$88.44
Code 19000 covers aspiration of the first breast cyst; 19001 is added for each additional cyst aspirated in that session.
On this page
CMS RVU26D · Effective 2026-10-01
19001 Breast cyst aspiration Medicare reimbursement rates in Iowa
Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration. Compare 19001 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 19001 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
$24.44
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$16.80
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 procedure
About 19001: Additional breast cyst aspiration
Reports needle aspiration of each additional breast cyst treated after the first cyst during the same session as the primary aspiration.
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 A needle is placed into a distinct fluid-filled breast cyst and fluid is withdrawn; this is commonly performed by a breast surgeon, radiologist, or other qualified clinician in an office or imaging setting.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.
CMS billing rules for 19001
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.41 · 52%
- Practice expense (office) RVU0.33 · 42%
- Malpractice RVU0.05 · 6%
417
Medicare services in 2024 · #3701 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.
19001 compared with similar codes
Office rates for Iowa, from the same CMS release.
$437.89
Code 19083 covers ultrasound-guided breast biopsy for tissue sampling. Code 19001 is for aspiration of an additional breast cyst.
$465.32
Code 19020 describes surgical exploration and drainage of a breast abscess; 19001 reports needle aspiration of an additional cyst.
Compare 19001 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
$24.44
Facility
$16.80
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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 19001 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,656
- Code
- 19001
- Physician work
- 0.41
- Practice expense
- 0.33
- Malpractice
- 0.05
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.41 | × 1.000 | 0.4100 |
| Practice expense | 0.33 | × 0.915 | 0.3020 |
| Malpractice | 0.05 | × 0.397 | 0.0199 |
| Total RVUs | 0.7318 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$24.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.41 | 1 |
| Practice expense | 0.33 | 0.915 |
| Malpractice | 0.05 | 0.397 |
(0.41 × 1 + 0.33 × 0.915 + 0.05 × 0.397) × $33.4009 = $24.44
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.41 | 1 |
| Practice expense | 0.08 | 0.915 |
| Malpractice | 0.05 | 0.397 |
(0.41 × 1 + 0.08 × 0.915 + 0.05 × 0.397) × $33.4009 = $16.80
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.
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 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.
1,65317380,,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
1,65919081,,Bx breast 1st lesion strtctc,A,,3.21,10.76,,0.58,,0.35,14.32,4.14,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,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