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CPT code 19286: Breast localization, each additional lesion2026 Medicare rate & RVUs in Dallas, TX

Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality2.6K Medicare services in 2024

In Dallas, TX, Medicare pays $285.38 for 19286 in the office and $35.87 when it’s performed in a hospital or facility.

$285.38Office (non-facility)
$35.87Hospital or facility
−0.4%vs the national office rate ($286.58)

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.

We’ll open 19286 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Dallas, TX
  2. What 19286 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 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 Dallas, TX 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. Dallas, TX pays $285.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

19286 in Dallas, TX vs other payment areas
  1. Dallas, TX · this page$285.38
  2. Austin, TX · Texas$301.13+$15.75
  3. Beaumont, TX · Texas$263.34−$22.04
  4. Brazoria, TX · Texas$283.84−$1.54
  5. Fort Worth, TX · Texas$282.86−$2.52
  6. Galveston, TX · Texas$284.49−$0.89
  7. Houston, TX · Texas$286.14+$0.76

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

Every other payment area

19286 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$273.24$35.51
Los Angeles, CACalifornia$333.53$37.18
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

19286 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.

$249.05

$355.77

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

View every state and territory as a table
19286 office rate range by state
State / territoryOffice rate rangeLocalities
AK$315.721
AL$253.291
AR$249.051
AZ$278.221
CA$310.22–$401.3229
CO$302.631
CT$307.471
DC$333.961
DE$283.341
FL$276.83–$301.673
GA$259.52–$291.362
GU$320.371
HI$320.371
IA$263.021
ID$264.531
IL$266.01–$296.004
IN$266.361
KS$260.531
KY$257.921
LA$257.03–$271.892
MA$299.97–$337.022
MD$289.68–$333.963
ME$264.98–$283.172
MI$264.71–$279.692
MN$291.881
MO$251.19–$274.303
MS$250.231
MT$286.571
NC$268.351
ND$284.791
NE$265.011
NH$296.691
NJ$311.52–$329.472
NM$265.951
NV$286.331
NY$272.89–$339.295
OH$264.341
OK$258.531
OR$284.66–$314.652
PA$265.43–$298.152
PR$289.351
RI$295.221
SC$266.681
SD$284.581
TN$261.911
TX$263.34–$301.138
UT$270.921
VA$281.35–$333.962
VI$289.351
VT$282.541
WA$299.78–$345.492
WI$273.751
WV$254.361
WY$285.801

See 19286 in every payment locality

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

Office or facility?

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 Dallas, TX 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

99

Locality
Dallas, TX
Physician work
1.009
Practice expense
0.996
Malpractice
0.858
Office calculation for 19286 in Dallas, TX
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0090.8375
Practice expense7.66× 0.9967.6294
Malpractice0.09× 0.8580.0772
Total RVUs8.5441
Conversion factor× 33.4009

Office rate, Dallas, TX$285.38

Office: (0.83 × 1.009 + 7.66 × 0.996 + 0.09 × 0.858) × $33.4009 = $285.38

Facility: (0.83 × 1.009 + 0.16 × 0.996 + 0.09 × 0.858) × $33.4009 = $35.87

Open 19286 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

Codes related to 19286

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

Codes related to 19286
CodeHow it relatesOffice range, Dallas, TX
Primary code
19285Breast localization, first lesion, ultrasound guidancePrimary code for the first ultrasound-guided breast localization lesion.$348.87
Used instead
19282Breast localization, each additional lesionAdditional lesion localization when mammographic guidance is used.$164.06
19284Breast localization, additional stereotactic lesionAdditional lesion localization when stereotactic guidance is used.$180.89
19288Breast localization, additional lesion, MRI guidanceAdditional lesion localization when MRI guidance is used.$455.09

How 19286 has changed in Dallas, TX

19286 · Office / nonfacility

$285.38

Effective 2026-10-01

The base rate is $5.48 higher than on 2025-10-01, moving from $279.90 to $285.38 (2.0%).

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

    $279.90changed to$285.38

    • 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 1.011 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.996
    • Malpractice GPCI 0.877 changed to 0.858

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $298.39changed to$279.90

    • 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.

  3. March 9, 2024

    RVU24AR

    $293.52changed to$298.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $316.71changed to$293.52

    • 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 1.017 changed to 1.011
    • Practice expense GPCI 1.017 changed to 1.007
    • Malpractice GPCI 0.711 changed to 0.877

  5. January 1, 2023

    RVU23A

    $334.66changed to$316.71

    • 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 1.023 changed to 1.017
    • Practice expense GPCI 1.026 changed to 1.017
    • Malpractice GPCI 0.546 changed to 0.711

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $381.83changed to$334.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.77 changed to 8.53

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $406.63changed to$381.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.14 changed to 9.77
    • Work GPCI 1.018 changed to 1.023
    • Practice expense GPCI 1.020 changed to 1.026
    • Malpractice GPCI 0.657 changed to 0.546

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $434.38changed to$406.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.97 changed to 10.14
    • Work GPCI 1.012 changed to 1.018
    • Practice expense GPCI 1.014 changed to 1.020
    • Malpractice GPCI 0.768 changed to 0.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $469.67changed to$434.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.95 changed to 10.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $463.83changed to$469.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.85 changed to 11.95
    • Work GPCI 1.015 changed to 1.012
    • Practice expense GPCI 1.012 changed to 1.014
    • Malpractice GPCI 0.770 changed to 0.768

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $463.37changed to$463.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.90 changed to 11.85
    • Work GPCI 1.018 changed to 1.015
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.772 changed to 0.770

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $388.82changed to$463.37

    • 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.

  13. July 1, 2015

    RVU15C

    $386.89changed to$388.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $400.79changed to$386.89

    • 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
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.013 changed to 1.009
    • Malpractice GPCI 0.803 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$400.79

    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$285.38$35.87RVU26D
2026-07-01$285.38$35.87RVU26C
2026-04-01$285.38$35.87RVU26B
2026-01-01$285.38$35.87RVU26A
2025-10-01$279.90$40.16RVU25D
2025-07-01$279.90$40.16RVU25C
2025-04-01$279.90$40.16RVU25B
2025-01-01$279.90$40.16RVU25A
2024-10-01$298.39$41.29RVU24D
2024-07-01$298.39$41.29RVU24C
2024-04-01$298.39$41.29RVU24B
2024-03-09$298.39$41.29RVU24AR
2024-01-01$293.52$40.62RVU24A
2023-10-01$316.71$42.39RVU23D
2023-07-01$316.71$42.39RVU23C
2023-04-01$316.71$42.39RVU23B
2023-01-01$316.71$42.39RVU23A
2022-10-01$334.66$42.80RVU22D
2022-07-01$334.66$42.80RVU22C
2022-04-01$334.66$42.80RVU22B
2022-01-01$334.66$42.80RVU22A
2021-10-01$381.83$43.15RVU21D
2021-07-01$381.83$43.15RVU21C
2021-04-01$381.83$43.15RVU21B
2021-01-01$381.83$43.15RVU21A
2020-10-01$406.63$45.14RVU20D
2020-07-01$406.63$45.14RVU20C
2020-04-01$406.63$45.14RVU20B
2020-01-01$406.63$45.14RVU20A
2019-10-01$434.38$44.82RVU19D
2019-07-01$434.38$44.82RVU19C
2019-04-01$434.38$44.82RVU19B
2019-01-01$434.38$44.82RVU19A
2018-10-01$469.67$44.77RVU18D
2018-07-01$469.67$44.77RVU18C
2018-04-01$469.67$44.77RVU18B
2018-01-01$469.67$44.77RVU18AR1
2017-10-01$463.83$45.07RVU17D
2017-07-01$463.83$45.07RVU17C
2017-04-01$463.83$45.07RVU17B
2017-01-01$463.83$45.07RVU17A
2016-10-01$463.37$45.03RVU16D
2016-07-01$463.37$45.03RVU16C
2016-04-01$463.37$45.03RVU16B
2016-01-01$463.37$45.03RVU16A
2015-10-01$388.82$45.47RVU15D
2015-07-01$388.82$45.47RVU15C
2015-04-01$386.89$45.24RVU15B
2015-01-01$386.89$45.24RVU15A
2014-10-01$400.79$43.71RVU14D
2014-07-01$400.79$43.71RVU14C
2014-04-01$400.79$43.71RVU14B
2014-01-01$400.79$43.71RVU14A
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 19286 for an earlier date of service

Where the Dallas, TX rate applies

Dallas, TX is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 19286PPRRVU2026_Oct_nonQPP.csv, line 1,678 (RVU26D)
Geographic factors for Dallas, TXGPCI2026.csv, line 99 (RVU26D)

Open CMS sourceHow we calculate rates

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