68 for 19000 in the office and $39.25 when it’s performed in a hospital or facility.

$109.68Office (non-facility)
$39.25Hospital or facility
+14.0%vs the national office rate ($96.19)

Check a contract rate as a % of Medicare · 19000 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 19000 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 19000 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 19000 covers

A clinician uses a needle to withdraw fluid from a breast cyst, commonly one that is palpable, uncomfortable, or identified on imaging. The service may be performed in an office or facility by a physician involved in breast care, such as a breast surgeon or radiologist. Aspiration removes cyst fluid; it is distinct from taking a core tissue sample from a breast lesion.

Report 19000 for the first cyst aspirated in the session and 19001 for each additional cyst. Document the cyst’s location, the clinical reason for aspiration, and the aspiration performed; identify additional cysts when reporting the add-on code. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 19000

Across 109 of 109 payment localities, the office rate for 19000 runs from $85.23 in Arkansas to $126.29 in San Benito County, CA. Washington, DC area pays $109.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

19000 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$109.68
  2. Los Angeles, CA · California$108.00−$1.68
  3. Miami, FL · Florida$104.48−$5.20
  4. Chicago, IL · Illinois$101.47−$8.21
  5. Manhattan, NY · New York$110.65+$0.97
  6. Alaska · Alaska$112.47+$2.79
  7. Alabama · Alabama$86.46−$23.22

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

19000 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$85.23$33.87
ArizonaArizona$93.65$35.71
Bakersfield, CACalifornia$101.53$36.00
Chico, CACalifornia$101.21$35.68
El Centro, CACalifornia$101.23$35.70
Fresno, CACalifornia$101.21$35.68
Hanford, CACalifornia$101.21$35.68
Madera, CACalifornia$101.21$35.68

19000 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$85.23

$113.75

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
19000 office rate range by state
State / territoryOffice rate rangeLocalities
AK$112.471
AL$86.461
AR$85.231
AZ$93.651
CA$101.21–$126.2929
CO$99.891
CT$102.531
DC$109.681
DE$95.181
FL$95.18–$104.483
GA$89.87–$98.062
GU$103.571
HI$103.571
IA$88.441
ID$89.051
IL$92.60–$101.474
IN$89.551
KS$88.121
KY$88.651
LA$88.55–$92.852
MA$99.34–$109.552
MD$96.95–$109.683
ME$89.60–$94.252
MI$91.00–$96.442
MN$95.501
MO$87.11–$93.083
MS$86.181
MT$96.191
NC$90.501
ND$94.011
NE$88.891
NH$98.411
NJ$103.64–$108.592
NM$91.531
NV$95.651
NY$91.85–$113.415
OH$90.561
OK$88.411
OR$94.84–$102.922
PA$90.65–$100.072
PR$96.861
RI$98.471
SC$90.691
SD$93.751
TN$88.571
TX$90.07–$99.618
UT$91.911
VA$94.01–$109.682
VI$96.861
VT$93.731
WA$99.12–$111.682
WI$90.921
WV$89.251
WY$95.241

See 19000 in every payment locality

How the 19000 rate is calculated

Each of 19000’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 19000

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.82

0.82 RVUs× 1.000 GPCI

Practice expense1.95

1.95 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

2.8800

Conversion factor

$33.4009

Medicare rate

$96.19

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,655

Code
19000
Physician work
0.82
Practice expense
1.95
Malpractice
0.11

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 19000 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0540.8643
Practice expense1.95× 1.1782.2971
Malpractice0.11× 1.1130.1224
Total RVUs3.2838
Conversion factor× 33.4009

Office rate, Washington, DC area$109.68

Office: (0.82 × 1.054 + 1.95 × 1.178 + 0.11 × 1.113) × $33.4009 = $109.68

Facility: (0.82 × 1.054 + 0.16 × 1.178 + 0.11 × 1.113) × $33.4009 = $39.25

Open 19000 in the RVU calculator

Payment rules and modifiers for 19000

The CMS indicators that decide how 19000 is paid alongside other services.

CMS payment indicators · 19000

Breast aspiration, first cyst

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

19000 without 51 · national office

$96.19

Breast aspiration, first cyst

19000-51 · Second procedure: 50%

$48.10

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 19000

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 19000
CodeHow it relatesOffice range, Washington, DC area
Add-on codes
19001Breast cyst aspiration, each additional cystThis code is the primary service to which 19001 adds each additional aspirated cyst.$29.28
Used instead
19083Breast biopsy, first lesion, ultrasound-guidedUltrasound-guided core biopsy when tissue sampling, rather than cyst-fluid aspiration, is performed.$547.04
19081Breast biopsy, stereotactic, first lesionStereotactic-guided core biopsy when tissue sampling, rather than cyst-fluid aspiration, is performed.$549.38

