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

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 Vermont, Medicare pays $282.54 for 19286 in the office and $34.53 when it’s performed in a hospital or facility.

$282.54Office (non-facility)
$34.53Hospital or facility
−1.4%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 Vermont
  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 Vermont 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. Vermont pays $282.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

19286 in Vermont vs other payment areas
  1. Vermont · this page$282.54
  2. Los Angeles, CA · California$333.53+$50.99
  3. Washington, DC area · District of Columbia$333.96+$51.42
  4. Miami, FL · Florida$301.67+$19.13
  5. Chicago, IL · Illinois$291.95+$9.41
  6. Manhattan, NY · New York$331.56+$49.02
  7. Alaska · Alaska$315.72+$33.18

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

Every other payment area

19286 in every other Medicare payment locality
Payment localityOfficeFacility
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

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 19286 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0000.8300
Practice expense7.66× 0.9907.5834
Malpractice0.09× 0.5060.0455
Total RVUs8.4589
Conversion factor× 33.4009

Office rate, Vermont$282.54

Office: (0.83 × 1 + 7.66 × 0.99 + 0.09 × 0.506) × $33.4009 = $282.54

Facility: (0.83 × 1 + 0.16 × 0.99 + 0.09 × 0.506) × $33.4009 = $34.53

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, Vermont
Primary code
19285Breast localization, first lesion, ultrasound guidancePrimary code for the first ultrasound-guided breast localization lesion.$344.52
Used instead
19282Breast localization, each additional lesionAdditional lesion localization when mammographic guidance is used.$162.05
19284Breast localization, additional stereotactic lesionAdditional lesion localization when stereotactic guidance is used.$178.43
19288Breast localization, additional lesion, MRI guidanceAdditional lesion localization when MRI guidance is used.$450.83

How 19286 has changed in Vermont

19286 · Office / nonfacility

$282.54

Effective 2026-10-01

The base rate is $7.34 higher than on 2025-10-01, moving from $275.20 to $282.54 (2.7%).

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

    $275.20changed to$282.54

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $293.29changed to$275.20

    • 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

    $288.50changed to$293.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $310.05changed to$288.50

    • 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 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $326.67changed to$310.05

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $372.69changed to$326.67

    • 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

    $401.44changed to$372.69

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.14 changed to 9.77
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $433.84changed to$401.44

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.97 changed to 10.14
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $469.18changed to$433.84

    • 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

    $462.10changed to$469.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.85 changed to 11.95
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $460.41changed to$462.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.90 changed to 11.85
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $386.19changed to$460.41

    • 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

    $384.27changed to$386.19

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $397.62changed to$384.27

    • 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 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$397.62

    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$282.54$34.53RVU26D
2026-07-01$282.54$34.53RVU26C
2026-04-01$282.54$34.53RVU26B
2026-01-01$282.54$34.53RVU26A
2025-10-01$275.20$38.79RVU25D
2025-07-01$275.20$38.79RVU25C
2025-04-01$275.20$38.79RVU25B
2025-01-01$275.20$38.79RVU25A
2024-10-01$293.29$39.76RVU24D
2024-07-01$293.29$39.76RVU24C
2024-04-01$293.29$39.76RVU24B
2024-03-09$293.29$39.76RVU24AR
2024-01-01$288.50$39.11RVU24A
2023-10-01$310.05$41.12RVU23D
2023-07-01$310.05$41.12RVU23C
2023-04-01$310.05$41.12RVU23B
2023-01-01$310.05$41.12RVU23A
2022-10-01$326.67$41.93RVU22D
2022-07-01$326.67$41.93RVU22C
2022-04-01$326.67$41.93RVU22B
2022-01-01$326.67$41.93RVU22A
2021-10-01$372.69$42.27RVU21D
2021-07-01$372.69$42.27RVU21C
2021-04-01$372.69$42.27RVU21B
2021-01-01$372.69$42.27RVU21A
2020-10-01$401.44$44.21RVU20D
2020-07-01$401.44$44.21RVU20C
2020-04-01$401.44$44.21RVU20B
2020-01-01$401.44$44.21RVU20A
2019-10-01$433.84$43.90RVU19D
2019-07-01$433.84$43.90RVU19C
2019-04-01$433.84$43.90RVU19B
2019-01-01$433.84$43.90RVU19A
2018-10-01$469.18$43.85RVU18D
2018-07-01$469.18$43.85RVU18C
2018-04-01$469.18$43.85RVU18B
2018-01-01$469.18$43.85RVU18AR1
2017-10-01$462.10$44.17RVU17D
2017-07-01$462.10$44.17RVU17C
2017-04-01$462.10$44.17RVU17B
2017-01-01$462.10$44.17RVU17A
2016-10-01$460.41$44.13RVU16D
2016-07-01$460.41$44.13RVU16C
2016-04-01$460.41$44.13RVU16B
2016-01-01$460.41$44.13RVU16A
2015-10-01$386.19$44.54RVU15D
2015-07-01$386.19$44.54RVU15C
2015-04-01$384.27$44.32RVU15B
2015-01-01$384.27$44.32RVU15A
2014-10-01$397.62$43.01RVU14D
2014-07-01$397.62$43.01RVU14C
2014-04-01$397.62$43.01RVU14B
2014-01-01$397.62$43.01RVU14A
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 Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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