Common surgery & pain management

19120 - RVUs & Medicare payment (2026)

Excision of breast lesion.

Component	Non-facility	Facility
Work RVU	5.77	5.77
Practice expense RVU	9.94	4.99
Malpractice RVU	1.45	1.45
Total RVUs	17.16	12.21
National payment (CF $33.4009)	$573.16	$407.82
Qualifying APM payment (CF $33.5675)	$576.02	$409.86

How 19120 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 19120 ranges from $502.86 in Arkansas (AR) to $718.63 in San Jose-Sunnyvale-Santa Clara (CA); calculate 19120 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $718.63 San Jose-Sunnyvale-Santa Clara (CA) $711.90 San Francisco-Oakland-Berkeley (CA) $701.39 San Francisco-Oakland-Berkeley (CA) $699.74 NYC Suburbs/Long Island (NY) $689.75 Alaska (AK) $669.36 Manhattan (NY) $667.66 Queens (NY) $667.33 National average $573.16 … 97 more localities between … Iowa (IA) $515.73 Mississippi (MS) $514.37 Alabama (AL) $510.64 Arkansas (AR) $502.86

Non-facility payment for 19120 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: 090

90-day global period: routine pre- and post-operative care within 90 days is included in the payment.

Related codes - common surgery & pain management

29881 · knee arthroscopy with meniscectomy
27447 · total knee arthroplasty (knee replacement)
27130 · total hip arthroplasty (hip replacement)
47562 · laparoscopic cholecystectomy (gallbladder removal)
49505 · open repair of inguinal hernia, initial
63030 · lumbar discectomy, single level
62323 · lumbar/caudal epidural injection with imaging guidance
64483 · transforaminal epidural injection, lumbar/sacral, first level
64493 · facet joint injection, lumbar/sacral, first level
59400 · vaginal delivery with antepartum and postpartum care

Frequently asked questions

How much does Medicare pay for 19120 in 2026?

The national non-facility payment is $573.16 and the facility payment is $407.82, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 19120?

The 2026 work RVU for 19120 is 5.77. Total RVUs are 17.16 in the non-facility setting and 12.21 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.