$88.12
19000 describes needle aspiration of a breast cyst or fluid collection. Choose 19020 when the surgeon incises breast tissue to explore and drain a deep abscess.
On this page
CMS RVU26D · Effective 2026-10-01
19020 Breast abscess drainage Medicare reimbursement rates in Kansas
Report this service when a surgeon incises breast tissue to explore and drain a deep abscess rather than aspirating a fluid collection. Compare 19020 office and facility rates across CMS payment localities in Kansas.
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 19020 in Kansas?
Kansas 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
$464.66
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$285.61
1 of 1 localities have a supported rate.
Payment area: Kansas
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 surgery
About 19020: Deep breast abscess exploration and drainage
Report this service when a surgeon incises breast tissue to explore and drain a deep abscess rather than aspirating a fluid collection.
This service involves an incision into the breast to reach, explore, and drain a deep abscess. It is typically performed by a breast or general surgeon in an operating room or other procedural setting when the collection requires open drainage. The operative record should identify the breast and side, describe the incision and abscess cavity, and document exploration and drainage. Needle aspiration of a cyst or fluid collection is a different service.
Report the service for the breast treated; when both breasts are treated, CMS recognizes bilateral billing with modifier 50 and pays at 150%. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. CMS does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 19020
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 procedure with modifier 50 is paid at 150%.
- 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 RVU3.73 · 24%
- Practice expense (office) RVU10.75 · 70%
- Malpractice RVU0.92 · 6%
921
Medicare services in 2024 · #3029 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.
19020 compared with similar codes
Office rates for Kansas, from the same CMS release.
$24.50
19001 is for each additional breast cyst aspirated and is reported with 19000; it does not describe open abscess drainage.
$316.29
19101 is an open breast biopsy to obtain tissue for diagnosis. Choose 19020 when the operative purpose is exploration and drainage of a deep abscess.
Compare 19020 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
Kansas →
Office / nonfacility
$464.66
Facility
$285.61
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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 19020 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
1,657
- Code
- 19020
- Physician work
- 3.73
- Practice expense
- 10.75
- Malpractice
- 0.92
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.73 | × 1.000 | 3.7300 |
| Practice expense | 10.75 | × 0.904 | 9.7180 |
| Malpractice | 0.92 | × 0.504 | 0.4637 |
| Total RVUs | 13.9117 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$464.66
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.73 | 1 |
| Practice expense | 10.75 | 0.904 |
| Malpractice | 0.92 | 0.504 |
(3.73 × 1 + 10.75 × 0.904 + 0.92 × 0.504) × $33.4009 = $464.66
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.73 | 1 |
| Practice expense | 4.82 | 0.904 |
| Malpractice | 0.92 | 0.504 |
(3.73 × 1 + 4.82 × 0.904 + 0.92 × 0.504) × $33.4009 = $285.61
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.
19020 billing questions
When is this code more appropriate than breast cyst aspiration?
Use this code when the surgeon makes an incision to explore and drain a deep breast abscess. Needle aspiration of a breast cyst or fluid collection is represented by 19000 instead.
Can exploration and drainage be reported as separate services?
No. Exploration and drainage are part of the open abscess service; document both in the operative report rather than unbundling them.
How should bilateral treatment be reported?
For procedures on both breasts, CMS recognizes modifier 50 and pays at 150%. Document the treatment performed on each side.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
1,65417999,,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
1,66019082,,Bx breast add lesion strtctc,A,,1.61,9.10,,0.30,,0.17,10.88,2.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958