CPT code 19286: Breast localization, each additional lesion2026 Medicare rate & RVUs in Marin County, CA
Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.
In Marin County, CA, Medicare pays $392.49 for 19286 in the office and $39.27 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 19286 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 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.
How Marin County, CA compares for 19286
Across 109 of 109 payment localities, the office rate for 19286 runs from $249.05 in Arkansas to $401.32 in San Benito County, CA. Marin County, CA pays $392.49. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Marin County, CA · this page$392.49
- Bakersfield, CA · California$310.49−$82.00
- Chico, CA · California$310.22−$82.27
- El Centro, CA · California$310.23−$82.26
- Fresno, CA · California$310.22−$82.27
- Hanford, CA · California$310.22−$82.27
- Los Angeles, CA · California$333.53−$58.96
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $310.22 | $35.66 |
| Merced, CACalifornia | $310.22 | $35.66 |
| Modesto, CACalifornia | $310.22 | $35.66 |
| Napa, CACalifornia | $368.21 | $38.04 |
| Oxnard, CACalifornia | $332.79 | $36.69 |
| Redding, CACalifornia | $310.22 | $35.66 |
| Rest of CaliforniaCalifornia | $310.22 | $35.66 |
| Riverside, CACalifornia | $311.20 | $36.64 |
| Sacramento, CACalifornia | $327.89 | $36.55 |
| Salinas, CACalifornia | $326.72 | $36.39 |
| San Diego, CACalifornia | $336.18 | $36.58 |
| San Francisco, CACalifornia | $392.38 | $39.17 |
| San Benito County, CACalifornia | $401.32 | $40.09 |
| Santa Clara County, CACalifornia | $400.90 | $39.67 |
| San Luis Obispo, CACalifornia | $321.22 | $35.89 |
| Santa Cruz, CACalifornia | $340.78 | $36.41 |
| Santa Maria, CACalifornia | $328.43 | $36.34 |
| Santa Rosa, CACalifornia | $344.35 | $36.73 |
| Stockton, CACalifornia | $310.22 | $35.66 |
| Vallejo, CACalifornia | $368.06 | $37.89 |
| Visalia, CACalifornia | $310.22 | $35.66 |
| Yuba City, CACalifornia | $310.22 | $35.66 |
| Washington, DC areaDistrict of Columbia | $333.96 | $38.86 |
| Miami, FLFlorida | $301.67 | $40.89 |
| Chicago, ILIllinois | $291.95 | $40.19 |
| Manhattan, NYNew York | $331.56 | $40.47 |
| AlaskaAlaska | $315.72 | $48.93 |
| AlabamaAlabama | $253.29 | $34.10 |
| ArkansasArkansas | $249.05 | $33.86 |
| ArizonaArizona | $278.22 | $35.47 |
| ColoradoColorado | $302.63 | $36.09 |
| ConnecticutConnecticut | $307.47 | $37.67 |
| DelawareDelaware | $283.34 | $35.84 |
| Fort Lauderdale, FLFlorida | $292.33 | $38.57 |
| Rest of FloridaFlorida | $276.83 | $37.35 |
| Atlanta, GAGeorgia | $291.36 | $36.85 |
| Rest of GeorgiaGeorgia | $259.52 | $36.07 |
| Hawaii, Guam, HIHawaii | $320.37 | $35.54 |
| IowaIowa | $263.02 | $33.81 |
| IdahoIdaho | $264.53 | $34.06 |
| East St. Louis, ILIllinois | $269.16 | $38.69 |
| Rest of IllinoisIllinois | $266.01 | $37.30 |
| Suburban Chicago, ILIllinois | $296.00 | $38.73 |
| IndianaIndiana | $266.36 | $34.14 |
| KansasKansas | $260.53 | $34.07 |
| KentuckyKentucky | $257.92 | $35.22 |
| New Orleans, LALouisiana | $271.89 | $36.17 |
| Rest of LouisianaLouisiana | $257.03 | $35.33 |
| Metropolitan Boston, MAMassachusetts | $337.02 | $37.92 |
| Rest of MassachusettsMassachusetts | $299.97 | $36.19 |
| Baltimore area, MDMaryland | $306.41 | $37.62 |
| Rest of MarylandMaryland | $289.68 | $36.17 |
| Rest of MaineMaine | $264.98 | $34.51 |
| Southern Maine, MEMaine | $283.17 | $34.92 |
| Detroit, MIMichigan | $279.69 | $37.95 |
| Rest of MichiganMichigan | $264.71 | $36.00 |
| MinnesotaMinnesota | $291.88 | $34.11 |
| Metropolitan Kansas City, MOMissouri | $270.90 | $35.68 |
| Metropolitan St. Louis, MOMissouri | $274.30 | $35.82 |
| Rest of MissouriMissouri | $251.19 | $35.26 |
| MississippiMississippi | $250.23 | $34.55 |
| MontanaMontana | $286.57 | $36.07 |
| North CarolinaNorth Carolina | $268.35 | $34.63 |
| North DakotaNorth Dakota | $284.79 | $34.29 |
| NebraskaNebraska | $265.01 | $33.79 |
| New HampshireNew Hampshire | $296.69 | $35.92 |
| Northern New JerseyNew Jersey | $329.47 | $38.88 |
| Rest of New JerseyNew Jersey | $311.52 | $37.97 |
| New MexicoNew Mexico | $265.95 | $36.23 |
| NevadaNevada | $286.33 | $35.58 |
| NYC suburbs and Long Island, NYNew York | $339.29 | $41.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $312.76 | $38.46 |
| Queens, NYNew York | $336.25 | $40.15 |
| Rest of New YorkNew York | $272.89 | $34.91 |
| OhioOhio | $264.34 | $35.63 |
| OklahomaOklahoma | $258.53 | $34.83 |
| Portland, OROregon | $314.65 | $36.34 |
| Rest of OregonOregon | $284.66 | $35.16 |
| Metropolitan Philadelphia, PAPennsylvania | $298.15 | $37.37 |
| Rest of PennsylvaniaPennsylvania | $265.43 | $35.47 |
| Puerto RicoPuerto Rico | $289.35 | $36.09 |
| Rhode IslandRhode Island | $295.22 | $36.45 |
| South CarolinaSouth Carolina | $266.68 | $35.22 |
| South DakotaSouth Dakota | $284.58 | $34.08 |
| TennesseeTennessee | $261.91 | $34.19 |
| Austin, TXTexas | $301.13 | $36.10 |
| Beaumont, TXTexas | $263.34 | $35.38 |
| Brazoria, TXTexas | $283.84 | $35.59 |
| Dallas, TXTexas | $285.38 | $35.87 |
| Fort Worth, TXTexas | $282.86 | $35.86 |
| Galveston, TXTexas | $284.49 | $35.74 |
| Houston, TXTexas | $286.14 | $37.39 |
| Rest of TexasTexas | $273.24 | $35.51 |
| UtahUtah | $270.92 | $35.45 |
| VirginiaVirginia | $281.35 | $35.10 |
| Virgin Islands, VIUnited States Virgin Islands | $289.35 | $36.09 |
| VermontVermont | $282.54 | $34.53 |
| Rest of WashingtonWashington | $299.78 | $36.00 |
| King County, WAWashington | $345.49 | $38.12 |
| WisconsinWisconsin | $273.75 | $33.77 |
| West VirginiaWest Virginia | $254.36 | $36.67 |
| WyomingWyoming | $285.80 | $35.29 |
19286 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.
$249.05
$355.77
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 | $315.72 | 1 |
| AL | $253.29 | 1 |
| AR | $249.05 | 1 |
| AZ | $278.22 | 1 |
| CA | $310.22–$401.32 | 29 |
| CO | $302.63 | 1 |
| CT | $307.47 | 1 |
| DC | $333.96 | 1 |
| DE | $283.34 | 1 |
| FL | $276.83–$301.67 | 3 |
| GA | $259.52–$291.36 | 2 |
| GU | $320.37 | 1 |
| HI | $320.37 | 1 |
| IA | $263.02 | 1 |
| ID | $264.53 | 1 |
| IL | $266.01–$296.00 | 4 |
| IN | $266.36 | 1 |
| KS | $260.53 | 1 |
| KY | $257.92 | 1 |
| LA | $257.03–$271.89 | 2 |
| MA | $299.97–$337.02 | 2 |
| MD | $289.68–$333.96 | 3 |
| ME | $264.98–$283.17 | 2 |
| MI | $264.71–$279.69 | 2 |
| MN | $291.88 | 1 |
| MO | $251.19–$274.30 | 3 |
| MS | $250.23 | 1 |
| MT | $286.57 | 1 |
| NC | $268.35 | 1 |
| ND | $284.79 | 1 |
| NE | $265.01 | 1 |
| NH | $296.69 | 1 |
| NJ | $311.52–$329.47 | 2 |
| NM | $265.95 | 1 |
| NV | $286.33 | 1 |
| NY | $272.89–$339.29 | 5 |
| OH | $264.34 | 1 |
| OK | $258.53 | 1 |
| OR | $284.66–$314.65 | 2 |
| PA | $265.43–$298.15 | 2 |
| PR | $289.35 | 1 |
| RI | $295.22 | 1 |
| SC | $266.68 | 1 |
| SD | $284.58 | 1 |
| TN | $261.91 | 1 |
| TX | $263.34–$301.13 | 8 |
| UT | $270.92 | 1 |
| VA | $281.35–$333.96 | 2 |
| VI | $289.35 | 1 |
| VT | $282.54 | 1 |
| WA | $299.78–$345.49 | 2 |
| WI | $273.75 | 1 |
| WV | $254.36 | 1 |
| WY | $285.80 | 1 |
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.
The exact Marin County, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,678
- Code
- 19286
- Physician work
- 0.83
- Practice expense
- 7.66
- Malpractice
- 0.09
GPCI2026.csv
25
- Locality
- Marin County, CA
- Physician work
- 1.095
- Practice expense
- 1.410
- Malpractice
- 0.459
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.095 | 0.9088 |
| Practice expense | 7.66 | × 1.410 | 10.8006 |
| Malpractice | 0.09 | × 0.459 | 0.0413 |
| Total RVUs | 11.7508 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Marin County, CA$392.49
Office: (0.83 × 1.095 + 7.66 × 1.41 + 0.09 × 0.459) × $33.4009 = $392.49
Facility: (0.83 × 1.095 + 0.16 × 1.41 + 0.09 × 0.459) × $33.4009 = $39.27
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. |
How 19286 has changed in Marin County, CA
19286 · Office / nonfacility
$392.49
Effective 2026-10-01
The base rate is $9.31 higher than on 2025-10-01, moving from $383.18 to $392.49 (2.4%).
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
$383.18changed to$392.49
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.85 changed to 0.83
- Practice expense RVU 7.67 changed to 7.66
- Malpractice RVU 0.08 changed to 0.09
- Work GPCI 1.088 changed to 1.095
- Practice expense GPCI 1.419 changed to 1.410
- Malpractice GPCI 0.470 changed to 0.459
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$408.65changed to$383.18
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.97 changed to 7.67
- Malpractice RVU 0.09 changed to 0.08
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$401.99changed to$408.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$417.88changed to$401.99
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.27 changed to 7.97
- Malpractice RVU 0.10 changed to 0.09
- Work GPCI 1.082 changed to 1.088
- Practice expense GPCI 1.374 changed to 1.419
- Malpractice GPCI 0.487 changed to 0.470
January 1, 2023
RVU23A
$425.56changed to$417.88
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.53 changed to 8.27
- Malpractice RVU 0.09 changed to 0.10
- Work GPCI 1.077 changed to 1.082
- Practice expense GPCI 1.329 changed to 1.374
- Malpractice GPCI 0.504 changed to 0.487
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$480.27changed to$425.56
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.77 changed to 8.53
- Work GPCI 1.071 changed to 1.077
- Practice expense GPCI 1.311 changed to 1.329
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$509.69changed to$480.27
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 10.14 changed to 9.77
- Work GPCI 1.068 changed to 1.071
- Practice expense GPCI 1.299 changed to 1.311
- Malpractice GPCI 0.481 changed to 0.504
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$544.51changed to$509.69
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 10.97 changed to 10.14
- Work GPCI 1.065 changed to 1.068
- Practice expense GPCI 1.291 changed to 1.299
- Malpractice GPCI 0.458 changed to 0.481
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$584.20changed to$544.51
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.95 changed to 10.97
- Work GPCI 1.062 changed to 1.065
- Practice expense GPCI 1.279 changed to 1.291
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$574.35changed to$584.20
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.85 changed to 11.95
- Work GPCI 1.058 changed to 1.062
- Practice expense GPCI 1.271 changed to 1.279
- Malpractice GPCI 0.477 changed to 0.458
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$574.35
Held through RVU17B, RVU17C, RVU17D.
January 1, 2014
RVU14A
No ratechanged toNo rate
Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $392.49 | $39.27 | RVU26D |
| 2026-07-01 | $392.49 | $39.27 | RVU26C |
| 2026-04-01 | $392.49 | $39.27 | RVU26B |
| 2026-01-01 | $392.49 | $39.27 | RVU26A |
| 2025-10-01 | $383.18 | $45.36 | RVU25D |
| 2025-07-01 | $383.18 | $45.36 | RVU25C |
| 2025-04-01 | $383.18 | $45.36 | RVU25B |
| 2025-01-01 | $383.18 | $45.36 | RVU25A |
| 2024-10-01 | $408.65 | $46.36 | RVU24D |
| 2024-07-01 | $408.65 | $46.36 | RVU24C |
| 2024-04-01 | $408.65 | $46.36 | RVU24B |
| 2024-03-09 | $408.65 | $46.36 | RVU24AR |
| 2024-01-01 | $401.99 | $45.61 | RVU24A |
| 2023-10-01 | $417.88 | $47.25 | RVU23D |
| 2023-07-01 | $417.88 | $47.25 | RVU23C |
| 2023-04-01 | $417.88 | $47.25 | RVU23B |
| 2023-01-01 | $417.88 | $47.25 | RVU23A |
| 2022-10-01 | $425.56 | $47.51 | RVU22D |
| 2022-07-01 | $425.56 | $47.51 | RVU22C |
| 2022-04-01 | $425.56 | $47.51 | RVU22B |
| 2022-01-01 | $425.56 | $47.51 | RVU22A |
| 2021-10-01 | $480.27 | $47.53 | RVU21D |
| 2021-07-01 | $480.27 | $47.53 | RVU21C |
| 2021-04-01 | $480.27 | $47.53 | RVU21B |
| 2021-01-01 | $480.27 | $47.53 | RVU21A |
| 2020-10-01 | $509.69 | $49.33 | RVU20D |
| 2020-07-01 | $509.69 | $49.33 | RVU20C |
| 2020-04-01 | $509.69 | $49.33 | RVU20B |
| 2020-01-01 | $509.69 | $49.33 | RVU20A |
| 2019-10-01 | $544.51 | $48.53 | RVU19D |
| 2019-07-01 | $544.51 | $48.53 | RVU19C |
| 2019-04-01 | $544.51 | $48.53 | RVU19B |
| 2019-01-01 | $544.51 | $48.53 | RVU19A |
| 2018-10-01 | $584.20 | $48.25 | RVU18D |
| 2018-07-01 | $584.20 | $48.25 | RVU18C |
| 2018-04-01 | $584.20 | $48.25 | RVU18B |
| 2018-01-01 | $584.20 | $48.25 | RVU18AR1 |
| 2017-10-01 | $574.35 | $48.41 | RVU17D |
| 2017-07-01 | $574.35 | $48.41 | RVU17C |
| 2017-04-01 | $574.35 | $48.41 | RVU17B |
| 2017-01-01 | $574.35 | $48.41 | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | 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 Marin County, CA rate applies
Marin County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Alto
- Belvedere
- Black Point-Green Point
- Bolinas
- Corte Madera
- Dillon Beach
- Fairfax
- Inverness
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
Show the CMS file lines behind this rate
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