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CPT code 19285: Breast localization, first lesion, ultrasound guidance2026 Medicare rate & RVUs in Connecticut

Report percutaneous placement of a breast localization device for the first lesion when ultrasound guides targeting, commonly before surgical excision.

CMS RVU26DEffective Oct 1, 2026One payment locality28.7K Medicare services in 2024

In Connecticut, Medicare pays $374.99 for 19285 in the office and $74.98 when it’s performed in a hospital or facility.

$374.99Office (non-facility)
$74.98Hospital or facility
+7.0%vs the national office rate ($350.38)

Check a contract rate as a % of Medicare · 19285 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 19285 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 19285 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 19285 covers

A breast radiologist or other qualified physician places a localization device in or near a breast lesion that can be targeted with ultrasound. The service is commonly performed in a breast imaging department before surgery to help the surgeon find a nonpalpable lesion. It includes the imaging guidance used to direct placement; it is localization, not tissue sampling such as a core biopsy.

Report this code for the first lesion localized with ultrasound. For each additional lesion localized with ultrasound, 19286 is the related add-on code. Documentation should identify the target, ultrasound guidance, device placement, and lesion count. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral services, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. 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 Connecticut compares for 19285

Across 109 of 109 payment localities, the office rate for 19285 runs from $306.72 in Arkansas to $481.39 in San Benito County, CA. Connecticut pays $374.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

19285 in Connecticut vs other payment areas
  1. Connecticut · this page$374.99
  2. Los Angeles, CA · California$403.50+$28.51
  3. Washington, DC area · District of Columbia$405.48+$30.49
  4. Miami, FL · Florida$371.41−$3.58
  5. Chicago, IL · Illinois$359.99−$15.00
  6. Manhattan, NY · New York$404.25+$29.26
  7. Alaska · Alaska$394.18+$19.19

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

Every other payment area

19285 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$311.65$67.91
ArkansasArkansas$306.72$67.44
ArizonaArizona$340.55$70.63
Bakersfield, CACalifornia$376.81$71.51
Chico, CACalifornia$376.26$70.96
El Centro, CACalifornia$376.29$70.99
Fresno, CACalifornia$376.26$70.96
Hanford, CACalifornia$376.26$70.96

19285 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.

$306.72

$428.83

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

View every state and territory as a table
19285 office rate range by state
State / territoryOffice rate rangeLocalities
AK$394.181
AL$311.651
AR$306.721
AZ$340.551
CA$376.26–$481.3929
CO$368.211
CT$374.991
DC$405.481
DE$346.581
FL$340.69–$371.413
GA$320.33–$356.372
GU$387.431
HI$387.431
IA$322.191
ID$324.091
IL$328.62–$363.214
IN$326.191
KS$319.661
KY$317.791
LA$316.90–$334.152
MA$365.35–$408.042
MD$353.90–$405.483
ME$324.99–$345.562
MI$326.02–$344.392
MN$354.521
MO$310.35–$336.523
MS$308.651
MT$350.361
NC$328.851
ND$346.801
NE$324.391
NH$361.471
NJ$379.76–$400.502
NM$327.601
NV$349.661
NY$334.14–$413.685
OH$325.291
OK$318.121
OR$347.43–$381.792
PA$326.35–$364.382
PR$353.461
RI$360.311
SC$327.521
SD$346.381
TN$321.301
TX$323.95–$366.568
UT$332.431
VA$343.70–$405.482
VI$353.461
VT$344.521
WA$364.97–$417.632
WI$334.081
WV$315.121
WY$348.811

See 19285 in every payment locality

How the 19285 rate is calculated

Each of 19285’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 · 19285

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.66

1.66 RVUs× 1.000 GPCI

Practice expense8.65

8.65 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

10.4900

Conversion factor

$33.4009

Medicare rate

$350.38

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,677

Code
19285
Physician work
1.66
Practice expense
8.65
Malpractice
0.18

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 19285 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.66× 1.0201.6932
Practice expense8.65× 1.0779.3161
Malpractice0.18× 1.2100.2178
Total RVUs11.2271
Conversion factor× 33.4009

Office rate, Connecticut$374.99

Office: (1.66 × 1.02 + 8.65 × 1.077 + 0.18 × 1.21) × $33.4009 = $374.99

Facility: (1.66 × 1.02 + 0.31 × 1.077 + 0.18 × 1.21) × $33.4009 = $74.98

Open 19285 in the RVU calculator

Payment rules and modifiers for 19285

The CMS indicators that decide how 19285 is paid alongside other services.

CMS payment indicators · 19285

Breast localization, first lesion, ultrasound guidance

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

19285 without 50 · national office

$350.38

Breast localization, first lesion, ultrasound guidance

19285-50 · Bilateral: 150%

$525.57

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 19285

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

Codes related to 19285
CodeHow it relatesOffice range, Connecticut
Add-on codes
19286Breast localization, each additional lesionAdd-on code for each additional lesion localized with ultrasound.$307.47
Used instead
19283Breast localization, first lesion, stereotactic guidanceFirst-lesion breast localization when stereotactic guidance is used.$266.66
19287Breast localization, first lesion, MRI guidanceFirst-lesion breast localization when MRI guidance is used.$641.63
19281Breast localization, mammographic guidance, first lesionFirst-lesion breast localization without imaging guidance.$250.02
19284Breast localization, additional stereotactic lesionAdditional lesion localized with stereotactic guidance.$194.31

How 19285 has changed in Connecticut

19285 · Office / nonfacility

$374.99

Effective 2026-10-01

The base rate is $4.11 higher than on 2025-10-01, moving from $370.88 to $374.99 (1.1%).

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

    $370.88changed to$374.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.70 changed to 1.66
    • Practice expense RVU 8.74 changed to 8.65
    • Malpractice RVU 0.16 changed to 0.18
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $392.97changed to$370.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.04 changed to 8.74
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $386.55changed to$392.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $415.03changed to$386.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.35 changed to 9.04
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $436.59changed to$415.03

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.60 changed to 9.35
    • Malpractice RVU 0.17 changed to 0.18
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $487.37changed to$436.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.83 changed to 9.60
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $516.11changed to$487.37

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.12 changed to 10.83
    • Malpractice RVU 0.16 changed to 0.15
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $547.94changed to$516.11

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.92 changed to 11.12
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $584.97changed to$547.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.86 changed to 11.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $583.13changed to$584.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.80 changed to 12.86
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $581.57changed to$583.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.75 changed to 12.80
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $503.87changed to$581.57

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.78 changed to 12.75
    • Malpractice RVU 0.16 changed to 0.17

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $501.36changed to$503.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $521.99changed to$501.36

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.32 changed to 10.78
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$521.99

    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$374.99$74.98RVU26D
2026-07-01$374.99$74.98RVU26C
2026-04-01$374.99$74.98RVU26B
2026-01-01$374.99$74.98RVU26A
2025-10-01$370.88$84.33RVU25D
2025-07-01$370.88$84.33RVU25C
2025-04-01$370.88$84.33RVU25B
2025-01-01$370.88$84.33RVU25A
2024-10-01$392.97$86.45RVU24D
2024-07-01$392.97$86.45RVU24C
2024-04-01$392.97$86.45RVU24B
2024-03-09$392.97$86.45RVU24AR
2024-01-01$386.55$85.04RVU24A
2023-10-01$415.03$89.02RVU23D
2023-07-01$415.03$89.02RVU23C
2023-04-01$415.03$89.02RVU23B
2023-01-01$415.03$89.02RVU23A
2022-10-01$436.59$90.02RVU22D
2022-07-01$436.59$90.02RVU22C
2022-04-01$436.59$90.02RVU22B
2022-01-01$436.59$90.02RVU22A
2021-10-01$487.37$90.50RVU21D
2021-07-01$487.37$90.50RVU21C
2021-04-01$487.37$90.50RVU21B
2021-01-01$487.37$90.50RVU21A
2020-10-01$516.11$94.75RVU20D
2020-07-01$516.11$94.75RVU20C
2020-04-01$516.11$94.75RVU20B
2020-01-01$516.11$94.75RVU20A
2019-10-01$547.94$95.49RVU19D
2019-07-01$547.94$95.49RVU19C
2019-04-01$547.94$95.49RVU19B
2019-01-01$547.94$95.49RVU19A
2018-10-01$584.97$95.38RVU18D
2018-07-01$584.97$95.38RVU18C
2018-04-01$584.97$95.38RVU18B
2018-01-01$584.97$95.38RVU18AR1
2017-10-01$583.13$95.66RVU17D
2017-07-01$583.13$95.66RVU17C
2017-04-01$583.13$95.66RVU17B
2017-01-01$583.13$95.66RVU17A
2016-10-01$581.57$95.11RVU16D
2016-07-01$581.57$95.11RVU16C
2016-04-01$581.57$95.11RVU16B
2016-01-01$581.57$95.11RVU16A
2015-10-01$503.87$95.82RVU15D
2015-07-01$503.87$95.82RVU15C
2015-04-01$501.36$95.34RVU15B
2015-01-01$501.36$95.34RVU15A
2014-10-01$521.99$95.42RVU14D
2014-07-01$521.99$95.42RVU14C
2014-04-01$521.99$95.42RVU14B
2014-01-01$521.99$95.42RVU14A
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 19285 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

19285 billing questions

When should 19285 be used instead of 19283?

Use 19285 when ultrasound guides placement for the first lesion. Code 19283 is for first-lesion placement using stereotactic guidance.

How is a second ultrasound-localized lesion reported?

Report 19286 for each additional lesion localized with ultrasound, following 19285 for the first lesion.

Can the ultrasound guidance be billed separately?

The imaging guidance used to place the localization device is included in 19285.

Does 19285 include a breast biopsy?

No. It reports placement of a localization device, not tissue sampling. A separately performed biopsy is a distinct service when supported by the applicable coding and documentation.

What documentation supports reporting 19285?

Document the breast target, ultrasound guidance, device placement, and that this was the first lesion localized with that guidance modality.

How is bilateral placement handled?

For a bilateral service, CMS pays 19285 with modifier 50 at 150%. Same-session procedures are also subject to the standard multiple-procedure reduction.

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 19285PPRRVU2026_Oct_nonQPP.csv, line 1,677 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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