CPT code 19001: Breast cyst aspiration, each additional cyst2026 Medicare rate & RVUs in Montana
Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration.
In Montana, Medicare pays $26.38 for 19001 in the office and $18.03 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 19001 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 19001 covers
Code 19001 represents aspiration of each additional breast cyst after the initial cyst is aspirated. A needle is placed into a distinct fluid-filled breast cyst and fluid is withdrawn; this is commonly performed by a breast surgeon, radiologist, or other qualified clinician in an office or imaging setting. It applies to additional cysts treated in the same session, not to repeated passes into one cyst.
Report 19001 only with the primary breast cyst aspiration code 19000, using one unit for each additional cyst aspirated beyond the first. The record should identify the separate cysts treated and support aspiration at each site; multiple needle passes into one cyst do not establish additional cyst units. CMS classifies 19001 as an add-on code and pays it within the primary procedure’s global period, so it is not submitted by itself. When the service samples tissue from a breast lesion rather than aspirating a cyst, use the applicable biopsy code instead.
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 Montana compares for 19001
Across 109 of 109 payment localities, the office rate for 19001 runs from $24.02 in Arkansas to $33.20 in Alaska. Montana pays $26.38. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$26.38
- Los Angeles, CA · California$28.40+$2.02
- Washington, DC area · District of Columbia$29.28+$2.90
- Miami, FL · Florida$29.39+$3.01
- Chicago, IL · Illinois$28.70+$2.32
- Manhattan, NY · New York$30.03+$3.65
- Alaska · Alaska$33.20+$6.82
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $24.28 | $16.98 |
| ArkansasArkansas | $24.02 | $16.85 |
| ArizonaArizona | $25.80 | $17.71 |
| Bakersfield, CACalifornia | $27.05 | $17.90 |
| Chico, CACalifornia | $26.90 | $17.75 |
| El Centro, CACalifornia | $26.91 | $17.76 |
| Fresno, CACalifornia | $26.90 | $17.75 |
| Hanford, CACalifornia | $26.90 | $17.75 |
| Madera, CACalifornia | $26.90 | $17.75 |
| Merced, CACalifornia | $26.90 | $17.75 |
| Modesto, CACalifornia | $26.90 | $17.75 |
| Napa, CACalifornia | $29.93 | $18.93 |
| Oxnard, CACalifornia | $28.15 | $18.28 |
| Redding, CACalifornia | $26.90 | $17.75 |
| Rest of CaliforniaCalifornia | $26.90 | $17.75 |
| Riverside, CACalifornia | $27.45 | $18.29 |
| Sacramento, CACalifornia | $27.90 | $18.19 |
| Salinas, CACalifornia | $27.79 | $18.11 |
| San Diego, CACalifornia | $28.19 | $18.21 |
| Marin County, CACalifornia | $31.30 | $19.53 |
| San Francisco, CACalifornia | $31.25 | $19.47 |
| San Benito County, CACalifornia | $31.99 | $19.95 |
| Santa Clara County, CACalifornia | $31.76 | $19.72 |
| San Luis Obispo, CACalifornia | $27.38 | $17.87 |
| Santa Cruz, CACalifornia | $28.27 | $18.12 |
| Santa Maria, CACalifornia | $27.82 | $18.09 |
| Santa Rosa, CACalifornia | $28.54 | $18.28 |
| Stockton, CACalifornia | $26.90 | $17.75 |
| Vallejo, CACalifornia | $29.85 | $18.85 |
| Visalia, CACalifornia | $26.90 | $17.75 |
| Yuba City, CACalifornia | $26.90 | $17.75 |
| ColoradoColorado | $26.89 | $18.01 |
| ConnecticutConnecticut | $27.86 | $18.87 |
| DelawareDelaware | $26.15 | $17.90 |
| Fort Lauderdale, FLFlorida | $27.88 | $19.42 |
| Rest of FloridaFlorida | $26.74 | $18.76 |
| Atlanta, GAGeorgia | $26.94 | $18.46 |
| Rest of GeorgiaGeorgia | $25.52 | $18.07 |
| Hawaii, Guam, HIHawaii | $27.19 | $17.70 |
| IowaIowa | $24.44 | $16.80 |
| IdahoIdaho | $24.62 | $16.94 |
| East St. Louis, ILIllinois | $27.20 | $19.52 |
| Rest of IllinoisIllinois | $26.37 | $18.74 |
| Suburban Chicago, ILIllinois | $28.07 | $19.49 |
| IndianaIndiana | $24.72 | $16.98 |
| KansasKansas | $24.50 | $16.95 |
| KentuckyKentucky | $25.02 | $17.60 |
| New Orleans, LALouisiana | $25.96 | $18.11 |
| Rest of LouisianaLouisiana | $25.05 | $17.66 |
| Metropolitan Boston, MAMassachusetts | $28.90 | $18.93 |
| Rest of MassachusettsMassachusetts | $26.85 | $18.06 |
| Baltimore area, MDMaryland | $27.81 | $18.85 |
| Rest of MarylandMaryland | $26.52 | $18.07 |
| Rest of MaineMaine | $24.87 | $17.19 |
| Southern Maine, MEMaine | $25.67 | $17.40 |
| Detroit, MIMichigan | $27.15 | $19.09 |
| Rest of MichiganMichigan | $25.64 | $18.02 |
| MinnesotaMinnesota | $25.53 | $16.94 |
| Metropolitan Kansas City, MOMissouri | $25.68 | $17.84 |
| Metropolitan St. Louis, MOMissouri | $25.86 | $17.91 |
| Rest of MissouriMissouri | $24.82 | $17.62 |
| MississippiMississippi | $24.42 | $17.23 |
| North CarolinaNorth Carolina | $25.05 | $17.25 |
| North DakotaNorth Dakota | $25.39 | $17.04 |
| NebraskaNebraska | $24.50 | $16.79 |
| New HampshireNew Hampshire | $26.63 | $17.94 |
| Northern New JerseyNew Jersey | $29.13 | $19.44 |
| Rest of New JerseyNew Jersey | $28.11 | $18.99 |
| New MexicoNew Mexico | $25.81 | $18.15 |
| NevadaNevada | $26.12 | $17.76 |
| NYC suburbs and Long Island, NYNew York | $30.78 | $20.85 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $28.40 | $19.26 |
| Queens, NYNew York | $30.01 | $20.14 |
| Rest of New YorkNew York | $25.34 | $17.41 |
| OhioOhio | $25.44 | $17.82 |
| OklahomaOklahoma | $24.83 | $17.38 |
| Portland, OROregon | $27.40 | $18.12 |
| Rest of OregonOregon | $25.85 | $17.53 |
| Metropolitan Philadelphia, PAPennsylvania | $27.41 | $18.71 |
| Rest of PennsylvaniaPennsylvania | $25.39 | $17.73 |
| Puerto RicoPuerto Rico | $26.48 | $18.04 |
| Rhode IslandRhode Island | $26.83 | $18.20 |
| South CarolinaSouth Carolina | $25.30 | $17.58 |
| South DakotaSouth Dakota | $25.28 | $16.93 |
| TennesseeTennessee | $24.61 | $17.02 |
| Austin, TXTexas | $26.86 | $18.03 |
| Beaumont, TXTexas | $25.28 | $17.68 |
| Brazoria, TXTexas | $26.03 | $17.75 |
| Dallas, TXTexas | $26.23 | $17.91 |
| Fort Worth, TXTexas | $26.14 | $17.91 |
| Galveston, TXTexas | $26.13 | $17.84 |
| Houston, TXTexas | $27.05 | $18.76 |
| Rest of TexasTexas | $25.66 | $17.74 |
| UtahUtah | $25.56 | $17.71 |
| VirginiaVirginia | $25.71 | $17.50 |
| Virgin Islands, VIUnited States Virgin Islands | $26.48 | $18.04 |
| VermontVermont | $25.45 | $17.18 |
| Rest of WashingtonWashington | $26.75 | $17.96 |
| King County, WAWashington | $29.27 | $19.02 |
| WisconsinWisconsin | $24.77 | $16.77 |
| West VirginiaWest Virginia | $25.66 | $18.41 |
| WyomingWyoming | $25.95 | $17.60 |
19001 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$24.02
$33.20
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $33.20 | 1 |
| AL | $24.28 | 1 |
| AR | $24.02 | 1 |
| AZ | $25.80 | 1 |
| CA | $26.90–$31.99 | 29 |
| CO | $26.89 | 1 |
| CT | $27.86 | 1 |
| DC | $29.28 | 1 |
| DE | $26.15 | 1 |
| FL | $26.74–$29.39 | 3 |
| GA | $25.52–$26.94 | 2 |
| GU | $27.19 | 1 |
| HI | $27.19 | 1 |
| IA | $24.44 | 1 |
| ID | $24.62 | 1 |
| IL | $26.37–$28.70 | 4 |
| IN | $24.72 | 1 |
| KS | $24.50 | 1 |
| KY | $25.02 | 1 |
| LA | $25.05–$25.96 | 2 |
| MA | $26.85–$28.90 | 2 |
| MD | $26.52–$29.28 | 3 |
| ME | $24.87–$25.67 | 2 |
| MI | $25.64–$27.15 | 2 |
| MN | $25.53 | 1 |
| MO | $24.82–$25.86 | 3 |
