CPT code 19288: Breast localization, additional lesion, MRI guidance2026 Medicare rate & RVUs in Missouri
Reports MRI-guided percutaneous localization of each breast lesion beyond the first, typically to mark additional targets before breast-conserving surgery.
Medicare pays $400.08–$437.20 for 19288 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 19288 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$400.08 to $437.20
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $431.75 | $52.88 |
| Metropolitan St. Louis, MO | $437.20 | $53.08 |
| Rest of Missouri | $400.08 | $52.28 |
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
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.
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
| 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. |
19288 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 19287Breast localizationFirst lesion, MRI guidance
- Use 19287 for the first lesion in an MRI-guided localization service. Use 19288 for each additional lesion.
- 19286Breast localizationEach additional lesion
- Both represent additional breast lesions, but 19286 is for ultrasound guidance and 19288 is for MRI guidance.
- 19284Breast localizationAdditional stereotactic lesion
- 19284 represents an additional lesion localized stereotactically; 19288 represents one localized with MRI guidance.
- 19282Breast localizationEach additional lesion
- 19282 is for an additional lesion with mammographic guidance. Select 19288 when MRI provides the guidance.
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
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