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

In Vermont, Medicare pays $230.04 for 19281 in the office and $79.92 when it’s performed in a hospital or facility.

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.

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 Vermont 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. Vermont pays $230.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

19281 rates by state

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

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.

Payment rules and modifiers for 19281

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

What modifiers do to the payment

When to use modifier 50

Codes related to 19281

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

How 19281 has changed in Vermont

Price 19281 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates