$24.44
19000 reports aspiration of the first cyst; 19001 reports each additional cyst aspirated in the session.
On this page
CMS RVU26D · Effective 2026-10-01
19000 Breast aspiration Medicare reimbursement rates in Iowa
Reports needle aspiration of a breast cyst, typically to relieve symptoms or evaluate a fluid-filled lesion without taking a core tissue sample. Compare 19000 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 19000 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$88.44
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$33.74
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast procedures
About 19000: Breast cyst needle aspiration
Reports needle aspiration of a breast cyst, typically to relieve symptoms or evaluate a fluid-filled lesion without taking a core tissue sample.
A clinician uses a needle to withdraw fluid from a breast cyst, commonly one that is palpable, uncomfortable, or identified on imaging. The service may be performed in an office or facility by a physician involved in breast care, such as a breast surgeon or radiologist. Aspiration removes cyst fluid; it is distinct from taking a core tissue sample from a breast lesion.
Report 19000 for the first cyst aspirated in the session and 19001 for each additional cyst. Document the cyst’s location, the clinical reason for aspiration, and the aspiration performed; identify additional cysts when reporting the add-on code. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 19000
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.82 · 28%
- Practice expense (office) RVU1.95 · 68%
- Malpractice RVU0.11 · 4%
5.9K
Medicare services in 2024 · #1772 by national volume
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.
19000 compared with similar codes
Office rates for Iowa, from the same CMS release.
$437.89
19083 is for ultrasound-guided core biopsy of a breast lesion. Use 19000 when the service is needle aspiration of cyst fluid, not core tissue sampling.
$465.32
19020 describes incision and drainage of a deep breast abscess. 19000 is needle aspiration of a breast cyst.
Compare 19000 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$88.44
Facility
$33.74
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19000 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,655
- Code
- 19000
- Physician work
- 0.82
- Practice expense
- 1.95
- Malpractice
- 0.11
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.82 | × 1.000 | 0.8200 |
| Practice expense | 1.95 | × 0.915 | 1.7843 |
| Malpractice | 0.11 | × 0.397 | 0.0437 |
| Total RVUs | 2.6479 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$88.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 1.95 | 0.915 |
| Malpractice | 0.11 | 0.397 |
(0.82 × 1 + 1.95 × 0.915 + 0.11 × 0.397) × $33.4009 = $88.44
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 0.16 | 0.915 |
| Malpractice | 0.11 | 0.397 |
(0.82 × 1 + 0.16 × 0.915 + 0.11 × 0.397) × $33.4009 = $33.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
19000 billing questions
When should 19001 be reported instead of 19000?
Report 19000 for the first breast cyst aspirated. Report 19001 for each additional cyst aspirated during the session.
Is cyst aspiration the same as a breast core biopsy?
No. Aspiration withdraws fluid from a cyst; a core biopsy obtains tissue from a lesion. Use the code that reflects the service actually performed.
Can modifier 50 be used when cysts in both breasts are aspirated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not use modifier 50.
Does 19000 have a global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
How does the multiple-procedure rule affect 19000?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,65217360,,Chemical exfoliation acne,A,,1.42,2.06,,0.76,,0.14,3.62,2.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65317380,,Electrolysis epilation ea 30,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65417999,,Unlistd px skn muc memb subq,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65519000,,Puncture aspir cyst breast,A,,0.82,1.95,,0.16,,0.11,2.88,1.09,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65619001,,Puncture aspir cyst brst ea,A,,0.41,0.33,,0.08,,0.05,0.79,0.54,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65719020,,Mastotomy expl drg absc dp,A,,3.73,10.75,,4.82,,0.92,15.40,9.47,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65819030,,Njx px only mam ducto/glcto,A,,1.49,3.13,,0.28,,0.15,4.77,1.92,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136