CPT code 19281: Breast localization, mammographic guidance, first lesion2026 Medicare rate & RVUs in West Virginia
Reports percutaneous placement of a breast localization device under mammographic guidance to mark the first lesion for surgical targeting.
In West Virginia, Medicare pays $216.15 for 19281 in the office and $84.37 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.
On this page 11 sections
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 West Virginia 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. West Virginia pays $216.15. The RVUs are the same everywhere; the geographic indexes change the dollars.
- West Virginia · this page$216.15
- Los Angeles, CA · California$265.24+$49.09
- Washington, DC area · District of Columbia$268.12+$51.97
- Miami, FL · Florida$251.21+$35.06
- Chicago, IL · Illinois$244.30+$28.15
- Manhattan, NY · New York$269.16+$53.01
- Alaska · Alaska$275.14+$58.99
Other areas in West Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $248.65 | $82.45 |
| Merced, CACalifornia | $248.65 | $82.45 |
| Modesto, CACalifornia | $248.65 | $82.45 |
| Napa, CACalifornia | $287.73 | $87.87 |
| Oxnard, CACalifornia | $263.97 | $84.73 |
| Redding, CACalifornia | $248.65 | $82.45 |
| Rest of CaliforniaCalifornia | $248.65 | $82.45 |
| Riverside, CACalifornia | $250.73 | $84.53 |
| Sacramento, CACalifornia | $260.83 | $84.47 |
| Salinas, CACalifornia | $259.85 | $84.10 |
| San Diego, CACalifornia | $265.87 | $84.51 |
| Marin County, CACalifornia | $304.53 | $90.72 |
| San Francisco, CACalifornia | $304.31 | $90.50 |
| San Benito County, CACalifornia | $311.22 | $92.56 |
| Santa Clara County, CACalifornia | $310.34 | $91.67 |
| San Luis Obispo, CACalifornia | $255.67 | $82.96 |
| Santa Cruz, CACalifornia | $268.35 | $84.10 |
| Santa Maria, CACalifornia | $260.80 | $83.99 |
| Santa Rosa, CACalifornia | $271.06 | $84.84 |
| Stockton, CACalifornia | $248.65 | $82.45 |
| Vallejo, CACalifornia | $287.42 | $87.56 |
| Visalia, CACalifornia | $248.65 | $82.45 |
| Yuba City, CACalifornia | $248.65 | $82.45 |
| ColoradoColorado | $244.65 | $83.31 |
| ConnecticutConnecticut | $250.02 | $86.70 |
| DelawareDelaware | $232.53 | $82.71 |
| Fort Lauderdale, FLFlorida | $242.06 | $88.45 |
| Rest of FloridaFlorida | $230.81 | $85.85 |
| Atlanta, GAGeorgia | $238.89 | $84.83 |
| Rest of GeorgiaGeorgia | $218.39 | $83.12 |
| Hawaii, Guam, HIHawaii | $254.51 | $82.10 |
| IowaIowa | $217.10 | $78.35 |
| IdahoIdaho | $218.40 | $78.89 |
| East St. Louis, ILIllinois | $228.18 | $88.67 |
| Rest of IllinoisIllinois | $224.17 | $85.72 |
| Suburban Chicago, ILIllinois | $244.57 | $88.84 |
| IndianaIndiana | $219.62 | $79.05 |
| KansasKansas | $215.98 | $78.90 |
