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

Open removal of one or more breast lesions, such as a palpable fibroadenoma, when excision rather than needle sampling or marker-localized removal is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality6K Medicare services in 2024

In Houston, TX, Medicare pays $590.59 for 19120 in the office and $426.41 when it’s performed in a hospital or facility.

$590.59Office (non-facility)
$426.41Hospital or facility
+3.0%vs the national office rate ($573.16)

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.

We’ll open 19120 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 19120 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 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 Houston, TX 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. Houston, TX pays $590.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

19120 in Houston, TX vs other payment areas
  1. Houston, TX · this page$590.59
  2. Austin, TX · Texas$587.28−$3.31
  3. Beaumont, TX · Texas$539.84−$50.75
  4. Brazoria, TX · Texas$561.06−$29.53
  5. Dallas, TX · Texas$566.69−$23.90
  6. Fort Worth, TX · Texas$564.00−$26.59
  7. Galveston, TX · Texas$564.05−$26.54

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

Every other payment area

19120 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$551.53$394.63
Los Angeles, CACalifornia$625.55$429.95
Washington, DC areaDistrict of Columbia$648.14$453.37
Miami, FLFlorida$660.82$488.71
Chicago, ILIllinois$638.89$472.73
Manhattan, NYNew York$667.66$475.54
AlaskaAlaska$669.36$493.27
AlabamaAlabama$510.64$365.97

19120 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.

$502.86

$669.36

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

View every state and territory as a table
19120 office rate range by state
State / territoryOffice rate rangeLocalities
AK$669.361
AL$510.641
AR$502.861
AZ$555.891
CA$585.84–$718.6329
CO$586.111
CT$612.751
DC$648.141
DE$565.251
FL$582.91–$660.823
GA$546.60–$588.782
GU$598.251
HI$598.251
IA$515.731
ID$521.081
IL$571.54–$638.894
IN$524.031
KS$517.271
KY$532.191
LA$532.94–$560.162
MA$584.01–$640.142
MD$575.10–$648.143
ME$528.29–$552.302
MI$550.52–$594.762
MN$548.691
MO$526.08–$557.323
MS$514.371
MT$573.061
NC$533.431
ND$544.391
NE$517.471
NH$580.721
NJ$616.11–$641.722
NM$555.341
NV$565.401
NY$542.18–$689.755
OH$544.661
OK$526.831
OR$557.45–$600.702
PA$543.27–$599.592
PR$576.091
RI$582.551
SC$540.661
SD$541.001
TN$520.521
TX$539.84–$590.598
UT$548.301
VA$553.28–$648.142
VI$576.091
VT$545.911
WA$581.69–$649.302
WI$525.701
WV$550.541
WY$560.571

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.

How the rate is built · 19120

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.77

5.77 RVUs× 1.000 GPCI

Practice expense9.94

9.94 RVUs× 1.000 GPCI

Malpractice1.45

1.45 RVUs× 1.000 GPCI

Adjusted RVUs

17.1600

Conversion factor

$33.4009

Medicare rate

$573.16

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,670

Code
19120
Physician work
5.77
Practice expense
9.94
Malpractice
1.45

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 19120 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work5.77× 1.0085.8162
Practice expense9.94× 0.9939.8704
Malpractice1.45× 1.3761.9952
Total RVUs17.6818
Conversion factor× 33.4009

Office rate, Houston, TX$590.59

Office: (5.77 × 1.008 + 9.94 × 0.993 + 1.45 × 1.376) × $33.4009 = $590.59

Facility: (5.77 × 1.008 + 4.99 × 0.993 + 1.45 × 1.376) × $33.4009 = $426.41

Open 19120 in the RVU calculator

Payment rules and modifiers for 19120

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

CMS payment indicators · 19120

Breast lesion excision, without marker localization

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 · 19120

Breast lesion excision, without marker localization

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

19120 without 50 · national office

$573.16

Breast lesion excision, without marker localization

19120-50 · Bilateral: 150%

$859.74

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 19120

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

Codes related to 19120
CodeHow it relatesOffice range, Houston, TX
Used instead
19100Breast biopsy, without imaging guidancePercutaneous breast sampling when tissue diagnosis is obtained without open excision.$166.65
19101Breast biopsy, open, incisionalOpen breast biopsy when the procedure is diagnostic sampling rather than lesion excision.$359.61
19125Breast lesion excision, single marker-localized lesionOpen excision when the breast lesion was identified by preoperative radiologic marker placement.$655.26

How 19120 has changed in Houston, TX

19120 · Office / nonfacility

$590.59

Effective 2026-10-01

The base rate is $57.35 higher than on 2025-10-01, moving from $533.24 to $590.59 (10.8%).

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

    $533.24changed to$590.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.92 changed to 5.77
    • Practice expense RVU 8.40 changed to 9.94
    • Malpractice RVU 1.46 changed to 1.45
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $547.22changed to$533.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.34 changed to 8.40
    • Malpractice RVU 1.47 changed to 1.46

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $538.29changed to$547.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $545.58changed to$538.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.25 changed to 8.34
    • Malpractice RVU 1.44 changed to 1.47
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $547.61changed to$545.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.19 changed to 8.25
    • Malpractice RVU 1.43 changed to 1.44
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $544.34changed to$547.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.99 changed to 8.19
    • Malpractice RVU 1.41 changed to 1.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $530.67changed to$544.34

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.21 changed to 7.99
    • Malpractice RVU 1.39 changed to 1.41
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $519.47changed to$530.67

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.00 changed to 7.21
    • Malpractice RVU 1.38 changed to 1.39
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $513.77changed to$519.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.85 changed to 7.00
    • Malpractice RVU 1.39 changed to 1.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $509.42changed to$513.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.78 changed to 6.85
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $508.43changed to$509.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.79 changed to 6.78
    • Malpractice RVU 1.40 changed to 1.39
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $508.51changed to$508.43

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.77 changed to 6.79
    • Malpractice RVU 1.37 changed to 1.40

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $505.98changed to$508.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $498.18changed to$505.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.75 changed to 6.77
    • Malpractice RVU 1.20 changed to 1.37
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $500.55changed to$498.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.57 changed to 6.75
    • Malpractice RVU 1.25 changed to 1.20
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $500.55

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$590.59$426.41RVU26D
2026-07-01$590.59$426.41RVU26C
2026-04-01$590.59$426.41RVU26B
2026-01-01$590.59$426.41RVU26A
2025-10-01$533.24$435.26RVU25D
2025-07-01$533.24$435.26RVU25C
2025-04-01$533.24$435.26RVU25B
2025-01-01$533.24$435.26RVU25A
2024-10-01$547.22$444.72RVU24D
2024-07-01$547.22$444.72RVU24C
2024-04-01$547.22$444.72RVU24B
2024-03-09$547.22$444.72RVU24AR
2024-01-01$538.29$437.46RVU24A
2023-10-01$545.58$439.88RVU23D
2023-07-01$545.58$439.88RVU23C
2023-04-01$545.58$439.88RVU23B
2023-01-01$545.58$439.88RVU23A
2022-10-01$547.61$436.86RVU22D
2022-07-01$547.61$436.86RVU22C
2022-04-01$547.61$436.86RVU22B
2022-01-01$547.61$436.86RVU22A
2021-10-01$544.34$435.90RVU21D
2021-07-01$544.34$435.90RVU21C
2021-04-01$544.34$435.90RVU21B
2021-01-01$544.34$435.90RVU21A
2020-10-01$530.67$437.90RVU20D
2020-07-01$530.67$437.90RVU20C
2020-04-01$530.67$437.90RVU20B
2020-01-01$530.67$437.90RVU20A
2019-10-01$519.47$432.67RVU19D
2019-07-01$519.47$432.67RVU19C
2019-04-01$519.47$432.67RVU19B
2019-01-01$519.47$432.67RVU19A
2018-10-01$513.77$431.44RVU18D
2018-07-01$513.77$431.44RVU18C
2018-04-01$513.77$431.44RVU18B
2018-01-01$513.77$431.44RVU18AR1
2017-10-01$509.42$429.39RVU17D
2017-07-01$509.42$429.39RVU17C
2017-04-01$509.42$429.39RVU17B
2017-01-01$509.42$429.39RVU17A
2016-10-01$508.43$428.47RVU16D
2016-07-01$508.43$428.47RVU16C
2016-04-01$508.43$428.47RVU16B
2016-01-01$508.43$428.47RVU16A
2015-10-01$508.51$428.26RVU15D
2015-07-01$508.51$428.26RVU15C
2015-04-01$505.98$426.13RVU15B
2015-01-01$505.98$426.13RVU15A
2014-10-01$498.18$419.41RVU14D
2014-07-01$498.18$419.41RVU14C
2014-04-01$498.18$419.41RVU14B
2014-01-01$498.18$419.41RVU14A
2013-10-01$500.55$415.67RVU13D
2013-07-01$500.55$415.67RVU13C
2013-04-01$500.55$415.67RVU13B
2013-01-01$500.55$415.67RVU13AR

Price 19120 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

19120 billing questions

When should 19120 be chosen instead of 19125?

Use 19120 for open excision of one or more breast lesions not identified by preoperative placement of a radiologic marker. Use 19125 for an open excision of a lesion identified by that marker.

Can 19120 be reported for more than one lesion?

Yes. The code covers one or more lesions, so do not report extra units solely because multiple qualifying lesions were removed.

How does 19120 differ from a breast biopsy code?

19120 represents open removal of the lesion, while 19100 is percutaneous sampling and 19101 is open biopsy. Choose based on the procedure actually performed, not just the eventual pathology result.

How is bilateral excision reported?

Report modifier 50 for bilateral work; CMS pays the bilateral procedure at 150%.

Is an assistant surgeon payable for 19120?

No. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

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 19120PPRRVU2026_Oct_nonQPP.csv, line 1,670 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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