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CPT code 19000: Breast aspiration, first cyst2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $111.68 for 19000 in the office and $38.32 when it’s performed in a hospital or facility.

$111.68Office (non-facility)
$38.32Hospital or facility
+16.1%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 King County, WA
  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 King County, WA 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. King County, WA pays $111.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

19000 in King County, WA vs other payment areas
  1. King County, WA · this page$111.68
  2. Rest of Washington · Washington$99.12−$12.56
  3. Los Angeles, CA · California$108.00−$3.68
  4. Washington, DC area · District of Columbia$109.68−$2.00
  5. Miami, FL · Florida$104.48−$7.20
  6. Chicago, IL · Illinois$101.47−$10.21
  7. Manhattan, NY · New York$110.65−$1.03

Other areas in Washington first, then benchmark localities. Bars start at $0.

Every other payment area

19000 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$112.47$48.80
AlabamaAlabama$86.46$34.14
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

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 19000 in King County, WA
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0500.8610
Practice expense1.95× 1.2272.3927
Malpractice0.11× 0.8170.0899
Total RVUs3.3435
Conversion factor× 33.4009

Office rate, King County, WA$111.68

Office: (0.82 × 1.05 + 1.95 × 1.227 + 0.11 × 0.817) × $33.4009 = $111.68

Facility: (0.82 × 1.05 + 0.16 × 1.227 + 0.11 × 0.817) × $33.4009 = $38.32

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, King County, WA
Add-on codes
19001Breast cyst aspiration, each additional cystThis code is the primary service to which 19001 adds each additional aspirated cyst.$29.27
Used instead
19083Breast biopsy, first lesion, ultrasound-guidedUltrasound-guided core biopsy when tissue sampling, rather than cyst-fluid aspiration, is performed.$561.09
19081Breast biopsy, stereotactic, first lesionStereotactic-guided core biopsy when tissue sampling, rather than cyst-fluid aspiration, is performed.$563.10

How 19000 has changed in King County, WA

19000 · Office / nonfacility

$111.68

Effective 2026-10-01

The base rate is $3.08 higher than on 2025-10-01, moving from $108.60 to $111.68 (2.8%).

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

    $108.60changed to$111.68

    • 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 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $115.95changed to$108.60

    • 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

    $114.05changed to$115.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $118.92changed to$114.05

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.11 changed to 2.06
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $121.23changed to$118.92

    • 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 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $125.83changed to$121.23

    • 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

    $125.85changed to$125.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.16 changed to 2.22
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $124.40changed to$125.85

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.17 changed to 2.16
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $127.57changed to$124.40

    • 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

    $126.69changed to$127.57

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $126.24changed to$126.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.26 changed to 2.25
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $126.69changed to$126.24

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $126.06changed to$126.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $124.60changed to$126.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.21 changed to 2.26
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $126.00changed to$124.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.40 changed to 2.21
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $126.00

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$111.68$38.32RVU26D
2026-07-01$111.68$38.32RVU26C
2026-04-01$111.68$38.32RVU26B
2026-01-01$111.68$38.32RVU26A
2025-10-01$108.60$43.88RVU25D
2025-07-01$108.60$43.88RVU25C
2025-04-01$108.60$43.88RVU25B
2025-01-01$108.60$43.88RVU25A
2024-10-01$115.95$44.47RVU24D
2024-07-01$115.95$44.47RVU24C
2024-04-01$115.95$44.47RVU24B
2024-03-09$115.95$44.47RVU24AR
2024-01-01$114.05$43.74RVU24A
2023-10-01$118.92$45.29RVU23D
2023-07-01$118.92$45.29RVU23C
2023-04-01$118.92$45.29RVU23B
2023-01-01$118.92$45.29RVU23A
2022-10-01$121.23$45.61RVU22D
2022-07-01$121.23$45.61RVU22C
2022-04-01$121.23$45.61RVU22B
2022-01-01$121.23$45.61RVU22A
2021-10-01$125.83$46.26RVU21D
2021-07-01$125.83$46.26RVU21C
2021-04-01$125.83$46.26RVU21B
2021-01-01$125.83$46.26RVU21A
2020-10-01$125.85$47.73RVU20D
2020-07-01$125.85$47.73RVU20C
2020-04-01$125.85$47.73RVU20B
2020-01-01$125.85$47.73RVU20A
2019-10-01$124.40$47.58RVU19D
2019-07-01$124.40$47.58RVU19C
2019-04-01$124.40$47.58RVU19B
2019-01-01$124.40$47.58RVU19A
2018-10-01$127.57$47.53RVU18D
2018-07-01$127.57$47.53RVU18C
2018-04-01$127.57$47.53RVU18B
2018-01-01$127.57$47.53RVU18AR1
2017-10-01$126.69$46.55RVU17D
2017-07-01$126.69$46.55RVU17C
2017-04-01$126.69$46.55RVU17B
2017-01-01$126.69$46.55RVU17A
2016-10-01$126.24$45.60RVU16D
2016-07-01$126.24$45.60RVU16C
2016-04-01$126.24$45.60RVU16B
2016-01-01$126.24$45.60RVU16A
2015-10-01$126.69$45.76RVU15D
2015-07-01$126.69$45.76RVU15C
2015-04-01$126.06$45.53RVU15B
2015-01-01$126.06$45.53RVU15A
2014-10-01$124.60$46.33RVU14D
2014-07-01$124.60$46.33RVU14C
2014-04-01$124.60$46.33RVU14B
2014-01-01$124.60$46.33RVU14A
2013-10-01$126.00$44.66RVU13D
2013-07-01$126.00$44.66RVU13C
2013-04-01$126.00$44.66RVU13B
2013-01-01$126.00$44.66RVU13AR

Price 19000 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 19000 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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