Summary & Overview
CPT 19000: Needle Aspiration of Breast Cyst
CPT code 19000 denotes needle aspiration of a breast cyst, a common minimally invasive procedure used for symptomatic relief and diagnostic evaluation. Nationally, this code is relevant across outpatient settings where breast complaints are evaluated, including physician offices, breast clinics, and ambulatory surgery centers. Use of 19000 affects care pathways for patients with palpable or imaging-detected cysts and interfaces with imaging, pathology, and follow-up clinical management.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and commonly reported modifiers for billing. The publication summarizes benchmarking references and coding practice considerations that influence how 19000 is billed and reimbursed across major payers. It also highlights clinical scenarios in which aspiration is performed and how the code fits into diagnostic workflows.
This report is intended for billing professionals, practice managers, and clinicians seeking a national-level briefing on the clinical meaning, billing context, and payer landscape for CPT code 19000. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 19000 describes needle aspiration of a breast cyst, a procedure in which a provider inserts a needle into a breast cyst to drain fluid. This service is a minimally invasive diagnostic and therapeutic procedure used to relieve symptoms, confirm a benign cystic process, or obtain fluid for analysis.
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Service type: Percutaneous breast cyst aspiration
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Typical site of service: Outpatient clinic, physician office, or ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 38-year-old female presents to an outpatient breast clinic with a painful, fluctuant mass in the upper outer quadrant of the right breast that has been progressively enlarging over several days. Prior ultrasound of the breast confirms a simple cyst measuring 2.5 cm without suspicious internal vascularity. The clinician discusses options and performs ultrasound-guided fine-needle aspiration of the cyst to obtain symptomatic relief and diagnostic fluid. The procedure is performed in an ambulatory procedure room under sterile technique with local anesthetic; fluid is aspirated and sent to pathology/cytology as indicated. Post-procedure instructions include wound care, return precautions for recurrent swelling or signs of infection, and documentation of the aspirate volume and any immediate complications. Typical payors for this outpatient service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. | Data not available in the input. |
26 | Data not available in the input. | Data not available in the input. |
50 | Data not available in the input. | Data not available in the input. |
51 | Data not available in the input. | Data not available in the input. |
52 | Data not available in the input. | Data not available in the input. |
53 | Data not available in the input. | Data not available in the input. |
59 | Data not available in the input. | Data not available in the input. |
76 | Data not available in the input. | Data not available in the input. |
78 | Data not available in the input. | Data not available in the input. |
TC | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | General Surgery | General surgeons commonly perform breast procedures including cyst aspiration in clinic or ambulatory settings. |
| 207RH0000X | Breast Surgery | Breast surgeons specialize in diagnostic and therapeutic breast procedures including needle aspiration. |
| 207L00000X | Obstetrics & Gynecology | OB/GYNs with breast practice perform evaluation and procedures for benign breast conditions. |
| 207S00000X | Family Medicine | Family physicians in office settings may perform simple breast aspirations for symptomatic relief. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19000 | Data not available in the input. | Data not available in the input. |
19001 | Data not available in the input. | Data not available in the input. |
76942 | Data not available in the input. | Data not available in the input. |
88172 | Data not available in the input. | Data not available in the input. |
99213 | Data not available in the input. | Data not available in the input. |