CPT code 19085: Breast biopsy, first lesion, MRI guidance2026 Medicare rate & RVUs in Bartlett, Illinois
CPT 19085: $737.70–$744.53 office ($161.73–$167.38 facility) across 2 localities in Bartlett, IL in 2026 Medicare. Compare each area.
Medicare pays $737.70–$744.53 for 19085 in the office in Bartlett, 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 19085 pays more and less in Bartlett, Illinois
Bartlett, 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 | $737.70 | $167.38 |
| Suburban Chicago, IL | $744.53 | $161.73 |
How payment areas work in Bartlett
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 · DuPage County, Kane County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
How the 19085 rate is calculated
Each of 19085’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 · 19085
RVUs × geographic indexes × conversion factor
Work3.55
3.55 RVUs× 1.000 GPCI
Practice expense17.62
17.62 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
21.5200
Conversion factor
$33.4009
Medicare rate
$718.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19085
The CMS indicators that decide how 19085 is paid alongside other services.
CMS payment indicators · 19085
Breast biopsy, first lesion, MRI guidance
| 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
19085 without 50 · national office
$718.79
Breast biopsy, first lesion, MRI guidance
19085-50 · Bilateral: 150%
$1,078.19
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 19085 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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