CPT code 19001: Breast cyst aspiration2026 Medicare rate & RVUs
Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration.
Medicare pays $26.39 for 19001 nationally in the office and $18.04 in a hospital or facility. Local office rates run $24.02–$33.20.
Medicare rate · 19001
Breast cyst aspiration
- Work RVUs
- 0.41
- Total RVUs
- 0.79
- Global days
- ZZZ
National rate · 2026
$26.39
Office setting, before claim adjustments.
See every locality for 19001 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
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 A needle is placed into a distinct fluid-filled breast cyst and fluid is withdrawn; this is commonly performed by a breast surgeon, radiologist, or other qualified clinician in an office or imaging setting.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.
Where 19001 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$24.02 to $33.20
109 of 109 payment localities
19001 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $33.20 | 1 |
| AL | $24.28 | 1 |
| AR | $24.02 | 1 |
| AZ | $25.80 | 1 |
| CA | $26.90–$31.99 | 29 |
| CO | $26.89 | 1 |
| CT | $27.86 | 1 |
| DC | $29.28 | 1 |
| DE | $26.15 | 1 |
| FL | $26.74–$29.39 | 3 |
| GA | $25.52–$26.94 | 2 |
| GU | $27.19 | 1 |
| HI | $27.19 | 1 |
| IA | $24.44 | 1 |
| ID | $24.62 | 1 |
| IL | $26.37–$28.70 | 4 |
| IN | $24.72 | 1 |
| KS | $24.50 | 1 |
| KY | $25.02 | 1 |
| LA | $25.05–$25.96 | 2 |
| MA | $26.85–$28.90 | 2 |
| MD | $26.52–$29.28 | 3 |
| ME | $24.87–$25.67 | 2 |
| MI | $25.64–$27.15 | 2 |
| MN | $25.53 | 1 |
| MO | $24.82–$25.86 | 3 |
| MS | $24.42 | 1 |
| MT | $26.38 | 1 |
| NC | $25.05 | 1 |
| ND | $25.39 | 1 |
| NE | $24.50 | 1 |
| NH | $26.63 | 1 |
| NJ | $28.11–$29.13 | 2 |
| NM | $25.81 | 1 |
| NV | $26.12 | 1 |
| NY | $25.34–$30.78 | 5 |
| OH | $25.44 | 1 |
| OK | $24.83 | 1 |
| OR | $25.85–$27.40 | 2 |
| PA | $25.39–$27.41 | 2 |
| PR | $26.48 | 1 |
| RI | $26.83 | 1 |
| SC | $25.30 | 1 |
| SD | $25.28 | 1 |
| TN | $24.61 | 1 |
| TX | $25.28–$27.05 | 8 |
| UT | $25.56 | 1 |
| VA | $25.71–$29.28 | 2 |
| VI | $26.48 | 1 |
| VT | $25.45 | 1 |
| WA | $26.75–$29.27 | 2 |
| WI | $24.77 | 1 |
| WV | $25.66 | 1 |
| WY | $25.95 | 1 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
19001 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 19000Breast aspiration
- Code 19000 covers aspiration of the first breast cyst; 19001 is added for each additional cyst aspirated in that session.
- 19083Breast biopsy
- Code 19083 covers ultrasound-guided breast biopsy for tissue sampling. Code 19001 is for aspiration of an additional breast cyst.
- 19020Breast abscess drainage
- Code 19020 describes surgical exploration and drainage of a breast abscess; 19001 reports needle aspiration of an additional cyst.
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
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