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CPT code 19288: Breast localization, additional lesion, MRI guidance2026 Medicare rate & RVUs in Delaware

Reports MRI-guided percutaneous localization of each breast lesion beyond the first, typically to mark additional targets before breast-conserving surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality71 Medicare services in 2024

In Delaware, Medicare pays $451.79 for 19288 in the office and $53.15 when it’s performed in a hospital or facility.

$451.79Office (non-facility)
$53.15Hospital or facility
−1.1%vs the national office rate ($456.92)

Check a contract rate as a % of Medicare · 19288 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 19288 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 19288 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 19288 covers

An MRI-guided breast localization procedure places a marker or other localization device percutaneously at an MRI-visible target so the surgeon can identify it for excision. Breast radiologists commonly perform it in an MRI suite, often before surgery for a nonpalpable lesion that needs image-guided targeting.

Report 19288 for each lesion after the first addressed during the MRI-guided localization service, with 19287 for the first lesion. The imaging modality determines the code family: MRI guidance supports this add-on, while mammographic, stereotactic, or ultrasound guidance uses its own family. Documentation should identify the additional lesion, MRI guidance, percutaneous device placement, and connection to the first-lesion service. Imaging guidance is part of the localization service. CMS classifies 19288 as an add-on, so it is billed only with a primary procedure and paid within that procedure’s global period.

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 Delaware compares for 19288

Across 109 of 109 payment localities, the office rate for 19288 runs from $397.01 in Arkansas to $641.39 in San Benito County, CA. Delaware pays $451.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

19288 in Delaware vs other payment areas
  1. Delaware · this page$451.79
  2. Los Angeles, CA · California$532.53+$80.74
  3. Washington, DC area · District of Columbia$532.82+$81.03
  4. Miami, FL · Florida$479.91+$28.12
  5. Chicago, IL · Illinois$464.46+$12.67
  6. Manhattan, NY · New York$528.55+$76.76
  7. Alaska · Alaska$502.73+$50.94

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

Every other payment area

19288 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$403.79$50.74
ArkansasArkansas$397.01$50.41
ArizonaArizona$443.60$52.63
Bakersfield, CACalifornia$495.62$53.41
Chico, CACalifornia$495.25$53.03
El Centro, CACalifornia$495.27$53.05
Fresno, CACalifornia$495.25$53.03
Hanford, CACalifornia$495.25$53.03

19288 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.

$397.01

$568.32

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

View every state and territory as a table
19288 office rate range by state
State / territoryOffice rate rangeLocalities
AK$502.731
AL$403.791
AR$397.011
AZ$443.601
CA$495.25–$641.3929
CO$482.861
CT$490.261
DC$532.821
DE$451.791
FL$440.85–$479.913
GA$413.29–$464.432
GU$511.571
HI$511.571
IA$419.561
ID$421.921
IL$423.41–$471.414
IN$424.851
KS$415.461
KY$410.941
LA$409.47–$433.212
MA$478.57–$537.962
MD$461.95–$532.823
ME$422.52–$451.742
MI$421.67–$445.282
MN$466.031
MO$400.08–$437.203
MS$398.731
MT$456.921
NC$427.931
ND$454.541
NE$422.771
NH$473.281
NJ$496.81–$525.612
NM$423.601
NV$456.671
NY$435.18–$540.745
OH$421.191
OK$412.041
OR$454.09–$502.212
PA$422.99–$475.312
PR$461.391
RI$470.851
SC$425.071
SD$454.261
TN$417.651
TX$419.63–$480.408
UT$431.851
VA$448.76–$532.822
VI$461.391
VT$450.831
WA$478.30–$551.612
WI$436.881
WV$404.791
WY$455.881

See 19288 in every payment locality

How the 19288 rate is calculated

Each of 19288’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 · 19288

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense12.31

12.31 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

13.6800

Conversion factor

$33.4009

Medicare rate

$456.92

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,680

Code
19288
Physician work
1.25
Practice expense
12.31
Malpractice
0.12

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 19288 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0051.2562
Practice expense12.31× 0.98812.1623
Malpractice0.12× 0.8990.1079
Total RVUs13.5264
Conversion factor× 33.4009

Office rate, Delaware$451.79

Office: (1.25 × 1.005 + 12.31 × 0.988 + 0.12 × 0.899) × $33.4009 = $451.79

Facility: (1.25 × 1.005 + 0.23 × 0.988 + 0.12 × 0.899) × $33.4009 = $53.15

Open 19288 in the RVU calculator

Payment rules and modifiers for 19288

The CMS indicators that decide how 19288 is paid alongside other services.

CMS payment indicators · 19288

Breast localization, additional lesion, MRI guidance

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 19288

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

Codes related to 19288
CodeHow it relatesOffice range, Delaware
Add-on codes
19287Breast localization, first lesion, MRI guidanceReports the first MRI-guided lesion; 19288 is used for each additional lesion.$592.75
Same family
19281Breast localization, mammographic guidance, first lesionFirst lesion localized with mammographic guidance rather than MRI.$232.53
19282Breast localization, each additional lesionAdditional lesion localized with mammographic guidance rather than MRI.$163.01
19283Breast localization, first lesion, stereotactic guidanceFirst lesion localized with stereotactic guidance rather than MRI.$247.65
19284Breast localization, additional stereotactic lesionAdditional lesion localized with stereotactic guidance rather than MRI.$179.75
19285Breast localization, first lesion, ultrasound guidanceFirst lesion localized with ultrasound guidance rather than MRI.$346.58
19286Breast localization, each additional lesionAdditional lesion localized with ultrasound guidance rather than MRI.$283.34

How 19288 has changed in Delaware

19288 · Office / nonfacility

$451.79

Effective 2026-10-01

The base rate is $2.35 higher than on 2025-10-01, moving from $449.44 to $451.79 (0.5%).

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

    $449.44changed to$451.79

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.28 changed to 1.25
    • Practice expense RVU 12.59 changed to 12.31
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $479.04changed to$449.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 13.10 changed to 12.59
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $471.23changed to$479.04

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $511.27changed to$471.23

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 13.60 changed to 13.10
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $544.61changed to$511.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 14.04 changed to 13.60
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $612.60changed to$544.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 15.82 changed to 14.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $647.09changed to$612.60

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 16.19 changed to 15.82
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $685.11changed to$647.09

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.27 changed to 16.19
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $723.98changed to$685.11

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 18.35 changed to 17.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $726.13changed to$723.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 18.36 changed to 18.35
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $726.91changed to$726.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 18.32 changed to 18.36
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $734.45changed to$726.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 18.40 changed to 18.32
    • Malpractice RVU 0.16 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $730.79changed to$734.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $721.44changed to$730.79

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 18.12 changed to 18.40
    • Malpractice RVU 0.04 changed to 0.16
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$721.44

    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$451.79$53.15RVU26D
2026-07-01$451.79$53.15RVU26C
2026-04-01$451.79$53.15RVU26B
2026-01-01$451.79$53.15RVU26A
2025-10-01$449.44$60.54RVU25D
2025-07-01$449.44$60.54RVU25C
2025-04-01$449.44$60.54RVU25B
2025-01-01$449.44$60.54RVU25A
2024-10-01$479.04$61.33RVU24D
2024-07-01$479.04$61.33RVU24C
2024-04-01$479.04$61.33RVU24B
2024-03-09$479.04$61.33RVU24AR
2024-01-01$471.23$60.32RVU24A
2023-10-01$511.27$63.21RVU23D
2023-07-01$511.27$63.21RVU23C
2023-04-01$511.27$63.21RVU23B
2023-01-01$511.27$63.21RVU23A
2022-10-01$544.61$64.32RVU22D
2022-07-01$544.61$64.32RVU22C
2022-04-01$544.61$64.32RVU22B
2022-01-01$544.61$64.32RVU22A
2021-10-01$612.60$64.85RVU21D
2021-07-01$612.60$64.85RVU21C
2021-04-01$612.60$64.85RVU21B
2021-01-01$612.60$64.85RVU21A
2020-10-01$647.09$68.22RVU20D
2020-07-01$647.09$68.22RVU20C
2020-04-01$647.09$68.22RVU20B
2020-01-01$647.09$68.22RVU20A
2019-10-01$685.11$68.52RVU19D
2019-07-01$685.11$68.52RVU19C
2019-04-01$685.11$68.52RVU19B
2019-01-01$685.11$68.52RVU19A
2018-10-01$723.98$68.44RVU18D
2018-07-01$723.98$68.44RVU18C
2018-04-01$723.98$68.44RVU18B
2018-01-01$723.98$68.44RVU18AR1
2017-10-01$726.13$68.40RVU17D
2017-07-01$726.13$68.40RVU17C
2017-04-01$726.13$68.40RVU17B
2017-01-01$726.13$68.40RVU17A
2016-10-01$726.91$68.36RVU16D
2016-07-01$726.91$68.36RVU16C
2016-04-01$726.91$68.36RVU16B
2016-01-01$726.91$68.36RVU16A
2015-10-01$734.45$70.93RVU15D
2015-07-01$734.45$70.93RVU15C
2015-04-01$730.79$70.57RVU15B
2015-01-01$730.79$70.57RVU15A
2014-10-01$721.44$65.88RVU14D
2014-07-01$721.44$65.88RVU14C
2014-04-01$721.44$65.88RVU14B
2014-01-01$721.44$65.88RVU14A
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 19288 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

19288 billing questions

Can 19288 be billed by itself?

No. It is an add-on for an additional MRI-guided lesion and is reported with 19287 for the first lesion.

Are units based on the number of devices or lesions?

Report one unit for each additional lesion localized after the first, not for each device placed at a lesion.

Is MRI guidance separately reported?

No. MRI guidance is included in the breast localization service represented by this code.

When should 19286 be used instead?

Use 19286 for an additional lesion localized with ultrasound guidance. Code 19288 is for additional lesions localized with MRI guidance.

What documentation supports an additional unit?

Document the additional target or lesion, percutaneous device placement, MRI guidance, and the first-lesion service reported with 19287.

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 19288PPRRVU2026_Oct_nonQPP.csv, line 1,680 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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