How 19000 has changed in Washington, DC area

19000 · Office / nonfacility

$109.68

Effective 2026-10-01

The base rate is $1.24 higher than on 2025-10-01, moving from $108.44 to $109.68 (1.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $108.44changed to$109.68

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.84 changed to 0.82
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $115.57changed to$108.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.06 changed to 1.95
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $113.68changed to$115.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $121.45changed to$113.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.11 changed to 2.06
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $126.65changed to$121.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.14 changed to 2.11
    • Malpractice RVU 0.10 changed to 0.11
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $131.60changed to$126.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.22 changed to 2.14
    • Malpractice RVU 0.11 changed to 0.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $132.05changed to$131.60

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.16 changed to 2.22
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $130.87changed to$132.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.17 changed to 2.16
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $134.20changed to$130.87

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.25 changed to 2.17

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $133.91changed to$134.20

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $134.16changed to$133.91

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.26 changed to 2.25
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $134.64changed to$134.16

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $133.97changed to$134.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $131.50changed to$133.97

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.21 changed to 2.26
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $132.03changed to$131.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.40 changed to 2.21
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $132.03

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$109.68$39.25RVU26D
2026-07-01$109.68$39.25RVU26C
2026-04-01$109.68$39.25RVU26B
2026-01-01$109.68$39.25RVU26A
2025-10-01$108.44$45.21RVU25D
2025-07-01$108.44$45.21RVU25C
2025-04-01$108.44$45.21RVU25B
2025-01-01$108.44$45.21RVU25A
2024-10-01$115.57$45.74RVU24D
2024-07-01$115.57$45.74RVU24C
2024-04-01$115.57$45.74RVU24B
2024-03-09$115.57$45.74RVU24AR
2024-01-01$113.68$44.99RVU24A
2023-10-01$121.45$47.40RVU23D
2023-07-01$121.45$47.40RVU23C
2023-04-01$121.45$47.40RVU23B
2023-01-01$121.45$47.40RVU23A
2022-10-01$126.65$48.38RVU22D
2022-07-01$126.65$48.38RVU22C
2022-04-01$126.65$48.38RVU22B
2022-01-01$126.65$48.38RVU22A
2021-10-01$131.60$49.23RVU21D
2021-07-01$131.60$49.23RVU21C
2021-04-01$131.60$49.23RVU21B
2021-01-01$131.60$49.23RVU21A
2020-10-01$132.05$50.53RVU20D
2020-07-01$132.05$50.53RVU20C
2020-04-01$132.05$50.53RVU20B
2020-01-01$132.05$50.53RVU20A
2019-10-01$130.87$50.10RVU19D
2019-07-01$130.87$50.10RVU19C
2019-04-01$130.87$50.10RVU19B
2019-01-01$130.87$50.10RVU19A
2018-10-01$134.20$50.04RVU18D
2018-07-01$134.20$50.04RVU18C
2018-04-01$134.20$50.04RVU18B
2018-01-01$134.20$50.04RVU18AR1
2017-10-01$133.91$50.02RVU17D
2017-07-01$133.91$50.02RVU17C
2017-04-01$133.91$50.02RVU17B
2017-01-01$133.91$50.02RVU17A
2016-10-01$134.16$50.03RVU16D
2016-07-01$134.16$50.03RVU16C
2016-04-01$134.16$50.03RVU16B
2016-01-01$134.16$50.03RVU16A
2015-10-01$134.64$50.21RVU15D
2015-07-01$134.64$50.21RVU15C
2015-04-01$133.97$49.96RVU15B
2015-01-01$133.97$49.96RVU15A
2014-10-01$131.50$49.69RVU14D
2014-07-01$131.50$49.69RVU14C
2014-04-01$131.50$49.69RVU14B
2014-01-01$131.50$49.69RVU14A
2013-10-01$132.03$46.84RVU13D
2013-07-01$132.03$46.84RVU13C
2013-04-01$132.03$46.84RVU13B
2013-01-01$132.03$46.84RVU13AR

Price 19000 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

19000 billing questions

When should 19001 be reported instead of 19000?

Report 19000 for the first breast cyst aspirated. Report 19001 for each additional cyst aspirated during the session.

Is cyst aspiration the same as a breast core biopsy?

No. Aspiration withdraws fluid from a cyst; a core biopsy obtains tissue from a lesion. Use the code that reflects the service actually performed.

Can modifier 50 be used when cysts in both breasts are aspirated?

No. CMS identifies bilateral adjustment as inappropriate for this code, so do not use modifier 50.

Does 19000 have a global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

How does the multiple-procedure rule affect 19000?

When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 19000PPRRVU2026_Oct_nonQPP.csv, line 1,655 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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