CPT code 19081: Breast biopsy, stereotactic, first lesion2026 Medicare rate & RVUs in Barrington, Illinois
CPT 19081: $495.99–$497.78 office ($148.58–$154.27 facility) across 2 localities in Barrington, IL in 2026 Medicare. Compare each area.
Medicare pays $495.99–$497.78 for 19081 in the office in Barrington, Illinois, from Chicago, IL to Suburban Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 6 sections
Where 19081 pays more and less in Barrington, Illinois
Barrington, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $495.99 | $154.27 |
| Suburban Chicago, IL | $497.78 | $148.58 |
How payment areas work in Barrington
City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.
- Chicago · Cook County
- Suburban Chicago · Lake County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
How the 19081 rate is calculated
Each of 19081’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 19081
RVUs × geographic indexes × conversion factor
Work3.21
3.21 RVUs× 1.000 GPCI
Practice expense10.76
10.76 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
14.3200
Conversion factor
$33.4009
Medicare rate
$478.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19081
The CMS indicators that decide how 19081 is paid alongside other services.
CMS payment indicators · 19081
Breast biopsy, stereotactic, first lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19081 without 50 · national office
$478.30
Breast biopsy, stereotactic, first lesion
19081-50 · Bilateral: 150%
$717.45
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 19081 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist