CPT code 19086: Breast biopsy, additional MRI-guided lesion2026 Medicare rate & RVUs in Barrington, Illinois
CPT 19086: $563.33–$571.10 office ($80.57–$83.31 facility) across 2 localities in Barrington, IL in 2026 Medicare. Compare each area.
Medicare pays $563.33–$571.10 for 19086 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 19086 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 | $563.33 | $83.31 |
| Suburban Chicago, IL | $571.10 | $80.57 |
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 19086 rate is calculated
Each of 19086’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 · 19086
RVUs × geographic indexes × conversion factor
Work1.77
1.77 RVUs× 1.000 GPCI
Practice expense14.62
14.62 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
16.5600
Conversion factor
$33.4009
Medicare rate
$553.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19086
The CMS indicators that decide how 19086 is paid alongside other services.
CMS payment indicators · 19086
Breast biopsy, additional MRI-guided lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
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
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