CPT code 19286: Breast localization, each additional lesion2026 Medicare rate & RVUs in California
Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.
Medicare pays $310.22–$401.32 for 19286 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 19286 covers
This code represents percutaneous placement of a localization device at an additional breast lesion, using ultrasound guidance. It is used when a clinician places devices to mark separate targets, commonly before breast-conserving surgery or another planned breast procedure. The ultrasound-guided placement, rather than a diagnostic ultrasound examination alone, is the service captured by this code.
Report it for each qualifying additional lesion after the first ultrasound-guided lesion, with the primary ultrasound-guided placement code 19285 on the claim. The record should support the separate lesion treated, its location, the percutaneous device placement, and ultrasound guidance. This is an add-on code: it is not billed alone and is paid within the global period of the primary procedure. The first lesion is reported with 19285; this code represents additional lesions, not additional devices placed at the same lesion.
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.
Where 19286 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$310.22 to $401.32
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $310.49 | $35.94 |
| Chico, CA | $310.22 | $35.66 |
| El Centro, CA | $310.23 | $35.68 |
| Fresno, CA | $310.22 | $35.66 |
| Hanford, CA | $310.22 | $35.66 |
| Los Angeles, CA | $333.53 | $37.18 |
| Madera, CA | $310.22 | $35.66 |
| Marin County, CA | $392.49 | $39.27 |
| Merced, CA | $310.22 | $35.66 |
| Modesto, CA | $310.22 | $35.66 |
| Napa, CA | $368.21 | $38.04 |
| Oxnard, CA | $332.79 | $36.69 |
| Redding, CA | $310.22 | $35.66 |
| Rest of California | $310.22 | $35.66 |
| Riverside, CA | $311.20 | $36.64 |
| Sacramento, CA | $327.89 | $36.55 |
| Salinas, CA | $326.72 | $36.39 |
| San Benito County, CA | $401.32 | $40.09 |
| San Diego, CA | $336.18 | $36.58 |
| San Francisco, CA | $392.38 | $39.17 |
| San Luis Obispo, CA | $321.22 | $35.89 |
| Santa Clara County, CA | $400.90 | $39.67 |
| Santa Cruz, CA | $340.78 | $36.41 |
| Santa Maria, CA | $328.43 | $36.34 |
| Santa Rosa, CA | $344.35 | $36.73 |
| Stockton, CA | $310.22 | $35.66 |
| Vallejo, CA | $368.06 | $37.89 |
| Visalia, CA | $310.22 | $35.66 |
| Yuba City, CA | $310.22 | $35.66 |
How the 19286 rate is calculated
Each of 19286’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 · 19286
RVUs × geographic indexes × conversion factor
Work0.83
0.83 RVUs× 1.000 GPCI
Practice expense7.66
7.66 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
8.5800
Conversion factor
$33.4009
Medicare rate
$286.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19286
The CMS indicators that decide how 19286 is paid alongside other services.
CMS payment indicators · 19286
Breast localization, each additional lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
19286 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 19285Breast localizationFirst lesion, ultrasound guidance
- 19285 reports the first ultrasound-guided lesion; 19286 reports each additional lesion localized with ultrasound during the procedure.
- 19282Breast localizationEach additional lesion
- Both represent additional breast lesions, but 19282 is for mammographic guidance rather than ultrasound guidance.
- 19284Breast localizationAdditional stereotactic lesion
- Both are add-on codes for additional lesions; 19284 applies when stereotactic guidance is used.
- 19288Breast localizationAdditional lesion, MRI guidance
- Both cover additional lesions, but 19288 is for MRI-guided placement rather than ultrasound-guided placement.
19286 billing questions
When is 19286 reported instead of 19285?
Use 19285 for the first lesion localized with ultrasound guidance. Report 19286 for each additional lesion localized during the procedure.
Can 19286 be billed without 19285?
No. It is an add-on code and must be reported with the primary ultrasound-guided placement code, 19285.
Does 19286 count additional devices or additional lesions?
It represents each additional lesion, not each extra device placed at one lesion. The record should distinguish the separately localized targets.
Is ultrasound guidance separately reported for the placement?
The code represents placement with ultrasound guidance. Document the guidance used for the additional lesion rather than reporting this code for device placement without ultrasound.
What documentation supports the additional-lesion unit?
Document the additional target's location, percutaneous device placement, and ultrasound guidance, as well as the first lesion reported with 19285.
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
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