CPT code 19286: Breast localization, each additional lesion2026 Medicare rate & RVUs in North Carolina
Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.
In North Carolina, Medicare pays $268.35 for 19286 in the office and $34.63 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 North Carolina 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. North Carolina pays $268.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$268.35
- Los Angeles, CA · California$333.53+$65.18
- Washington, DC area · District of Columbia$333.96+$65.61
- Miami, FL · Florida$301.67+$33.32
- Chicago, IL · Illinois$291.95+$23.60
- Manhattan, NY · New York$331.56+$63.21
- Alaska · Alaska$315.72+$47.37
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $253.29 | $34.10 |
| ArkansasArkansas | $249.05 | $33.86 |
| ArizonaArizona | $278.22 | $35.47 |
| Bakersfield, CACalifornia | $310.49 | $35.94 |
| Chico, CACalifornia | $310.22 | $35.66 |
| El Centro, CACalifornia | $310.23 | $35.68 |
| Fresno, CACalifornia | $310.22 | $35.66 |
| Hanford, CACalifornia | $310.22 | $35.66 |
| 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 |
| Marin County, CACalifornia | $392.49 | $39.27 |
| 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 |
| 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 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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 7.66 | × 0.933 | 7.1468 |
| Malpractice | 0.09 | × 0.639 | 0.0575 |
| Total RVUs | 8.0343 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$268.35
Office: (0.83 × 1 + 7.66 × 0.933 + 0.09 × 0.639) × $33.4009 = $268.35
Facility: (0.83 × 1 + 0.16 × 0.933 + 0.09 × 0.639) × $33.4009 = $34.63
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 North Carolina
19286 · Office / nonfacility
$268.35
Effective 2026-10-01
The base rate is $9.40 higher than on 2025-10-01, moving from $258.95 to $268.35 (3.6%).
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
$258.95changed to$268.35
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$275.96changed to$258.95
- 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
$271.45changed to$275.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$291.11changed to$271.45
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$305.90changed to$291.11
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$348.59changed to$305.90
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.77 changed to 8.53
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$373.47changed to$348.59
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 10.14 changed to 9.77
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$400.96changed to$373.47
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 10.97 changed to 10.14
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$433.36changed to$400.96
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.95 changed to 10.97
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$428.81changed to$433.36
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.85 changed to 11.95
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$429.15changed to$428.81
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 11.90 changed to 11.85
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$360.47changed to$429.15
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.79 changed to 11.90
- Malpractice RVU 0.10 changed to 0.09
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$358.67changed to$360.47
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$369.69changed to$358.67
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 10.17 changed to 9.79
- Malpractice RVU 0.03 changed to 0.10
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$369.69
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 | $268.35 | $34.63 | RVU26D |
| 2026-07-01 | $268.35 | $34.63 | RVU26C |
| 2026-04-01 | $268.35 | $34.63 | RVU26B |
| 2026-01-01 | $268.35 | $34.63 | RVU26A |
| 2025-10-01 | $258.95 | $38.50 | RVU25D |
| 2025-07-01 | $258.95 | $38.50 | RVU25C |
| 2025-04-01 | $258.95 | $38.50 | RVU25B |
| 2025-01-01 | $258.95 | $38.50 | RVU25A |
| 2024-10-01 | $275.96 | $39.53 | RVU24D |
| 2024-07-01 | $275.96 | $39.53 | RVU24C |
| 2024-04-01 | $275.96 | $39.53 | RVU24B |
| 2024-03-09 | $275.96 | $39.53 | RVU24AR |
| 2024-01-01 | $271.45 | $38.89 | RVU24A |
| 2023-10-01 | $291.11 | $41.06 | RVU23D |
| 2023-07-01 | $291.11 | $41.06 | RVU23C |
| 2023-04-01 | $291.11 | $41.06 | RVU23B |
| 2023-01-01 | $291.11 | $41.06 | RVU23A |
| 2022-10-01 | $305.90 | $41.92 | RVU22D |
| 2022-07-01 | $305.90 | $41.92 | RVU22C |
| 2022-04-01 | $305.90 | $41.92 | RVU22B |
| 2022-01-01 | $305.90 | $41.92 | RVU22A |
| 2021-10-01 | $348.59 | $42.27 | RVU21D |
| 2021-07-01 | $348.59 | $42.27 | RVU21C |
| 2021-04-01 | $348.59 | $42.27 | RVU21B |
| 2021-01-01 | $348.59 | $42.27 | RVU21A |
| 2020-10-01 | $373.47 | $43.88 | RVU20D |
| 2020-07-01 | $373.47 | $43.88 | RVU20C |
| 2020-04-01 | $373.47 | $43.88 | RVU20B |
| 2020-01-01 | $373.47 | $43.88 | RVU20A |
| 2019-10-01 | $400.96 | $43.29 | RVU19D |
| 2019-07-01 | $400.96 | $43.29 | RVU19C |
| 2019-04-01 | $400.96 | $43.29 | RVU19B |
| 2019-01-01 | $400.96 | $43.29 | RVU19A |
| 2018-10-01 | $433.36 | $43.24 | RVU18D |
| 2018-07-01 | $433.36 | $43.24 | RVU18C |
| 2018-04-01 | $433.36 | $43.24 | RVU18B |
| 2018-01-01 | $433.36 | $43.24 | RVU18AR1 |
| 2017-10-01 | $428.81 | $43.56 | RVU17D |
| 2017-07-01 | $428.81 | $43.56 | RVU17C |
| 2017-04-01 | $428.81 | $43.56 | RVU17B |
| 2017-01-01 | $428.81 | $43.56 | RVU17A |
| 2016-10-01 | $429.15 | $43.56 | RVU16D |
| 2016-07-01 | $429.15 | $43.56 | RVU16C |
| 2016-04-01 | $429.15 | $43.56 | RVU16B |
| 2016-01-01 | $429.15 | $43.56 | RVU16A |
| 2015-10-01 | $360.47 | $44.00 | RVU15D |
| 2015-07-01 | $360.47 | $44.00 | RVU15C |
| 2015-04-01 | $358.67 | $43.78 | RVU15B |
| 2015-01-01 | $358.67 | $43.78 | RVU15A |
| 2014-10-01 | $369.69 | $42.22 | RVU14D |
| 2014-07-01 | $369.69 | $42.22 | RVU14C |
| 2014-04-01 | $369.69 | $42.22 | RVU14B |
| 2014-01-01 | $369.69 | $42.22 | 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 North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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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