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CPT code 19281: Breast localization, mammographic guidance, first lesion2026 Medicare rate & RVUs in Delaware

Reports percutaneous placement of a breast localization device under mammographic guidance to mark the first lesion for surgical targeting.

CMS RVU26DEffective Oct 1, 2026One payment locality20.8K Medicare services in 2024

In Delaware, Medicare pays $232.53 for 19281 in the office and $82.71 when it’s performed in a hospital or facility.

$232.53Office (non-facility)
$82.71Hospital or facility
−1.0%vs the national office rate ($234.81)

Check a contract rate as a % of Medicare · 19281 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 19281 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 19281 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 19281 covers

A breast imager, typically a radiologist, uses mammographic imaging to guide percutaneous placement of a localization device at a breast target that is difficult to find by palpation. The service commonly prepares a mammographically visible mass, architectural distortion, or calcification cluster for surgical excision; a wire or marker can identify the target for the surgeon. Report this code for the first lesion localized with mammographic guidance, not for each device placed around one target.

Documentation should identify the lesion, the mammographic guidance used, and the placement performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 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 Delaware compares for 19281

Across 109 of 109 payment localities, the office rate for 19281 runs from $208.70 in Arkansas to $311.22 in San Benito County, CA. Delaware pays $232.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

19281 in Delaware vs other payment areas
  1. Delaware · this page$232.53
  2. Los Angeles, CA · California$265.24+$32.71
  3. Washington, DC area · District of Columbia$268.12+$35.59
  4. Miami, FL · Florida$251.21+$18.68
  5. Chicago, IL · Illinois$244.30+$11.77
  6. Manhattan, NY · New York$269.16+$36.63
  7. Alaska · Alaska$275.14+$42.61

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

Every other payment area

19281 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$211.64$78.95
ArkansasArkansas$208.70$78.44
ArizonaArizona$228.83$81.89
Bakersfield, CACalifornia$249.24$83.05
Chico, CACalifornia$248.65$82.45
El Centro, CACalifornia$248.68$82.48
Fresno, CACalifornia$248.65$82.45
Hanford, CACalifornia$248.65$82.45

19281 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.

$208.70

$279.94

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
19281 office rate range by state
State / territoryOffice rate rangeLocalities
AK$275.141
AL$211.641
AR$208.701
AZ$228.831
CA$248.65–$311.2229
CO$244.651
CT$250.021
DC$268.121
DE$232.531
FL$230.81–$251.213
GA$218.39–$238.892
GU$254.511
HI$254.511
IA$217.101
ID$218.401
IL$224.17–$244.574
IN$219.621
KS$215.981
KY$216.141
LA$215.76–$226.032
MA$243.22–$268.472
MD$236.90–$268.123
ME$219.34–$231.002
MI$221.42–$233.452
MN$235.081
MO$212.10–$226.983
MS$210.451
MT$234.801
NC$221.571
ND$231.041
NE$218.281
NH$240.711
NJ$253.06–$265.482
NM$222.531
NV$233.911
NY$224.76–$275.285
OH$220.651
OK$215.921
OR$232.27–$252.362
PA$221.07–$243.902
PR$236.511
RI$240.751
SC$221.441
SD$230.591
TN$217.011
TX$219.66–$243.698
UT$224.361
VA$230.17–$268.122
VI$236.511
VT$230.041
WA$242.79–$273.982
WI$223.561
WV$216.151
WY$233.161

See 19281 in every payment locality

How the 19281 rate is calculated

Each of 19281’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 · 19281

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.95

1.95 RVUs× 1.000 GPCI

Practice expense4.89

4.89 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

7.0300

Conversion factor

$33.4009

Medicare rate

$234.81

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,673

Code
19281
Physician work
1.95
Practice expense
4.89
Malpractice
0.19

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 19281 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.95× 1.0051.9597
Practice expense4.89× 0.9884.8313
Malpractice0.19× 0.8990.1708
Total RVUs6.9619
Conversion factor× 33.4009

Office rate, Delaware$232.53

Office: (1.95 × 1.005 + 4.89 × 0.988 + 0.19 × 0.899) × $33.4009 = $232.53

Facility: (1.95 × 1.005 + 0.35 × 0.988 + 0.19 × 0.899) × $33.4009 = $82.71

Open 19281 in the RVU calculator

Payment rules and modifiers for 19281

The CMS indicators that decide how 19281 is paid alongside other services.

CMS payment indicators · 19281

Breast localization, mammographic guidance, first lesion

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

19281 without 50 · national office

$234.81

Breast localization, mammographic guidance, first lesion

19281-50 · Bilateral: 150%

$352.22

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).

When to use modifier 50

Codes related to 19281

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

Codes related to 19281
CodeHow it relatesOffice range, Delaware
Add-on codes
19282Breast localization, each additional lesionAdd-on for each additional lesion localized with mammographic guidance.$163.01
Used instead
19283Breast localization, first lesion, stereotactic guidanceFirst lesion localization when stereotactic mammographic guidance is used.$247.65
19285Breast localization, first lesion, ultrasound guidanceFirst lesion localization when ultrasound guidance is used.$346.58
19287Breast localization, first lesion, MRI guidanceFirst lesion localization when MRI guidance is used.$592.75
Same family
19284Breast localization, additional stereotactic lesionAdditional-lesion code in the stereotactic guidance branch.$179.75

How 19281 has changed in Delaware

19281 · Office / nonfacility

$232.53

Effective 2026-10-01

The base rate is $1.60 higher than on 2025-10-01, moving from $230.93 to $232.53 (0.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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

  1. January 1, 2026

    RVU26A

    $230.93changed to$232.53

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.00 changed to 1.95
    • Practice expense RVU 5.00 changed to 4.89
    • Malpractice RVU 0.17 changed to 0.19
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $238.96changed to$230.93

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.03 changed to 5.00
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $235.06changed to$238.96

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $247.32changed to$235.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.08 changed to 5.03
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $251.82changed to$247.32

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.99 changed to 5.08
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $256.47changed to$251.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.08 changed to 4.99
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $255.76changed to$256.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.81 changed to 5.08
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $253.18changed to$255.76

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.72 changed to 4.81
    • Malpractice RVU 0.18 changed to 0.16
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $250.33changed to$253.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.65 changed to 4.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $250.29changed to$250.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.64 changed to 4.65
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $249.99changed to$250.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.62 changed to 4.64
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $250.91changed to$249.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.61 changed to 4.62
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $249.66changed to$250.91

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $252.13changed to$249.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.67 changed to 4.61
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$252.13

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$232.53$82.71RVU26D
2026-07-01$232.53$82.71RVU26C
2026-04-01$232.53$82.71RVU26B
2026-01-01$232.53$82.71RVU26A
2025-10-01$230.93$93.92RVU25D
2025-07-01$230.93$93.92RVU25C
2025-04-01$230.93$93.92RVU25B
2025-01-01$230.93$93.92RVU25A
2024-10-01$238.96$96.31RVU24D
2024-07-01$238.96$96.31RVU24C
2024-04-01$238.96$96.31RVU24B
2024-03-09$238.96$96.31RVU24AR
2024-01-01$235.06$94.73RVU24A
2023-10-01$247.32$98.88RVU23D
2023-07-01$247.32$98.88RVU23C
2023-04-01$247.32$98.88RVU23B
2023-01-01$247.32$98.88RVU23A
2022-10-01$251.82$100.80RVU22D
2022-07-01$251.82$100.80RVU22C
2022-04-01$251.82$100.80RVU22B
2022-01-01$251.82$100.80RVU22A
2021-10-01$256.47$100.99RVU21D
2021-07-01$256.47$100.99RVU21C
2021-04-01$256.47$100.99RVU21B
2021-01-01$256.47$100.99RVU21A
2020-10-01$255.76$105.79RVU20D
2020-07-01$255.76$105.79RVU20C
2020-04-01$255.76$105.79RVU20B
2020-01-01$255.76$105.79RVU20A
2019-10-01$253.18$106.65RVU19D
2019-07-01$253.18$106.65RVU19C
2019-04-01$253.18$106.65RVU19B
2019-01-01$253.18$106.65RVU19A
2018-10-01$250.33$106.53RVU18D
2018-07-01$250.33$106.53RVU18C
2018-04-01$250.33$106.53RVU18B
2018-01-01$250.33$106.53RVU18AR1
2017-10-01$250.29$107.20RVU17D
2017-07-01$250.29$107.20RVU17C
2017-04-01$250.29$107.20RVU17B
2017-01-01$250.29$107.20RVU17A
2016-10-01$249.99$107.13RVU16D
2016-07-01$249.99$107.13RVU16C
2016-04-01$249.99$107.13RVU16B
2016-01-01$249.99$107.13RVU16A
2015-10-01$250.91$107.91RVU15D
2015-07-01$250.91$107.91RVU15C
2015-04-01$249.66$107.37RVU15B
2015-01-01$249.66$107.37RVU15A
2014-10-01$252.13$106.00RVU14D
2014-07-01$252.13$106.00RVU14C
2014-04-01$252.13$106.00RVU14B
2014-01-01$252.13$106.00RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 19281 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

19281 billing questions

When is 19281 reported instead of 19283?

Use 19281 for localization guided by mammographic imaging without stereotactic guidance. Use 19283 when stereotactic guidance is used.

How is an additional lesion reported?

19281 represents the first lesion localized with mammographic guidance. Report 19282 for each additional lesion localized with that guidance.

Are units based on devices or lesions?

The code distinguishes the first lesion from additional lesions, not the number of wires or markers placed around one lesion.

Can 19281 be used for ultrasound- or MRI-guided placement?

No. The guidance modality determines the code: 19285 is for ultrasound guidance and 19287 is for MRI guidance.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Separately performed procedures may be subject to the standard multiple procedure reduction.

When is modifier 50 appropriate?

For bilateral performance, CMS pays this procedure at 150% with modifier 50. Assistant-at-surgery payment requires documented medical necessity.

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 19281PPRRVU2026_Oct_nonQPP.csv, line 1,673 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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