CPT code 19081: Breast biopsy, stereotactic, first lesion2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $482.08 for 19081 in the office and $138.32 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 19081 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 19081 covers

A radiologist typically performs this percutaneous breast biopsy by using mammographic stereotactic targeting to guide a needle into an abnormality and collect tissue samples. Common targets include suspicious calcifications or another mammographic finding that is not well seen with ultrasound. Marker placement and specimen imaging, when performed, are part of the service. The code covers the first lesion biopsied with stereotactic guidance during the session; a distinct additional lesion may be reported with 19082.

Select this code when stereotactic imaging guides the biopsy, rather than ultrasound or MRI. The report should identify the target and guidance method and document tissue sampling; include details of marker placement or specimen imaging when performed. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces other procedures to 50%. Modifier 50 for bilateral performance is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

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.

How Puerto Rico compares for 19081

Across 109 of 109 payment localities, the office rate for 19081 runs from $421.96 in Arkansas to $643.52 in San Benito County, CA. Puerto Rico pays $482.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

19081 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 19081 in every payment locality

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.

Payment rules and modifiers for 19081

The CMS indicators that decide how 19081 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 19081

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 19081 has changed in Puerto Rico

Price 19081 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates