FeeBase
Log inGet started
Menu

CPT code 19126: Breast lesion excision, each additional lesion2026 Medicare rate & RVUs in Montana

Reports open excision of each additional breast lesion identified by preoperative radiological marking, alongside the primary localized-lesion excision.

CMS RVU26DEffective Oct 1, 2026One payment locality475 Medicare services in 2024

In Montana, Medicare pays $143.91 for 19126 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$143.91Hospital or facility

Check a contract rate as a % of Medicare · 19126 nationwide

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

We’ll open 19126 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 19126 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 19126 covers

This add-on represents open removal of an additional breast lesion that was identified by preoperative radiological marking. A breast surgeon or other operating surgeon excises the separately localized lesion, often during the same operation as removal of the first localized lesion. It is suited to cases with more than one distinct lesion selected for excision, including nonpalpable findings localized before surgery.

Report 19126 with 19125 for each additional localized lesion beyond the first; do not report it by itself. The operative record should support the separate lesion excised and its preoperative radiological localization. CMS treats this as an add-on code billed with a primary procedure, with payment within that procedure’s global period.

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 Montana compares for 19126

Across 109 of 109 payment localities, the facility rate for 19126 runs from $126.08 in Wisconsin to $182.34 in Alaska. Montana pays $143.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

19126 in Montana vs other payment areas
  1. Montana · this page$143.91
  2. Los Angeles, CA · California$144.08+$0.17
  3. Washington, DC area · District of Columbia$156.15+$12.24
  4. Miami, FL · Florida$182.22+$38.31
  5. Chicago, IL · Illinois$176.32+$32.41
  6. Manhattan, NY · New York$168.26+$24.35
  7. Alaska · Alaska$182.34+$38.43

Other areas in Montana first, then benchmark localities. Bars start at $0.

Every other payment area

19126 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$130.37
ArkansasArkansas—$128.74
ArizonaArizona—$139.70
Bakersfield, CACalifornia—$138.55
Chico, CACalifornia—$136.58
El Centro, CACalifornia—$136.70
Fresno, CACalifornia—$136.58
Hanford, CACalifornia—$136.58

19126 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
19126 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 19126 in every payment locality

How the 19126 rate is calculated

Each of 19126’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 · 19126

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.86

2.86 RVUs× 1.000 GPCI

Practice expense0.72

0.72 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

4.3100

Conversion factor

$33.4009

Medicare rate

$143.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,672

Code
19126
Physician work
2.86
Practice expense
0.72
Malpractice
0.73

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Facility calculation for 19126 in Montana
ComponentRVULocality factorAdjusted
Physician work2.86× 1.0002.8600
Practice expense0.72× 1.0000.7200
Malpractice0.73× 0.9980.7285
Total RVUs4.3085
Conversion factor× 33.4009

Facility rate, Montana$143.91

Facility: (2.86 × 1 + 0.72 × 1 + 0.73 × 0.998) × $33.4009 = $143.91

Open 19126 in the RVU calculator

Payment rules and modifiers for 19126

The CMS indicators that decide how 19126 is paid alongside other services.

CMS payment indicators · 19126

Breast lesion excision, each additional lesion

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 19126

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

Codes related to 19126
CodeHow it relatesOffice range, Montana
Add-on codes
19125Breast lesion excision, single marker-localized lesionPrimary localized breast-lesion excision reported with 19126 for additional lesions.$634.84
Used instead
19120Breast lesion excision, without marker localizationOpen breast-lesion excision when the specific preoperative radiological-marker coding structure is not used.$573.06
Often billed with
19285Breast localization, first lesion, ultrasound guidanceBreast localization-device placement for one lesion may accompany the excision encounter.$350.36
19286Breast localization, each additional lesionAdditional breast localization-device placement may accompany excision of multiple localized lesions.$286.57

How 19126 has changed in Montana

19126 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$143.91RVU26D
2026-07-01Not available in this setting$143.91RVU26C
2026-04-01Not available in this setting$143.91RVU26B
2026-01-01Not available in this setting$143.91RVU26A
2025-10-01Not available in this setting$154.10RVU25D
2025-07-01Not available in this setting$154.10RVU25C
2025-04-01Not available in this setting$154.10RVU25B
2025-01-01Not available in this setting$154.10RVU25A
2024-10-01Not available in this setting$158.24RVU24D
2024-07-01Not available in this setting$158.24RVU24C
2024-04-01Not available in this setting$158.24RVU24B
2024-03-09Not available in this setting$158.24RVU24AR
2024-01-01Not available in this setting$155.66RVU24A
2023-10-01Not available in this setting$160.43RVU23D
2023-07-01Not available in this setting$160.43RVU23C
2023-04-01Not available in this setting$160.43RVU23B
2023-01-01Not available in this setting$160.43RVU23A
2022-10-01Not available in this setting$164.49RVU22D
2022-07-01Not available in this setting$164.49RVU22C
2022-04-01Not available in this setting$164.49RVU22B
2022-01-01Not available in this setting$164.49RVU22A
2021-10-01Not available in this setting$164.82RVU21D
2021-07-01Not available in this setting$164.82RVU21C
2021-04-01Not available in this setting$164.82RVU21B
2021-01-01Not available in this setting$164.82RVU21A
2020-10-01Not available in this setting$176.36RVU20D
2020-07-01Not available in this setting$176.36RVU20C
2020-04-01Not available in this setting$176.36RVU20B
2020-01-01Not available in this setting$176.36RVU20A
2019-10-01Not available in this setting$184.58RVU19D
2019-07-01Not available in this setting$184.58RVU19C
2019-04-01Not available in this setting$184.58RVU19B
2019-01-01Not available in this setting$184.58RVU19A
2018-10-01Not available in this setting$184.02RVU18D
2018-07-01Not available in this setting$184.02RVU18C
2018-04-01Not available in this setting$184.02RVU18B
2018-01-01Not available in this setting$184.02RVU18AR1
2017-10-01Not available in this setting$178.58RVU17D
2017-07-01Not available in this setting$178.58RVU17C
2017-04-01Not available in this setting$178.58RVU17B
2017-01-01Not available in this setting$178.58RVU17A
2016-10-01Not available in this setting$173.23RVU16D
2016-07-01Not available in this setting$173.23RVU16C
2016-04-01Not available in this setting$173.23RVU16B
2016-01-01Not available in this setting$173.23RVU16A
2015-10-01Not available in this setting$173.85RVU15D
2015-07-01Not available in this setting$173.85RVU15C
2015-04-01Not available in this setting$172.99RVU15B
2015-01-01Not available in this setting$172.99RVU15A
2014-10-01Not available in this setting$168.33RVU14D
2014-07-01Not available in this setting$168.33RVU14C
2014-04-01Not available in this setting$168.33RVU14B
2014-01-01Not available in this setting$168.33RVU14A
2013-10-01Not available in this setting$162.80RVU13D
2013-07-01Not available in this setting$162.80RVU13C
2013-04-01Not available in this setting$162.80RVU13B
2013-01-01Not available in this setting$162.80RVU13AR

Price 19126 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

19126 billing questions

When should 19126 be reported instead of 19125?

Use 19125 for the first breast lesion identified by preoperative radiological marking and 19126 for each additional separately localized lesion excised during the operation.

Can 19126 be billed by itself?

No. It is an add-on code reported with 19125, the primary localized-lesion excision.

What documentation supports an additional unit?

The operative record should establish that another distinct lesion was excised and that it had been identified by preoperative radiological marking.

How is 19126 paid under the CMS rule?

CMS identifies it as an add-on billed with a primary procedure, with payment within that procedure’s global period.

How does 19126 differ from 19120?

19126 is for an additional lesion identified by preoperative radiological marking and accompanies 19125. 19120 describes breast lesion excision without that specific localization-code structure.

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
RVUs for 19126PPRRVU2026_Oct_nonQPP.csv, line 1,672 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 19126 pays in Montana?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 19126 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist