CPT code 19086: Breast biopsy, additional MRI-guided lesion2026 Medicare rate & RVUs in North Dakota
Report this add-on for tissue sampling of an additional breast lesion using MRI guidance, alongside the primary MRI-guided breast biopsy code.
In North Dakota, Medicare pays $549.75 for 19086 in the office and $72.11 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 19086 nationwide
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 11 sections
What 19086 covers
This code covers needle sampling of an additional breast target identified and accessed with MRI guidance. It is typically performed by a radiologist or other qualified breast-imaging clinician in an outpatient imaging center or hospital MRI suite. The biopsy may include placement of a marker at the sampled site and imaging of the specimen when performed. The first MRI-guided lesion is reported separately with the primary code.
Report one unit for each additional lesion sampled under MRI guidance, supported by documentation identifying the targets and confirming MRI guidance and tissue sampling. Do not use this code by itself: it is an add-on reported with the primary MRI-guided breast biopsy procedure. Under the CMS rule for this code, payment is within the primary procedure’s global period. The documentation should distinguish each additional target from the first lesion and from targets sampled using another guidance method.
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 North Dakota compares for 19086
Across 109 of 109 payment localities, the office rate for 19086 runs from $481.51 in Arkansas to $772.83 in San Benito County, CA. North Dakota pays $549.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$549.75
- Los Angeles, CA · California$643.00+$93.25
- Washington, DC area · District of Columbia$643.87+$94.12
- Miami, FL · Florida$581.82+$32.07
- Chicago, IL · Illinois$563.33+$13.58
- Manhattan, NY · New York$639.34+$89.59
- Alaska · Alaska$611.87+$62.12
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $489.61 | $71.69 |
| ArkansasArkansas | $481.51 | $71.23 |
| ArizonaArizona | $537.16 | $74.34 |
| Bakersfield, CACalifornia | $598.90 | $75.42 |
| Chico, CACalifornia | $598.37 | $74.88 |
| El Centro, CACalifornia | $598.40 | $74.91 |
| Fresno, CACalifornia | $598.37 | $74.88 |
| Hanford, CACalifornia | $598.37 | $74.88 |
| Madera, CACalifornia | $598.37 | $74.88 |
| Merced, CACalifornia | $598.37 | $74.88 |
| Modesto, CACalifornia | $598.37 | $74.88 |
| Napa, CACalifornia | $709.34 | $79.82 |
| Oxnard, CACalifornia | $641.51 | $76.95 |
| Redding, CACalifornia | $598.37 | $74.88 |
| Rest of CaliforniaCalifornia | $598.37 | $74.88 |
| Riverside, CACalifornia | $600.23 | $76.74 |
| Sacramento, CACalifornia | $632.21 | $76.72 |
| Salinas, CACalifornia | $629.96 | $76.38 |
| San Diego, CACalifornia | $648.00 | $76.75 |
| Marin County, CACalifornia | $755.88 | $82.41 |
| San Francisco, CACalifornia | $755.68 | $82.22 |
| San Benito County, CACalifornia | $772.83 | $84.08 |
| Santa Clara County, CACalifornia | $772.04 | $83.29 |
| San Luis Obispo, CACalifornia | $619.37 | $75.34 |
| Santa Cruz, CACalifornia | $656.71 | $76.39 |
| Santa Maria, CACalifornia | $633.20 | $76.28 |
| Santa Rosa, CACalifornia | $663.60 | $77.06 |
| Stockton, CACalifornia | $598.37 | $74.88 |
| Vallejo, CACalifornia | $709.06 | $79.54 |
| Visalia, CACalifornia | $598.37 | $74.88 |
| Yuba City, CACalifornia | $598.37 | $74.88 |
| ColoradoColorado | $583.84 | $75.64 |
| ConnecticutConnecticut | $593.09 | $78.68 |
| DelawareDelaware | $546.98 | $75.08 |
| Fort Lauderdale, FLFlorida | $564.06 | $80.21 |
| Rest of FloridaFlorida | $534.49 | $77.87 |
