Billing code 19001: Breast cyst aspirationMedicare rate & RVUs in Alaska

Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration.

CMS RVU26DEffective Oct 1, 20261 payment locality417 Medicare services in 2024

Medicare pays $33.20 for 19001 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$33.20Office (non-facility)
$24.31Hospital or facility

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 19001 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 19001 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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 A needle is placed into a distinct fluid-filled breast cyst and fluid is withdrawn; this is commonly performed by a breast surgeon, radiologist, or other qualified clinician in an office or imaging setting.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.

19001 in Alaska*

19001 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$33.20$24.31

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

19001 compared with similar codes

Compare codes · National

4 codes, side by side

  • 19001

    Breast cyst aspiration0.41 wRVU

    $26.39

  • 19000

    Breast aspiration0.82 wRVU

    $96.19+$69.80

  • 19083

    Breast biopsy3.02 wRVU

    $475.63+$449.24

  • 19020

    Breast abscess drainage3.73 wRVU

    $514.37+$487.98

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
RVUs for 19001PPRRVU2026_Oct_nonQPP.csv, line 1,656 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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