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

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 Delaware, Medicare pays $507.58 for 19020 in the office and $311.89 when it’s performed in a hospital or facility.

$507.58Office (non-facility)
$311.89Hospital or facility
−1.3%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 Delaware
  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 Delaware 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. Delaware pays $507.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

19020 in Delaware vs other payment areas
  1. Delaware · this page$507.58
  2. Los Angeles, CA · California$574.86+$67.28
  3. Washington, DC area · District of Columbia$588.49+$80.91
  4. Miami, FL · Florida$576.08+$68.50
  5. Chicago, IL · Illinois$556.84+$49.26
  6. Manhattan, NY · New York$598.52+$90.94
  7. Alaska · Alaska$586.21+$78.63

Other areas in Delaware 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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 19020 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.73× 1.0053.7486
Practice expense10.75× 0.98810.6210
Malpractice0.92× 0.8990.8271
Total RVUs15.1967
Conversion factor× 33.4009

Office rate, Delaware$507.58

Office: (3.73 × 1.005 + 10.75 × 0.988 + 0.92 × 0.899) × $33.4009 = $507.58

Facility: (3.73 × 1.005 + 4.82 × 0.988 + 0.92 × 0.899) × $33.4009 = $311.89

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, Delaware
Used instead
19000Breast aspiration, first cystNeedle aspiration of a breast cyst or fluid collection, rather than open drainage of a deep abscess.$95.18
19001Breast cyst aspiration, each additional cystAdditional breast cyst aspiration when multiple cysts are aspirated; reported with 19000.$26.15
10060Abscess drainage, simple, single abscessSimple or single abscess drainage in situations managed as a superficial skin abscess rather than a deep breast abscess.$127.34
10061Abscess drainage, complex or multipleComplicated or multiple superficial skin abscess drainage, distinct from open drainage of a deep breast abscess.$217.85

How 19020 has changed in Delaware

19020 · Office / nonfacility

$507.58

Effective 2026-10-01

The base rate is $62.94 higher than on 2025-10-01, moving from $444.64 to $507.58 (14.2%).

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

    $444.64changed to$507.58

    • 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 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $469.08changed to$444.64

    • 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

    $461.42changed to$469.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $481.46changed to$461.42

    • 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 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $495.98changed to$481.46

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $503.40changed to$495.98

    • 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

    $496.90changed to$503.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.85 changed to 9.57
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $497.14changed to$496.90

    • 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
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $498.83changed to$497.14

    • 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

    $494.66changed to$498.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.76 changed to 8.88
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $494.38changed to$494.66

    • 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
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $495.76changed to$494.38

    • 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

    $493.29changed to$495.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $482.96changed to$493.29

    • 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 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $496.74changed to$482.96

    • 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 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $496.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$507.58$311.89RVU26D
2026-07-01$507.58$311.89RVU26C
2026-04-01$507.58$311.89RVU26B
2026-01-01$507.58$311.89RVU26A
2025-10-01$444.64$307.31RVU25D
2025-07-01$444.64$307.31RVU25C
2025-04-01$444.64$307.31RVU25B
2025-01-01$444.64$307.31RVU25A
2024-10-01$469.08$315.20RVU24D
2024-07-01$469.08$315.20RVU24C
2024-04-01$469.08$315.20RVU24B
2024-03-09$469.08$315.20RVU24AR
2024-01-01$461.42$310.05RVU24A
2023-10-01$481.46$319.37RVU23D
2023-07-01$481.46$319.37RVU23C
2023-04-01$481.46$319.37RVU23B
2023-01-01$481.46$319.37RVU23A
2022-10-01$495.98$324.09RVU22D
2022-07-01$495.98$324.09RVU22C
2022-04-01$495.98$324.09RVU22B
2022-01-01$495.98$324.09RVU22A
2021-10-01$503.40$322.60RVU21D
2021-07-01$503.40$322.60RVU21C
2021-04-01$503.40$322.60RVU21B
2021-01-01$503.40$322.60RVU21A
2020-10-01$496.90$327.04RVU20D
2020-07-01$496.90$327.04RVU20C
2020-04-01$496.90$327.04RVU20B
2020-01-01$496.90$327.04RVU20A
2019-10-01$497.14$326.01RVU19D
2019-07-01$497.14$326.01RVU19C
2019-04-01$497.14$326.01RVU19B
2019-01-01$497.14$326.01RVU19A
2018-10-01$498.83$325.32RVU18D
2018-07-01$498.83$325.32RVU18C
2018-04-01$498.83$325.32RVU18B
2018-01-01$498.83$325.32RVU18AR1
2017-10-01$494.66$323.24RVU17D
2017-07-01$494.66$323.24RVU17C
2017-04-01$494.66$323.24RVU17B
2017-01-01$494.66$323.24RVU17A
2016-10-01$494.38$322.73RVU16D
2016-07-01$494.38$322.73RVU16C
2016-04-01$494.38$322.73RVU16B
2016-01-01$494.38$322.73RVU16A
2015-10-01$495.76$322.01RVU15D
2015-07-01$495.76$322.01RVU15C
2015-04-01$493.29$320.41RVU15B
2015-01-01$493.29$320.41RVU15A
2014-10-01$482.96$312.66RVU14D
2014-07-01$482.96$312.66RVU14C
2014-04-01$482.96$312.66RVU14B
2014-01-01$482.96$312.66RVU14A
2013-10-01$496.74$310.97RVU13D
2013-07-01$496.74$310.97RVU13C
2013-04-01$496.74$310.97RVU13B
2013-01-01$496.74$310.97RVU13AR

Price 19020 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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