| Atlanta, GAGeorgia | $562.25 | $76.98 |
| Rest of GeorgiaGeorgia | $501.47 | $75.42 |
| Hawaii, Guam, HIHawaii | $617.63 | $74.56 |
| IowaIowa | $508.19 | $71.15 |
| IdahoIdaho | $511.06 | $71.64 |
| East St. Louis, ILIllinois | $519.81 | $80.39 |
| Rest of IllinoisIllinois | $513.83 | $77.75 |
| Suburban Chicago, ILIllinois | $571.10 | $80.57 |
| IndianaIndiana | $514.55 | $71.79 |
| KansasKansas | $503.42 | $71.64 |
| KentuckyKentucky | $498.43 | $73.82 |
| New Orleans, LALouisiana | $525.08 | $75.63 |
| Rest of LouisianaLouisiana | $496.72 | $74.02 |
| Metropolitan Boston, MAMassachusetts | $649.65 | $79.36 |
| Rest of MassachusettsMassachusetts | $578.79 | $75.85 |
| Baltimore area, MDMaryland | $591.06 | $78.56 |
| Rest of MarylandMaryland | $559.10 | $75.74 |
| Rest of MaineMaine | $511.91 | $72.48 |
| Southern Maine, MEMaine | $546.63 | $73.29 |
| Detroit, MIMichigan | $539.92 | $79.01 |
| Rest of MichiganMichigan | $511.37 | $75.29 |
| MinnesotaMinnesota | $563.28 | $71.80 |
| Metropolitan Kansas City, MOMissouri | $523.20 | $74.70 |
| Metropolitan St. Louis, MOMissouri | $529.69 | $74.98 |
| Rest of MissouriMissouri | $485.58 | $73.86 |
| MississippiMississippi | $483.76 | $72.52 |
| MontanaMontana | $553.11 | $75.47 |
| North CarolinaNorth Carolina | $518.35 | $72.72 |
| NebraskaNebraska | $511.99 | $71.13 |
| New HampshireNew Hampshire | $572.43 | $75.21 |
| Northern New JerseyNew Jersey | $635.36 | $81.31 |
| Rest of New JerseyNew Jersey | $600.96 | $79.38 |
| New MexicoNew Mexico | $513.73 | $75.74 |
| NevadaNevada | $552.66 | $74.55 |
| NYC suburbs and Long Island, NYNew York | $654.06 | $86.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $603.36 | $80.35 |
| Queens, NYNew York | $648.29 | $83.72 |
| Rest of New YorkNew York | $527.02 | $73.27 |
| OhioOhio | $510.68 | $74.60 |
| OklahomaOklahoma | $499.60 | $73.08 |
| Portland, OROregon | $606.81 | $76.16 |
| Rest of OregonOregon | $549.48 | $73.76 |
| Metropolitan Philadelphia, PAPennsylvania | $575.30 | $78.08 |
| Rest of PennsylvaniaPennsylvania | $512.76 | $74.30 |
| Puerto RicoPuerto Rico | $558.41 | $75.52 |
| Rhode IslandRhode Island | $569.74 | $76.35 |
| South CarolinaSouth Carolina | $515.15 | $73.82 |
| South DakotaSouth Dakota | $549.35 | $71.72 |
| TennesseeTennessee | $506.05 | $71.88 |
| Austin, TXTexas | $580.91 | $75.58 |
| Beaumont, TXTexas | $508.77 | $74.12 |
| Brazoria, TXTexas | $547.95 | $74.61 |
| Dallas, TXTexas | $550.89 | $75.17 |
| Fort Worth, TXTexas | $546.08 | $75.14 |
| Galveston, TXTexas | $549.20 | $74.91 |
| Houston, TXTexas | $552.31 | $78.02 |
| Rest of TexasTexas | $527.66 | $74.39 |
| UtahUtah | $523.24 | $74.27 |
| VirginiaVirginia | $543.15 | $73.63 |
| Virgin Islands, VIUnited States Virgin Islands | $558.41 | $75.52 |
| VermontVermont | $545.43 | $72.57 |
| Rest of WashingtonWashington | $578.41 | $75.46 |
| King County, WAWashington | $665.88 | $79.83 |
| WisconsinWisconsin | $528.68 | $71.11 |
| West VirginiaWest Virginia | $491.60 | $76.53 |
| WyomingWyoming | $551.64 | $74.01 |
19086 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$481.51
$685.60
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $611.87 | 1 |
| AL | $489.61 | 1 |
| AR | $481.51 | 1 |
| AZ | $537.16 | 1 |
| CA | $598.37–$772.83 | 29 |
| CO | $583.84 | 1 |
| CT | $593.09 | 1 |
| DC | $643.87 | 1 |
| DE | $546.98 | 1 |
| FL | $534.49–$581.82 | 3 |
| GA | $501.47–$562.25 | 2 |
| GU | $617.63 | 1 |
| HI | $617.63 | 1 |
| IA | $508.19 | 1 |
| ID | $511.06 | 1 |
| IL | $513.83–$571.10 | 4 |
| IN | $514.55 | 1 |
| KS | $503.42 | 1 |
| KY | $498.43 | 1 |
| LA | $496.72–$525.08 | 2 |
| MA | $578.79–$649.65 | 2 |
| MD | $559.10–$643.87 | 3 |
| ME | $511.91–$546.63 | 2 |
| MI | $511.37–$539.92 | 2 |
| MN | $563.28 | 1 |
| MO | $485.58–$529.69 | 3 |
| MS | $483.76 | 1 |
| MT | $553.11 | 1 |
| NC | $518.35 | 1 |
| ND | $549.75 | 1 |
| NE | $511.99 | 1 |
| NH | $572.43 | 1 |
| NJ | $600.96–$635.36 | 2 |
| NM | $513.73 | 1 |
| NV | $552.66 | 1 |
| NY | $527.02–$654.06 | 5 |
| OH | $510.68 | 1 |
| OK | $499.60 | 1 |
| OR | $549.48–$606.81 | 2 |
| PA | $512.76–$575.30 | 2 |
| PR | $558.41 | 1 |
| RI | $569.74 | 1 |
| SC | $515.15 | 1 |
| SD | $549.35 | 1 |
| TN | $506.05 | 1 |
| TX | $508.77–$580.91 | 8 |
| UT | $523.24 | 1 |
| VA | $543.15–$643.87 | 2 |
| VI | $558.41 | 1 |
| VT | $545.43 | 1 |
| WA | $578.41–$665.88 | 2 |
| WI | $528.68 | 1 |
| WV | $491.60 | 1 |
| WY | $551.64 | 1 |
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.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,664
- Code
- 19086
- Physician work
- 1.77
- Practice expense
- 14.62
- Malpractice
- 0.17
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.77 | × 1.000 | 1.7700 |
| Practice expense | 14.62 | × 1.000 | 14.6200 |
| Malpractice | 0.17 | × 0.406 | 0.0690 |
| Total RVUs | 16.4590 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$549.75
Office: (1.77 × 1 + 14.62 × 1 + 0.17 × 0.406) × $33.4009 = $549.75
Facility: (1.77 × 1 + 0.32 × 1 + 0.17 × 0.406) × $33.4009 = $72.11
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. |
How 19086 has changed in North Dakota
19086 · Office / nonfacility
$549.75
Effective 2026-10-01
The base rate is $4.62 higher than on 2025-10-01, moving from $545.13 to $549.75 (0.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$545.13changed to$549.75
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.82 changed to 1.77
- Practice expense RVU 14.95 changed to 14.62
- Malpractice RVU 0.16 changed to 0.17
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$580.62changed to$545.13
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 15.54 changed to 14.95
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$571.15changed to$580.62
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$611.34changed to$571.15
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 16.14 changed to 15.54
- Malpractice RVU 0.17 changed to 0.16
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$641.61changed to$611.34
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 16.66 changed to 16.14
- Malpractice RVU 0.14 changed to 0.17
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$714.42changed to$641.61
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 18.59 changed to 16.66
- Malpractice RVU 0.15 changed to 0.14
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$748.61changed to$714.42
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 18.86 changed to 18.59
- Malpractice RVU 0.13 changed to 0.15
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$789.13changed to$748.61
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 19.99 changed to 18.86
- Malpractice RVU 0.16 changed to 0.13
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$829.30changed to$789.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 21.13 changed to 19.99
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$828.06changed to$829.30
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 21.16 changed to 21.13
- Malpractice RVU 0.17 changed to 0.16
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$827.23changed to$828.06
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 21.19 changed to 21.16
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$832.13changed to$827.23
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 21.21 changed to 21.19
- Malpractice RVU 0.23 changed to 0.17