| KentuckyKentucky | $216.14 | $81.33 |
| New Orleans, LALouisiana | $226.03 | $83.34 |
| Rest of LouisianaLouisiana | $215.76 | $81.56 |
| Metropolitan Boston, MAMassachusetts | $268.47 | $87.41 |
| Rest of MassachusettsMassachusetts | $243.22 | $83.54 |
| Baltimore area, MDMaryland | $249.28 | $86.57 |
| Rest of MarylandMaryland | $236.90 | $83.44 |
| Rest of MaineMaine | $219.34 | $79.83 |
| Southern Maine, MEMaine | $231.00 | $80.72 |
| Detroit, MIMichigan | $233.45 | $87.11 |
| Rest of MichiganMichigan | $221.42 | $82.97 |
| MinnesotaMinnesota | $235.08 | $79.04 |
| Metropolitan Kansas City, MOMissouri | $224.70 | $82.31 |
| Metropolitan St. Louis, MOMissouri | $226.98 | $82.62 |
| Rest of MissouriMissouri | $212.10 | $81.39 |
| MississippiMississippi | $210.45 | $79.89 |
| MontanaMontana | $234.80 | $83.16 |
| North CarolinaNorth Carolina | $221.57 | $80.09 |
| North DakotaNorth Dakota | $231.04 | $79.40 |
| NebraskaNebraska | $218.28 | $78.32 |
| New HampshireNew Hampshire | $240.71 | $82.85 |
| Northern New JerseyNew Jersey | $265.48 | $89.57 |
| Rest of New JerseyNew Jersey | $253.06 | $87.46 |
| New MexicoNew Mexico | $222.53 | $83.47 |
| NevadaNevada | $233.91 | $82.12 |
| NYC suburbs and Long Island, NYNew York | $275.28 | $94.98 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $254.59 | $88.54 |
| Queens, NYNew York | $271.51 | $92.27 |
| Rest of New YorkNew York | $224.76 | $80.70 |
| OhioOhio | $220.65 | $82.20 |
| OklahomaOklahoma | $215.92 | $80.50 |
| Portland, OROregon | $252.36 | $83.88 |
| Rest of OregonOregon | $232.27 | $81.24 |
| Metropolitan Philadelphia, PAPennsylvania | $243.90 | $86.04 |
| Rest of PennsylvaniaPennsylvania | $221.07 | $81.86 |
| Puerto RicoPuerto Rico | $236.51 | $83.20 |
| Rhode IslandRhode Island | $240.75 | $84.11 |
| South CarolinaSouth Carolina | $221.44 | $81.33 |
| South DakotaSouth Dakota | $230.59 | $78.95 |
| TennesseeTennessee | $217.01 | $79.17 |
| Austin, TXTexas | $243.69 | $83.25 |
| Beaumont, TXTexas | $219.66 | $81.67 |
| Brazoria, TXTexas | $232.46 | $82.19 |
| Dallas, TXTexas | $233.84 | $82.81 |
| Fort Worth, TXTexas | $232.29 | $82.77 |
| Galveston, TXTexas | $233.09 | $82.52 |
| Houston, TXTexas | $236.57 | $85.99 |
| Rest of TexasTexas | $225.86 | $81.96 |
| UtahUtah | $224.36 | $81.82 |
| VirginiaVirginia | $230.17 | $81.10 |
| Virgin Islands, VIUnited States Virgin Islands | $236.51 | $83.20 |
| VermontVermont | $230.04 | $79.92 |
| Rest of WashingtonWashington | $242.79 | $83.12 |
| King County, WAWashington | $273.98 | $87.92 |
| WisconsinWisconsin | $223.56 | $78.29 |
| WyomingWyoming | $233.16 | $81.52 |
19281 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.
$208.70
$279.94
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 | $275.14 | 1 |
| AL | $211.64 | 1 |
| AR | $208.70 | 1 |
| AZ | $228.83 | 1 |
| CA | $248.65–$311.22 | 29 |
| CO | $244.65 | 1 |
| CT | $250.02 | 1 |
| DC | $268.12 | 1 |
| DE | $232.53 | 1 |
| FL | $230.81–$251.21 | 3 |
| GA | $218.39–$238.89 | 2 |
| GU | $254.51 | 1 |
| HI | $254.51 | 1 |
| IA | $217.10 | 1 |
| ID | $218.40 | 1 |
| IL | $224.17–$244.57 | 4 |
| IN | $219.62 | 1 |
| KS | $215.98 | 1 |
| KY | $216.14 | 1 |
| LA | $215.76–$226.03 | 2 |
| MA | $243.22–$268.47 | 2 |
| MD | $236.90–$268.12 | 3 |
| ME | $219.34–$231.00 | 2 |
| MI | $221.42–$233.45 | 2 |
| MN | $235.08 | 1 |
| MO | $212.10–$226.98 | 3 |
| MS | $210.45 | 1 |
| MT | $234.80 | 1 |
| NC | $221.57 | 1 |
| ND | $231.04 | 1 |
| NE | $218.28 | 1 |
| NH | $240.71 | 1 |
| NJ | $253.06–$265.48 | 2 |
| NM | $222.53 | 1 |
| NV | $233.91 | 1 |
| NY | $224.76–$275.28 | 5 |
| OH | $220.65 | 1 |
| OK | $215.92 | 1 |
| OR | $232.27–$252.36 | 2 |
| PA | $221.07–$243.90 | 2 |
| PR | $236.51 | 1 |
| RI | $240.75 | 1 |
| SC | $221.44 | 1 |
| SD | $230.59 | 1 |
| TN | $217.01 | 1 |
| TX | $219.66–$243.69 | 8 |
| UT | $224.36 | 1 |
| VA | $230.17–$268.12 | 2 |
| VI | $236.51 | 1 |
| VT | $230.04 | 1 |
| WA | $242.79–$273.98 | 2 |
| WI | $223.56 | 1 |
| WV | $216.15 | 1 |
| WY | $233.16 | 1 |
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
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 West Virginia 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
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.95 | × 1.000 | 1.9500 |
| Practice expense | 4.89 | × 0.869 | 4.2494 |
| Malpractice | 0.19 | × 1.431 | 0.2719 |
| Total RVUs | 6.4713 | ||
| Conversion factor | × 33.4009 | ||
Office rate, West Virginia$216.15
Office: (1.95 × 1 + 4.89 × 0.869 + 0.19 × 1.431) × $33.4009 = $216.15
Facility: (1.95 × 1 + 0.35 × 0.869 + 0.19 × 1.431) × $33.4009 = $84.37
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
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).
How 19281 has changed in West Virginia
19281 · Office / nonfacility
$216.15
Effective 2026-10-01
The base rate is $4.71 higher than on 2025-10-01, moving from $211.44 to $216.15 (2.2%).
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
$211.44changed to$216.15
- 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
- Practice expense GPCI 0.862 changed to 0.869
- Malpractice GPCI 1.333 changed to 1.431
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$218.89changed to$211.44
- 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.
March 9, 2024
RVU24AR
$215.32changed to$218.89
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$223.54changed to$215.32
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.08 changed to 5.03
- Practice expense GPCI 0.860 changed to 0.862
- Malpractice GPCI 1.266 changed to 1.333
January 1, 2023
RVU23A
$224.84changed to$223.54
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.99 changed to 5.08
- Practice expense GPCI 0.858 changed to 0.860
- Malpractice GPCI 1.198 changed to 1.266
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$228.56changed to$224.84
- 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.
January 1, 2021
RVU21A
$228.15changed to$228.56
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.81 changed to 5.08
- Practice expense GPCI 0.857 changed to 0.858
- Malpractice GPCI 1.247 changed to 1.198
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$226.27changed to$228.15
- 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
- Malpractice GPCI 1.296 changed to 1.247
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$223.86changed to$226.27
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.65 changed to 4.72
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$221.15changed to$223.86
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.64 changed to 4.65
- Practice expense GPCI 0.847 changed to 0.857
- Malpractice GPCI 1.289 changed to 1.296
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$218.16changed to$221.15
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.62 changed to 4.64
- Practice expense GPCI 0.836 changed to 0.847
- Malpractice GPCI 1.282 changed to 1.289
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$219.11changed to$218.16
- 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.
July 1, 2015
RVU15C
$218.02changed to$219.11
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$219.38changed to$218.02
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 4.67 changed to 4.61
- Practice expense GPCI 0.832 changed to 0.836
- Malpractice GPCI 1.256 changed to 1.282
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$219.38
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 | $216.15 | $84.37 | RVU26D |
| 2026-07-01 | $216.15 | $84.37 | RVU26C |
| 2026-04-01 | $216.15 | $84.37 | RVU26B |
| 2026-01-01 | $216.15 | $84.37 | RVU26A |
| 2025-10-01 | $211.44 | $92.38 | RVU25D |
| 2025-07-01 | $211.44 | $92.38 | RVU25C |
| 2025-04-01 | $211.44 | $92.38 | RVU25B |
| 2025-01-01 | $211.44 | $92.38 | RVU25A |
| 2024-10-01 | $218.89 | $94.93 | RVU24D |
| 2024-07-01 | $218.89 | $94.93 | RVU24C |
| 2024-04-01 | $218.89 | $94.93 | RVU24B |
| 2024-03-09 | $218.89 | $94.93 | RVU24AR |
| 2024-01-01 | $215.32 | $93.39 | RVU24A |
| 2023-10-01 | $223.54 | $96.77 | RVU23D |
| 2023-07-01 | $223.54 | $96.77 | RVU23C |
| 2023-04-01 | $223.54 | $96.77 | RVU23B |
| 2023-01-01 | $223.54 | $96.77 | RVU23A |
| 2022-10-01 | $224.84 | $98.05 | RVU22D |
| 2022-07-01 | $224.84 | $98.05 | RVU22C |
| 2022-04-01 | $224.84 | $98.05 | RVU22B |
| 2022-01-01 | $224.84 | $98.05 | RVU22A |
| 2021-10-01 | $228.56 | $98.03 | RVU21D |
| 2021-07-01 | $228.56 | $98.03 | RVU21C |
| 2021-04-01 | $228.56 | $98.03 | RVU21B |
| 2021-01-01 | $228.56 | $98.03 | RVU21A |
| 2020-10-01 | $228.15 | $102.27 | RVU20D |
| 2020-07-01 | $228.15 | $102.27 | RVU20C |
| 2020-04-01 | $228.15 | $102.27 | RVU20B |
| 2020-01-01 | $228.15 | $102.27 | RVU20A |
| 2019-10-01 | $226.27 | $103.03 | RVU19D |
| 2019-07-01 | $226.27 | $103.03 | RVU19C |
| 2019-04-01 | $226.27 | $103.03 | RVU19B |
| 2019-01-01 | $226.27 | $103.03 | RVU19A |
| 2018-10-01 | $223.86 | $102.92 | RVU18D |
| 2018-07-01 | $223.86 | $102.92 | RVU18C |
| 2018-04-01 | $223.86 | $102.92 | RVU18B |
| 2018-01-01 | $223.86 | $102.92 | RVU18AR1 |
| 2017-10-01 | $221.15 | $102.90 | RVU17D |
| 2017-07-01 | $221.15 | $102.90 | RVU17C |
| 2017-04-01 | $221.15 | $102.90 | RVU17B |
| 2017-01-01 | $221.15 | $102.90 | RVU17A |
| 2016-10-01 | $218.16 | $102.32 | RVU16D |
| 2016-07-01 | $218.16 | $102.32 | RVU16C |
| 2016-04-01 | $218.16 | $102.32 | RVU16B |
| 2016-01-01 | $218.16 | $102.32 | RVU16A |
| 2015-10-01 | $219.11 | $103.15 | RVU15D |
| 2015-07-01 | $219.11 | $103.15 | RVU15C |
| 2015-04-01 | $218.02 | $102.64 | RVU15B |
| 2015-01-01 | $218.02 | $102.64 | RVU15A |
| 2014-10-01 | $219.38 | $102.25 | RVU14D |
| 2014-07-01 | $219.38 | $102.25 | RVU14C |
| 2014-04-01 | $219.38 | $102.25 | RVU14B |
| 2014-01-01 | $219.38 | $102.25 | 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 West Virginia rate applies
West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.
- Accoville
- Addison (Webster Springs)
- Adrian
- Albright
- Alderson
- Alum Creek
- Amherstdale
- Anawalt
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
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