FeeBase
Log inGet started
Menu

CPT code 19020: Breast abscess drainage, deep abscess, open approach2026 Medicare rate & RVUs in Colorado

Report this service when a surgeon incises breast tissue to explore and drain a deep abscess rather than aspirating a fluid collection.

CMS RVU26DEffective Oct 1, 2026One payment locality921 Medicare services in 2024

In Colorado, Medicare pays $532.12 for 19020 in the office and $321.38 when it’s performed in a hospital or facility.

$532.12Office (non-facility)
$321.38Hospital or facility
+3.5%vs the national office rate ($514.37)

Check a contract rate as a % of Medicare · 19020 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 19020 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 19020 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 19020 covers

This service involves an incision into the breast to reach, explore, and drain a deep abscess. It is typically performed by a breast or general surgeon in an operating room or other procedural setting when the collection requires open drainage. The operative record should identify the breast and side, describe the incision and abscess cavity, and document exploration and drainage. Needle aspiration of a cyst or fluid collection is a different service.

Report the service for the breast treated; when both breasts are treated, CMS recognizes bilateral billing with modifier 50 and pays at 150%. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. CMS 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 Colorado compares for 19020

Across 109 of 109 payment localities, the office rate for 19020 runs from $448.84 in Arkansas to $672.52 in San Benito County, CA. Colorado pays $532.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

19020 in Colorado vs other payment areas
  1. Colorado · this page$532.12
  2. Los Angeles, CA · California$574.86+$42.74
  3. Washington, DC area · District of Columbia$588.49+$56.37
  4. Miami, FL · Florida$576.08+$43.96
  5. Chicago, IL · Illinois$556.84+$24.72
  6. Manhattan, NY · New York$598.52+$66.40
  7. Alaska · Alaska$586.21+$54.09

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

Every other payment area

19020 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$456.16$282.85
ArkansasArkansas$448.84$278.70
ArizonaArizona$498.82$306.89
Bakersfield, CACalifornia$539.20$322.11
Chico, CACalifornia$536.70$319.62
El Centro, CACalifornia$536.86$319.78
Fresno, CACalifornia$536.70$319.62
Hanford, CACalifornia$536.70$319.62

19020 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.

$448.84

$604.61

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

View every state and territory as a table
19020 office rate range by state
State / territoryOffice rate rangeLocalities
AK$586.211
AL$456.161
AR$448.841
AZ$498.821
CA$536.70–$672.5229
CO$532.121
CT$550.971
DC$588.491
DE$507.581
FL$514.03–$576.083
GA$481.50–$526.672
GU$550.631
HI$550.631
IA$465.321
ID$469.451
IL$500.44–$556.844
IN$472.371
KS$464.661
KY$471.911
LA$471.79–$497.372
MA$529.16–$585.762
MD$517.41–$588.493
ME$474.03–$499.802
MI$487.10–$522.892
MN$503.151
MO$464.02–$497.203
MS$456.441
MT$514.311
NC$479.221
ND$496.121
NE$467.611
NH$525.251
NJ$555.37–$581.762
NM$490.751
NV$509.601
NY$487.29–$616.545
OH$483.381
OK$469.101
OR$503.81–$548.362
PA$483.24–$537.272
PR$517.861
RI$525.271
SC$482.481
SD$493.971
TN$467.471
TX$479.88–$531.958
UT$489.701
VA$499.24–$588.492
VI$517.861
VT$495.601
WA$527.68–$596.492
WI$478.031
WV$480.581
WY$506.381

See 19020 in every payment locality

How the 19020 rate is calculated

Each of 19020’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 · 19020

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.73

3.73 RVUs× 1.000 GPCI

Practice expense10.75

10.75 RVUs× 1.000 GPCI

Malpractice0.92

0.92 RVUs× 1.000 GPCI

Adjusted RVUs

15.4000

Conversion factor

$33.4009

Medicare rate

$514.37

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

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,657

Code
19020
Physician work
3.73
Practice expense
10.75
Malpractice
0.92

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 19020 in Colorado
ComponentRVULocality factorAdjusted
Physician work3.73× 1.0123.7748
Practice expense10.75× 1.06411.4380
Malpractice0.92× 0.7810.7185
Total RVUs15.9313
Conversion factor× 33.4009

Office rate, Colorado$532.12

Office: (3.73 × 1.012 + 10.75 × 1.064 + 0.92 × 0.781) × $33.4009 = $532.12

Facility: (3.73 × 1.012 + 4.82 × 1.064 + 0.92 × 0.781) × $33.4009 = $321.38

Open 19020 in the RVU calculator

Payment rules and modifiers for 19020

19020 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 19020

Breast abscess drainage, deep abscess, open approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 19020

Breast abscess drainage, deep abscess, open approach

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

19020 without 50 · national office

$514.37

Breast abscess drainage, deep abscess, open approach

19020-50 · Bilateral: 150%

$771.56

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 19020

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

Codes related to 19020
CodeHow it relatesOffice range, Colorado
Used instead
19000Breast aspiration, first cystNeedle aspiration of a breast cyst or fluid collection, rather than open drainage of a deep abscess.$99.89
19001Breast cyst aspiration, each additional cystAdditional breast cyst aspiration when multiple cysts are aspirated; reported with 19000.$26.89
10060Abscess drainage, simple, single abscessSimple or single abscess drainage in situations managed as a superficial skin abscess rather than a deep breast abscess.$133.53
10061Abscess drainage, complex or multipleComplicated or multiple superficial skin abscess drainage, distinct from open drainage of a deep breast abscess.$226.93

How 19020 has changed in Colorado

19020 · Office / nonfacility

$532.12

Effective 2026-10-01

The base rate is $73.14 higher than on 2025-10-01, moving from $458.98 to $532.12 (15.9%).

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

    $458.98changed to$532.12

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.83 changed to 3.73
    • Practice expense RVU 9.11 changed to 10.75
    • Malpractice RVU 0.89 changed to 0.92
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $484.30changed to$458.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.42 changed to 9.11
    • Malpractice RVU 0.93 changed to 0.89

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $476.40changed to$484.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $490.72changed to$476.40

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.45 changed to 9.42
    • Malpractice RVU 0.89 changed to 0.93
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827

  5. January 1, 2023

    RVU23A

    $498.70changed to$490.72

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $506.41changed to$498.70

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.57 changed to 9.45
    • Malpractice RVU 0.86 changed to 0.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $496.24changed to$506.41

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.85 changed to 9.57
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $493.53changed to$496.24

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.83 changed to 8.85
    • Malpractice RVU 0.84 changed to 0.86
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $495.19changed to$493.53

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.88 changed to 8.83
    • Malpractice RVU 0.85 changed to 0.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $489.07changed to$495.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.76 changed to 8.88
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $486.70changed to$489.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.73 changed to 8.76
    • Malpractice RVU 0.86 changed to 0.85
    • Practice expense GPCI 1.011 changed to 1.015
    • Malpractice GPCI 1.090 changed to 1.066

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $488.04changed to$486.70

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.74 changed to 8.73
    • Malpractice RVU 0.84 changed to 0.86

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $485.61changed to$488.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $474.82changed to$485.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.62 changed to 8.74
    • Malpractice RVU 0.75 changed to 0.84
    • Practice expense GPCI 1.008 changed to 1.011
    • Malpractice GPCI 0.981 changed to 1.090

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $487.18changed to$474.82

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.77 changed to 8.62
    • Malpractice RVU 0.78 changed to 0.75
    • Practice expense GPCI 1.004 changed to 1.008
    • Malpractice GPCI 0.872 changed to 0.981

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $487.18

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$532.12$321.38RVU26D
2026-07-01$532.12$321.38RVU26C
2026-04-01$532.12$321.38RVU26B
2026-01-01$532.12$321.38RVU26A
2025-10-01$458.98$313.20RVU25D
2025-07-01$458.98$313.20RVU25C
2025-04-01$458.98$313.20RVU25B
2025-01-01$458.98$313.20RVU25A
2024-10-01$484.30$320.96RVU24D
2024-07-01$484.30$320.96RVU24C
2024-04-01$484.30$320.96RVU24B
2024-03-09$484.30$320.96RVU24AR
2024-01-01$476.40$315.72RVU24A
2023-10-01$490.72$321.71RVU23D
2023-07-01$490.72$321.71RVU23C
2023-04-01$490.72$321.71RVU23B
2023-01-01$490.72$321.71RVU23A
2022-10-01$498.70$322.61RVU22D
2022-07-01$498.70$322.61RVU22C
2022-04-01$498.70$322.61RVU22B
2022-01-01$498.70$322.61RVU22A
2021-10-01$506.41$321.19RVU21D
2021-07-01$506.41$321.19RVU21C
2021-04-01$506.41$321.19RVU21B
2021-01-01$506.41$321.19RVU21A
2020-10-01$496.24$324.38RVU20D
2020-07-01$496.24$324.38RVU20C
2020-04-01$496.24$324.38RVU20B
2020-01-01$496.24$324.38RVU20A
2019-10-01$493.53$322.56RVU19D
2019-07-01$493.53$322.56RVU19C
2019-04-01$493.53$322.56RVU19B
2019-01-01$493.53$322.56RVU19A
2018-10-01$495.19$321.85RVU18D
2018-07-01$495.19$321.85RVU18C
2018-04-01$495.19$321.85RVU18B
2018-01-01$495.19$321.85RVU18AR1
2017-10-01$489.07$319.32RVU17D
2017-07-01$489.07$319.32RVU17C
2017-04-01$489.07$319.32RVU17B
2017-01-01$489.07$319.32RVU17A
2016-10-01$486.70$318.38RVU16D
2016-07-01$486.70$318.38RVU16C
2016-04-01$486.70$318.38RVU16B
2016-01-01$486.70$318.38RVU16A
2015-10-01$488.04$317.66RVU15D
2015-07-01$488.04$317.66RVU15C
2015-04-01$485.61$316.08RVU15B
2015-01-01$485.61$316.08RVU15A
2014-10-01$474.82$309.44RVU14D
2014-07-01$474.82$309.44RVU14C
2014-04-01$474.82$309.44RVU14B
2014-01-01$474.82$309.44RVU14A
2013-10-01$487.18$308.53RVU13D
2013-07-01$487.18$308.53RVU13C
2013-04-01$487.18$308.53RVU13B
2013-01-01$487.18$308.53RVU13AR

Price 19020 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

19020 billing questions

When is this code more appropriate than breast cyst aspiration?

Use this code when the surgeon makes an incision to explore and drain a deep breast abscess. Needle aspiration of a breast cyst or fluid collection is represented by 19000 instead.

Can exploration and drainage be reported as separate services?

No. Exploration and drainage are part of the open abscess service; document both in the operative report rather than unbundling them.

How should bilateral treatment be reported?

For procedures on both breasts, CMS recognizes modifier 50 and pays at 150%. Document the treatment performed on each side.

What postoperative care is included?

The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be billed?

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

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 19020PPRRVU2026_Oct_nonQPP.csv, line 1,657 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 19020 pays in Colorado?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 19020 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist