CPT code 19288: Breast localization, additional lesion, MRI guidance2026 Medicare rate & RVUs in North Carolina
Reports MRI-guided percutaneous localization of each breast lesion beyond the first, typically to mark additional targets before breast-conserving surgery.
In North Carolina, Medicare pays $427.93 for 19288 in the office and $51.48 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $427.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$427.93
- Los Angeles, CA · California$532.53+$104.60
- Washington, DC area · District of Columbia$532.82+$104.89
- Miami, FL · Florida$479.91+$51.98
- Chicago, IL · Illinois$464.46+$36.53
- Manhattan, NY · New York$528.55+$100.62
- Alaska · Alaska$502.73+$74.80
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $495.25 | $53.03 |
| Merced, CACalifornia | $495.25 | $53.03 |
| Modesto, CACalifornia | $495.25 | $53.03 |
| Napa, CACalifornia | $588.33 | $56.54 |
| Oxnard, CACalifornia | $531.41 | $54.50 |
| Redding, CACalifornia | $495.25 | $53.03 |
| Rest of CaliforniaCalifornia | $495.25 | $53.03 |
| Riverside, CACalifornia | $496.56 | $54.34 |
| Sacramento, CACalifornia | $523.59 | $54.34 |
| Salinas, CACalifornia | $521.73 | $54.10 |
| San Diego, CACalifornia | $536.93 | $54.36 |
| Marin County, CACalifornia | $627.30 | $58.39 |
| San Francisco, CACalifornia | $627.16 | $58.25 |
| San Benito County, CACalifornia | $641.39 | $59.57 |
| Santa Clara County, CACalifornia | $640.84 | $59.01 |
| San Luis Obispo, CACalifornia | $512.93 | $53.36 |
| Santa Cruz, CACalifornia | $544.34 | $54.11 |
| Santa Maria, CACalifornia | $524.49 | $54.03 |
| Santa Rosa, CACalifornia | $550.06 | $54.59 |
| Stockton, CACalifornia | $495.25 | $53.03 |
| Vallejo, CACalifornia | $588.14 | $56.35 |
| Visalia, CACalifornia | $495.25 | $53.03 |
| Yuba City, CACalifornia | $495.25 | $53.03 |
| ColoradoColorado | $482.86 | $53.56 |
| ConnecticutConnecticut | $490.26 | $55.71 |
| DelawareDelaware | $451.79 | $53.15 |
| Fort Lauderdale, FLFlorida | $465.51 | $56.78 |
| Rest of FloridaFlorida | $440.85 | $55.12 |
| Atlanta, GAGeorgia | $464.43 | $54.50 |
| Rest of GeorgiaGeorgia | $413.29 | $53.38 |
| Hawaii, Guam, HIHawaii | $511.57 | $52.81 |
| IowaIowa | $419.56 | $50.37 |
| IdahoIdaho | $421.92 | $50.71 |
| East St. Louis, ILIllinois | $428.10 | $56.89 |
| Rest of IllinoisIllinois | $423.41 | $55.03 |
| Suburban Chicago, ILIllinois | $471.41 | $57.04 |
| IndianaIndiana | $424.85 | $50.82 |
| KansasKansas | $415.46 | $50.72 |
| KentuckyKentucky | $410.94 | $52.25 |
| New Orleans, LALouisiana | $433.21 | $53.53 |
| Rest of LouisianaLouisiana | $409.47 | $52.39 |
| Metropolitan Boston, MAMassachusetts | $537.96 | $56.20 |
| Rest of MassachusettsMassachusetts | $478.57 | $53.70 |
| Baltimore area, MDMaryland | $488.56 | $55.62 |
| Rest of MarylandMaryland | $461.95 | $53.62 |
| Rest of MaineMaine | $422.52 | $51.31 |
| Southern Maine, MEMaine | $451.74 | $51.89 |
| Detroit, MIMichigan | $445.28 | $55.92 |
| Rest of MichiganMichigan | $421.67 | $53.29 |
| MinnesotaMinnesota | $466.03 | $50.84 |
| Metropolitan Kansas City, MOMissouri | $431.75 | $52.88 |
| Metropolitan St. Louis, MOMissouri | $437.20 | $53.08 |
| Rest of MissouriMissouri | $400.08 | $52.28 |
| MississippiMississippi | $398.73 | $51.33 |
| MontanaMontana | $456.92 | $53.43 |
| North DakotaNorth Dakota | $454.54 | $51.06 |
| NebraskaNebraska | $422.77 | $50.36 |
| New HampshireNew Hampshire | $473.28 | $53.26 |
| Northern New JerseyNew Jersey | $525.61 | $57.57 |
| Rest of New JerseyNew Jersey | $496.81 | $56.21 |
| New MexicoNew Mexico | $423.60 | $53.61 |
| NevadaNevada | $456.67 | $52.78 |
| NYC suburbs and Long Island, NYNew York | $540.74 | $61.00 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $498.71 | $56.89 |
| Queens, NYNew York | $536.20 | $59.28 |
| Rest of New YorkNew York | $435.18 | $51.87 |
| OhioOhio | $421.19 | $52.81 |
| OklahomaOklahoma | $412.04 | $51.73 |
| Portland, OROregon | $502.21 | $53.94 |
| Rest of OregonOregon | $454.09 | $52.22 |
| Metropolitan Philadelphia, PAPennsylvania | $475.31 | $55.28 |
| Rest of PennsylvaniaPennsylvania | $422.99 | $52.59 |
| Puerto RicoPuerto Rico | $461.39 | $53.47 |
| Rhode IslandRhode Island | $470.85 | $54.06 |
| South CarolinaSouth Carolina | $425.07 | $52.26 |
| South DakotaSouth Dakota | $454.26 | $50.78 |
| TennesseeTennessee | $417.65 | $50.89 |
| Austin, TXTexas | $480.40 | $53.51 |
| Beaumont, TXTexas | $419.63 | $52.47 |
| Brazoria, TXTexas | $452.68 | $52.82 |
| Dallas, TXTexas | $455.09 | $53.22 |
| Fort Worth, TXTexas | $451.03 | $53.19 |
| Galveston, TXTexas | $453.69 | $53.03 |
| Houston, TXTexas | $455.89 | $55.23 |
| Rest of TexasTexas | $435.57 | $52.66 |
| UtahUtah | $431.85 | $52.57 |
| VirginiaVirginia | $448.76 | $52.13 |
| Virgin Islands, VIUnited States Virgin Islands | $461.39 | $53.47 |
| VermontVermont | $450.83 | $51.38 |
| Rest of WashingtonWashington | $478.30 | $53.43 |
| King County, WAWashington | $551.61 | $56.54 |
| WisconsinWisconsin | $436.88 | $50.35 |
| West VirginiaWest Virginia | $404.79 | $54.16 |
| WyomingWyoming | $455.88 | $52.40 |
19288 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.
$397.01
$568.32
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 | $502.73 | 1 |
| AL | $403.79 | 1 |
| AR | $397.01 | 1 |
| AZ | $443.60 | 1 |
| CA | $495.25–$641.39 | 29 |
| CO | $482.86 | 1 |
| CT | $490.26 | 1 |
| DC | $532.82 | 1 |
| DE | $451.79 | 1 |
| FL | $440.85–$479.91 | 3 |
| GA | $413.29–$464.43 | 2 |
| GU | $511.57 | 1 |
| HI | $511.57 | 1 |
| IA | $419.56 | 1 |
| ID | $421.92 | 1 |
| IL | $423.41–$471.41 | 4 |
| IN | $424.85 | 1 |
| KS | $415.46 | 1 |
| KY | $410.94 | 1 |
| LA | $409.47–$433.21 | 2 |
| MA | $478.57–$537.96 | 2 |
| MD | $461.95–$532.82 | 3 |
| ME | $422.52–$451.74 | 2 |
| MI | $421.67–$445.28 | 2 |
| MN | $466.03 | 1 |
| MO | $400.08–$437.20 | 3 |
| MS | $398.73 | 1 |
| MT | $456.92 | 1 |
| NC | $427.93 | 1 |
| ND | $454.54 | 1 |
| NE | $422.77 | 1 |
| NH | $473.28 | 1 |
| NJ | $496.81–$525.61 | 2 |
| NM | $423.60 | 1 |
| NV | $456.67 | 1 |
| NY | $435.18–$540.74 | 5 |
| OH | $421.19 | 1 |
| OK | $412.04 | 1 |
| OR | $454.09–$502.21 | 2 |
| PA | $422.99–$475.31 | 2 |
| PR | $461.39 | 1 |
| RI | $470.85 | 1 |
| SC | $425.07 | 1 |
| SD | $454.26 | 1 |
| TN | $417.65 | 1 |
| TX | $419.63–$480.40 | 8 |
| UT | $431.85 | 1 |
| VA | $448.76–$532.82 | 2 |
| VI | $461.39 | 1 |
| VT | $450.83 | 1 |
| WA | $478.30–$551.61 | 2 |
| WI | $436.88 | 1 |
| WV | $404.79 | 1 |
| WY | $455.88 | 1 |
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.
The exact North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.000 | 1.2500 |
| Practice expense | 12.31 | × 0.933 | 11.4852 |
| Malpractice | 0.12 | × 0.639 | 0.0767 |
| Total RVUs | 12.8119 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$427.93
Office: (1.25 × 1 + 12.31 × 0.933 + 0.12 × 0.639) × $33.4009 = $427.93
Facility: (1.25 × 1 + 0.23 × 0.933 + 0.12 × 0.639) × $33.4009 = $51.48
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. |
How 19288 has changed in North Carolina
19288 · Office / nonfacility
$427.93
Effective 2026-10-01
The base rate is $6.84 higher than on 2025-10-01, moving from $421.09 to $427.93 (1.6%).
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
$421.09changed to$427.93
- 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
- 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
$448.84changed to$421.09
- 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.
March 9, 2024
RVU24AR
$441.51changed to$448.84
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$473.36changed to$441.51
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 13.60 changed to 13.10
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$498.30changed to$473.36
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 14.04 changed to 13.60
- 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
$560.07changed to$498.30
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 15.82 changed to 14.04
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$592.59changed to$560.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 16.19 changed to 15.82
- 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
$628.34changed to$592.59
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 17.27 changed to 16.19
- 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
$663.84changed to$628.34
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 18.35 changed to 17.27
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$662.28changed to$663.84
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 18.36 changed to 18.35
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$658.87changed to$662.28
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 18.32 changed to 18.36
- 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
$665.30changed to$658.87
- 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.
July 1, 2015
RVU15C
$661.99changed to$665.30
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$649.92changed to$661.99
- 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 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$649.92
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 | $427.93 | $51.48 | RVU26D |
| 2026-07-01 | $427.93 | $51.48 | RVU26C |
| 2026-04-01 | $427.93 | $51.48 | RVU26B |
| 2026-01-01 | $427.93 | $51.48 | RVU26A |
| 2025-10-01 | $421.09 | $58.06 | RVU25D |
| 2025-07-01 | $421.09 | $58.06 | RVU25C |
| 2025-04-01 | $421.09 | $58.06 | RVU25B |
| 2025-01-01 | $421.09 | $58.06 | RVU25A |
| 2024-10-01 | $448.84 | $58.91 | RVU24D |
| 2024-07-01 | $448.84 | $58.91 | RVU24C |
| 2024-04-01 | $448.84 | $58.91 | RVU24B |
| 2024-03-09 | $448.84 | $58.91 | RVU24AR |
| 2024-01-01 | $441.51 | $57.95 | RVU24A |
| 2023-10-01 | $473.36 | $60.91 | RVU23D |
| 2023-07-01 | $473.36 | $60.91 | RVU23C |
| 2023-04-01 | $473.36 | $60.91 | RVU23B |
| 2023-01-01 | $473.36 | $60.91 | RVU23A |
| 2022-10-01 | $498.30 | $62.19 | RVU22D |
| 2022-07-01 | $498.30 | $62.19 | RVU22C |
| 2022-04-01 | $498.30 | $62.19 | RVU22B |
| 2022-01-01 | $498.30 | $62.19 | RVU22A |
| 2021-10-01 | $560.07 | $62.70 | RVU21D |
| 2021-07-01 | $560.07 | $62.70 | RVU21C |
| 2021-04-01 | $560.07 | $62.70 | RVU21B |
| 2021-01-01 | $560.07 | $62.70 | RVU21A |
| 2020-10-01 | $592.59 | $65.31 | RVU20D |
| 2020-07-01 | $592.59 | $65.31 | RVU20C |
| 2020-04-01 | $592.59 | $65.31 | RVU20B |
| 2020-01-01 | $592.59 | $65.31 | RVU20A |
| 2019-10-01 | $628.34 | $64.99 | RVU19D |
| 2019-07-01 | $628.34 | $64.99 | RVU19C |
| 2019-04-01 | $628.34 | $64.99 | RVU19B |
| 2019-01-01 | $628.34 | $64.99 | RVU19A |
| 2018-10-01 | $663.84 | $64.92 | RVU18D |
| 2018-07-01 | $663.84 | $64.92 | RVU18C |
| 2018-04-01 | $663.84 | $64.92 | RVU18B |
| 2018-01-01 | $663.84 | $64.92 | RVU18AR1 |
| 2017-10-01 | $662.28 | $64.87 | RVU17D |
| 2017-07-01 | $662.28 | $64.87 | RVU17C |
| 2017-04-01 | $662.28 | $64.87 | RVU17B |
| 2017-01-01 | $662.28 | $64.87 | RVU17A |
| 2016-10-01 | $658.87 | $64.84 | RVU16D |
| 2016-07-01 | $658.87 | $64.84 | RVU16C |
| 2016-04-01 | $658.87 | $64.84 | RVU16B |
| 2016-01-01 | $658.87 | $64.84 | RVU16A |
| 2015-10-01 | $665.30 | $66.79 | RVU15D |
| 2015-07-01 | $665.30 | $66.79 | RVU15C |
| 2015-04-01 | $661.99 | $66.45 | RVU15B |
| 2015-01-01 | $661.99 | $66.45 | RVU15A |
| 2014-10-01 | $649.92 | $63.21 | RVU14D |
| 2014-07-01 | $649.92 | $63.21 | RVU14C |
| 2014-04-01 | $649.92 | $63.21 | RVU14B |
| 2014-01-01 | $649.92 | $63.21 | 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
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
Fee sheets · Coming soon
Put 19288 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist