CPT code 19001: Breast cyst aspiration, each additional cyst2026 Medicare rate & RVUs in Virginia

Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration.

CMS RVU26DEffective Oct 1, 2026One payment locality417 Medicare services in 2024

In Virginia, Medicare pays $25.71 for 19001 in the office and $17.50 when it’s performed in a hospital or facility.

$25.71Office (non-facility)
$17.50Hospital or facility
−2.6%vs the national office rate ($26.39)

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.

We’ll open 19001 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 19001 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 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 A needle is placed into a distinct fluid-filled breast cyst and fluid is withdrawn; this is commonly performed by a breast surgeon, radiologist, or other qualified clinician in an office or imaging setting.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 Virginia 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. Virginia pays $25.71. The RVUs are the same everywhere; the geographic indexes change the dollars.

19001 in Virginia vs other payment areas
  1. Virginia · this page$25.71
  2. Los Angeles, CA · California$28.40+$2.69
  3. Washington, DC area · District of Columbia$29.28+$3.57
  4. Miami, FL · Florida$29.39+$3.68
  5. Chicago, IL · Illinois$28.70+$2.99
  6. Manhattan, NY · New York$30.03+$4.32
  7. Alaska · Alaska$33.20+$7.49

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

Every other payment area

19001 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
19001 office rate range by state
State / territoryOffice rate rangeLocalities
AK$33.201
AL$24.281
AR$24.021
AZ$25.801
CA$26.90–$31.9929
CO$26.891
CT$27.861
DC$29.281
DE$26.151
FL$26.74–$29.393
GA$25.52–$26.942
GU$27.191
HI$27.191
IA$24.441
ID$24.621
IL$26.37–$28.704
IN$24.721
KS$24.501
KY$25.021
LA$25.05–$25.962
MA$26.85–$28.902
MD$26.52–$29.283
ME$24.87–$25.672
MI$25.64–$27.152
MN$25.531
MO$24.82–$25.863
MS$24.421
MT$26.381
NC$25.051
ND$25.391
NE$24.501
NH$26.631
NJ$28.11–$29.132
NM$25.811
NV$26.121
NY$25.34–$30.785
OH$25.441
OK$24.831
OR$25.85–$27.402
PA$25.39–$27.412
PR$26.481
RI$26.831
SC$25.301
SD$25.281
TN$24.611
TX$25.28–$27.058
UT$25.561
VA$25.71–$29.282
VI$26.481
VT$25.451
WA$26.75–$29.272
WI$24.771
WV$25.661
WY$25.951

See 19001 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 19001 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.41× 1.0000.4100
Practice expense0.33× 0.9830.3244
Malpractice0.05× 0.7060.0353
Total RVUs0.7697
Conversion factor× 33.4009

Office rate, Virginia$25.71

Office: (0.41 × 1 + 0.33 × 0.983 + 0.05 × 0.706) × $33.4009 = $25.71

Facility: (0.41 × 1 + 0.08 × 0.983 + 0.05 × 0.706) × $33.4009 = $17.50

Open 19001 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

How 19001 has changed in Virginia

19001 · Office / nonfacility

$25.71

Effective 2026-10-01

The base rate is $0.94 higher than on 2025-10-01, moving from $24.77 to $25.71 (3.8%).

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

    $24.77changed to$25.71

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $25.75changed to$24.77

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $25.33changed to$25.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $26.09changed to$25.33

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $27.11changed to$26.09

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $27.33changed to$27.11

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $27.87changed to$27.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.31 changed to 0.32
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $27.43changed to$27.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.30 changed to 0.31
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $27.40changed to$27.43

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $27.23changed to$27.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $27.07changed to$27.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $27.17changed to$27.07

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $27.03changed to$27.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $26.62changed to$27.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.29 changed to 0.30
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $25.84changed to$26.62

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.31 changed to 0.29
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $25.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$25.71$17.50RVU26D
2026-07-01$25.71$17.50RVU26C
2026-04-01$25.71$17.50RVU26B
2026-01-01$25.71$17.50RVU26A
2025-10-01$24.77$19.36RVU25D
2025-07-01$24.77$19.36RVU25C
2025-04-01$24.77$19.36RVU25B
2025-01-01$24.77$19.36RVU25A
2024-10-01$25.75$20.18RVU24D
2024-07-01$25.75$20.18RVU24C
2024-04-01$25.75$20.18RVU24B
2024-03-09$25.75$20.18RVU24AR
2024-01-01$25.33$19.85RVU24A
2023-10-01$26.09$20.38RVU23D
2023-07-01$26.09$20.38RVU23C
2023-04-01$26.09$20.38RVU23B
2023-01-01$26.09$20.38RVU23A
2022-10-01$27.11$21.25RVU22D
2022-07-01$27.11$21.25RVU22C
2022-04-01$27.11$21.25RVU22B
2022-01-01$27.11$21.25RVU22A
2021-10-01$27.33$21.43RVU21D
2021-07-01$27.33$21.43RVU21C
2021-04-01$27.33$21.43RVU21B
2021-01-01$27.33$21.43RVU21A
2020-10-01$27.87$22.51RVU20D
2020-07-01$27.87$22.51RVU20C
2020-04-01$27.87$22.51RVU20B
2020-01-01$27.87$22.51RVU20A
2019-10-01$27.43$22.10RVU19D
2019-07-01$27.43$22.10RVU19C
2019-04-01$27.43$22.10RVU19B
2019-01-01$27.43$22.10RVU19A
2018-10-01$27.40$22.08RVU18D
2018-07-01$27.40$22.08RVU18C
2018-04-01$27.40$22.08RVU18B
2018-01-01$27.40$22.08RVU18AR1
2017-10-01$27.23$22.28RVU17D
2017-07-01$27.23$22.28RVU17C
2017-04-01$27.23$22.28RVU17B
2017-01-01$27.23$22.28RVU17A
2016-10-01$27.07$22.14RVU16D
2016-07-01$27.07$22.14RVU16C
2016-04-01$27.07$22.14RVU16B
2016-01-01$27.07$22.14RVU16A
2015-10-01$27.17$22.22RVU15D
2015-07-01$27.17$22.22RVU15C
2015-04-01$27.03$22.11RVU15B
2015-01-01$27.03$22.11RVU15A
2014-10-01$26.62$21.71RVU14D
2014-07-01$26.62$21.71RVU14C
2014-04-01$26.62$21.71RVU14B
2014-01-01$26.62$21.71RVU14A
2013-10-01$25.84$20.85RVU13D
2013-07-01$25.84$20.85RVU13C
2013-04-01$25.84$20.85RVU13B
2013-01-01$25.84$20.85RVU13AR

Price 19001 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 19001PPRRVU2026_Oct_nonQPP.csv, line 1,656 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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