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$827.99changed to$832.13
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$816.12changed to$827.99
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 20.93 changed to 21.21
- Malpractice RVU 0.06 changed to 0.23
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$816.12
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $549.75 | $72.11 | RVU26D |
| 2026-07-01 | $549.75 | $72.11 | RVU26C |
| 2026-04-01 | $549.75 | $72.11 | RVU26B |
| 2026-01-01 | $549.75 | $72.11 | RVU26A |
| 2025-10-01 | $545.13 | $82.90 | RVU25D |
| 2025-07-01 | $545.13 | $82.90 | RVU25C |
| 2025-04-01 | $545.13 | $82.90 | RVU25B |
| 2025-01-01 | $545.13 | $82.90 | RVU25A |
| 2024-10-01 | $580.62 | $84.64 | RVU24D |
| 2024-07-01 | $580.62 | $84.64 | RVU24C |
| 2024-04-01 | $580.62 | $84.64 | RVU24B |
| 2024-03-09 | $580.62 | $84.64 | RVU24AR |
| 2024-01-01 | $571.15 | $83.26 | RVU24A |
| 2023-10-01 | $611.34 | $86.77 | RVU23D |
| 2023-07-01 | $611.34 | $86.77 | RVU23C |
| 2023-04-01 | $611.34 | $86.77 | RVU23B |
| 2023-01-01 | $611.34 | $86.77 | RVU23A |
| 2022-10-01 | $641.61 | $87.91 | RVU22D |
| 2022-07-01 | $641.61 | $87.91 | RVU22C |
| 2022-04-01 | $641.61 | $87.91 | RVU22B |
| 2022-01-01 | $641.61 | $87.91 | RVU22A |
| 2021-10-01 | $714.42 | $88.79 | RVU21D |
| 2021-07-01 | $714.42 | $88.79 | RVU21C |
| 2021-04-01 | $714.42 | $88.79 | RVU21B |
| 2021-01-01 | $714.42 | $88.79 | RVU21A |
| 2020-10-01 | $748.61 | $92.50 | RVU20D |
| 2020-07-01 | $748.61 | $92.50 | RVU20C |
| 2020-04-01 | $748.61 | $92.50 | RVU20B |
| 2020-01-01 | $748.61 | $92.50 | RVU20A |
| 2019-10-01 | $789.13 | $92.85 | RVU19D |
| 2019-07-01 | $789.13 | $92.85 | RVU19C |
| 2019-04-01 | $789.13 | $92.85 | RVU19B |
| 2019-01-01 | $789.13 | $92.85 | RVU19A |
| 2018-10-01 | $829.30 | $93.11 | RVU18D |
| 2018-07-01 | $829.30 | $93.11 | RVU18C |
| 2018-04-01 | $829.30 | $93.11 | RVU18B |
| 2018-01-01 | $829.30 | $93.11 | RVU18AR1 |
| 2017-10-01 | $828.06 | $93.06 | RVU17D |
| 2017-07-01 | $828.06 | $93.06 | RVU17C |
| 2017-04-01 | $828.06 | $93.06 | RVU17B |
| 2017-01-01 | $828.06 | $93.06 | RVU17A |
| 2016-10-01 | $827.23 | $92.88 | RVU16D |
| 2016-07-01 | $827.23 | $92.88 | RVU16C |
| 2016-04-01 | $827.23 | $92.88 | RVU16B |
| 2016-01-01 | $827.23 | $92.88 | RVU16A |
| 2015-10-01 | $832.13 | $94.41 | RVU15D |
| 2015-07-01 | $832.13 | $94.41 | RVU15C |
| 2015-04-01 | $827.99 | $93.94 | RVU15B |
| 2015-01-01 | $827.99 | $93.94 | RVU15A |
| 2014-10-01 | $816.12 | $90.35 | RVU14D |
| 2014-07-01 | $816.12 | $90.35 | RVU14C |
| 2014-04-01 | $816.12 | $90.35 | RVU14B |
| 2014-01-01 | $816.12 | $90.35 | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
19086 billing questions
When is this code reported instead of 19085?
Use 19085 for the first lesion sampled with MRI guidance. Report 19086 for each additional lesion sampled with MRI guidance during the procedure.
Can 19086 be billed by itself?
No. It is an add-on code and must be reported with the primary MRI-guided breast biopsy code, 19085.
How many units should be reported?
Report one unit for each additional lesion sampled. The first lesion is represented by 19085, not by an additional unit of 19086.
Is marker placement separately reported?
Marker placement at the biopsy site, when performed, is part of the MRI-guided biopsy service. Specimen imaging, when performed, is also included in the service.
How does 19086 differ from 19084?
Both represent sampling of an additional lesion, but 19086 is for MRI guidance and 19084 is for ultrasound guidance.
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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