CPT code 19120: Breast lesion excision, without marker localization2026 Medicare rate & RVUs in Modesto, CA

In Modesto, CA, Medicare pays $585.84 for 19120 in the office and $404.63 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 19120 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 19120 covers

A surgeon removes breast tissue containing a cyst, fibroadenoma, or other lesion through an open incision. The specimen may include a palpable mass, abnormal duct tissue, aberrant breast tissue, or a nipple or areolar lesion. General or breast surgeons commonly perform the operation in an ambulatory surgery center or hospital operating room; selected cases may be done in an office procedure setting. This code covers one or more lesions when the operation is an excision, rather than needle sampling or removal of a lesion identified by a preoperative radiologic marker.

Choose 19120 based on the operative approach and target, not pathology findings alone. Document the breast and site, the lesion or lesions removed, and the open excision. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral work, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; 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 Modesto, CA compares for 19120

Across 109 of 109 payment localities, the office rate for 19120 runs from $502.86 in Arkansas to $718.63 in San Benito County, CA. Modesto, CA pays $585.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

19120 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 19120 in every payment locality

How the 19120 rate is calculated

Each of 19120’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.

Payment rules and modifiers for 19120

19120 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 19120

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

How 19120 has changed in Modesto, CA

Price 19120 for an earlier date of service

Where the Modesto, CA rate applies

Modesto, CA is a Medicare payment area, not a city. Our Census mapping connects it to 33 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• Modesto
• Airport
• Bret Harte
• Bystrom
• Ceres
• Cowan
• Crows Landing
• Del Rio

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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

Open CMS sourceHow we calculate rates