| MS | $24.42 | 1 |
| MT | $26.38 | 1 |
| NC | $25.05 | 1 |
| ND | $25.39 | 1 |
| NE | $24.50 | 1 |
| NH | $26.63 | 1 |
| NJ | $28.11–$29.13 | 2 |
| NM | $25.81 | 1 |
| NV | $26.12 | 1 |
| NY | $25.34–$30.78 | 5 |
| OH | $25.44 | 1 |
| OK | $24.83 | 1 |
| OR | $25.85–$27.40 | 2 |
| PA | $25.39–$27.41 | 2 |
| PR | $26.48 | 1 |
| RI | $26.83 | 1 |
| SC | $25.30 | 1 |
| SD | $25.28 | 1 |
| TN | $24.61 | 1 |
| TX | $25.28–$27.05 | 8 |
| UT | $25.56 | 1 |
| VA | $25.71–$29.28 | 2 |
| VI | $26.48 | 1 |
| VT | $25.45 | 1 |
| WA | $26.75–$29.27 | 2 |
| WI | $24.77 | 1 |
| WV | $25.66 | 1 |
| WY | $25.95 | 1 |
How the 19001 rate is calculated
Each of 19001’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 · 19001
RVUs × geographic indexes × conversion factor
Work0.41
0.41 RVUs× 1.000 GPCI
Practice expense0.33
0.33 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
0.7900
Conversion factor
$33.4009
Medicare rate
$26.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,656
- Code
- 19001
- Physician work
- 0.41
- Practice expense
- 0.33
- Malpractice
- 0.05
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.41 | × 1.000 | 0.4100 |
| Practice expense | 0.33 | × 1.000 | 0.3300 |
| Malpractice | 0.05 | × 0.998 | 0.0499 |
| Total RVUs | 0.7899 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$26.38
Office: (0.41 × 1 + 0.33 × 1 + 0.05 × 0.998) × $33.4009 = $26.38
Facility: (0.41 × 1 + 0.08 × 1 + 0.05 × 0.998) × $33.4009 = $18.03
Payment rules and modifiers for 19001
The CMS indicators that decide how 19001 is paid alongside other services.
CMS payment indicators · 19001
Breast cyst aspiration, each additional cyst
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 19001 has changed in Montana
19001 · Office / nonfacility
$26.38
Effective 2026-10-01
The base rate is $1.18 higher than on 2025-10-01, moving from $25.20 to $26.38 (4.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$25.20changed to$26.38
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.42 changed to 0.41
- Practice expense RVU 0.32 changed to 0.33
- Malpractice RVU 0.04 changed to 0.05
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$26.26changed to$25.20
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.05 changed to 0.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$25.83changed to$26.26
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$26.40changed to$25.83
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.04 changed to 0.05
January 1, 2023
RVU23A
$27.30changed to$26.40
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.05 changed to 0.04
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$27.53changed to$27.30
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$28.70changed to$27.53
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.31 changed to 0.32
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$28.89changed to$28.70
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.30 changed to 0.31
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$28.86changed to$28.89
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$28.40changed to$28.86
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$27.97changed to$28.40
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$28.07changed to$27.97
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$27.94changed to$28.07
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$27.52changed to$27.94
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.29 changed to 0.30
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$26.71changed to$27.52
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.31 changed to 0.29
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $26.71
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $26.38 | $18.03 | RVU26D |
| 2026-07-01 | $26.38 | $18.03 | RVU26C |
| 2026-04-01 | $26.38 | $18.03 | RVU26B |
| 2026-01-01 | $26.38 | $18.03 | RVU26A |
| 2025-10-01 | $25.20 | $19.70 | RVU25D |
| 2025-07-01 | $25.20 | $19.70 | RVU25C |
| 2025-04-01 | $25.20 | $19.70 | RVU25B |
| 2025-01-01 | $25.20 | $19.70 | RVU25A |
| 2024-10-01 | $26.26 | $20.60 | RVU24D |
| 2024-07-01 | $26.26 | $20.60 | RVU24C |
| 2024-04-01 | $26.26 | $20.60 | RVU24B |
| 2024-03-09 | $26.26 | $20.60 | RVU24AR |
| 2024-01-01 | $25.83 | $20.27 | RVU24A |
| 2023-10-01 | $26.40 | $20.64 | RVU23D |
| 2023-07-01 | $26.40 | $20.64 | RVU23C |
| 2023-04-01 | $26.40 | $20.64 | RVU23B |
| 2023-01-01 | $26.40 | $20.64 | RVU23A |
| 2022-10-01 | $27.30 | $21.42 | RVU22D |
| 2022-07-01 | $27.30 | $21.42 | RVU22C |
| 2022-04-01 | $27.30 | $21.42 | RVU22B |
| 2022-01-01 | $27.30 | $21.42 | RVU22A |
| 2021-10-01 | $27.53 | $21.59 | RVU21D |
| 2021-07-01 | $27.53 | $21.59 | RVU21C |
| 2021-04-01 | $27.53 | $21.59 | RVU21B |
| 2021-01-01 | $27.53 | $21.59 | RVU21A |
| 2020-10-01 | $28.70 | $23.29 | RVU20D |
| 2020-07-01 | $28.70 | $23.29 | RVU20C |
| 2020-04-01 | $28.70 | $23.29 | RVU20B |
| 2020-01-01 | $28.70 | $23.29 | RVU20A |
| 2019-10-01 | $28.89 | $23.48 | RVU19D |
| 2019-07-01 | $28.89 | $23.48 | RVU19C |
| 2019-04-01 | $28.89 | $23.48 | RVU19B |
| 2019-01-01 | $28.89 | $23.48 | RVU19A |
| 2018-10-01 | $28.86 | $23.46 | RVU18D |
| 2018-07-01 | $28.86 | $23.46 | RVU18C |
| 2018-04-01 | $28.86 | $23.46 | RVU18B |
| 2018-01-01 | $28.86 | $23.46 | RVU18AR1 |
| 2017-10-01 | $28.40 | $23.38 | RVU17D |
| 2017-07-01 | $28.40 | $23.38 | RVU17C |
| 2017-04-01 | $28.40 | $23.38 | RVU17B |
| 2017-01-01 | $28.40 | $23.38 | RVU17A |
| 2016-10-01 | $27.97 | $22.96 | RVU16D |
| 2016-07-01 | $27.97 | $22.96 | RVU16C |
| 2016-04-01 | $27.97 | $22.96 | RVU16B |
| 2016-01-01 | $27.97 | $22.96 | RVU16A |
| 2015-10-01 | $28.07 | $23.04 | RVU15D |
| 2015-07-01 | $28.07 | $23.04 | RVU15C |
| 2015-04-01 | $27.94 | $22.93 | RVU15B |
| 2015-01-01 | $27.94 | $22.93 | RVU15A |
| 2014-10-01 | $27.52 | $22.51 | RVU14D |
| 2014-07-01 | $27.52 | $22.51 | RVU14C |
| 2014-04-01 | $27.52 | $22.51 | RVU14B |
| 2014-01-01 | $27.52 | $22.51 | RVU14A |
| 2013-10-01 | $26.71 | $21.61 | RVU13D |
| 2013-07-01 | $26.71 | $21.61 | RVU13C |
| 2013-04-01 | $26.71 | $21.61 | RVU13B |
| 2013-01-01 | $26.71 | $21.61 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
19001 billing questions
Can 19001 be reported without 19000?
No. It is an add-on code and must be reported with the primary breast cyst aspiration code 19000.
How many units of 19001 should be reported?
Report one unit for each additional distinct breast cyst aspirated after the first cyst. Multiple needle passes into the same cyst do not count as additional cysts.
How does 19001 differ from 19000?
Code 19000 reports aspiration of the first breast cyst. Code 19001 reports each additional cyst aspirated in the same session.
What documentation supports additional units?
Document the distinct cysts treated and that aspiration was performed at each site. The record should distinguish separate cysts from repeat passes into one cyst.
When is a breast biopsy code more appropriate?
Use a biopsy code when the service obtains tissue from a lesion for diagnosis rather than withdrawing fluid from a breast cyst.
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
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