Billing code 19084: Breast biopsyMedicare rate & RVUs
Reports ultrasound-guided core biopsy of an additional distinct breast lesion during a session in which a primary breast biopsy procedure is also performed.
Medicare pays $357.39 for 19084 nationally in the office and $65.13 in a hospital or facility. Local office rates run $312.27–$493.77.
Medicare rate · 19084
Breast biopsy
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- Work RVUs
- 1.51
- Total RVUs
- 10.70
- Global days
- ZZZ
National rate · 2026
$357.39
Office setting, before claim adjustments.
See every locality for 19084 → · Billed by an NP, PA or therapist? →
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 10 sections
What 19084 covers
This add-on service covers biopsy of an additional distinct breast target identified and sampled with ultrasound guidance. A radiologist, breast surgeon, or other qualified physician may perform it in an outpatient imaging center, hospital, or office. The service includes ultrasound guidance and, when performed, marker placement and imaging of the specimen. It is selected by the imaging method used to guide the biopsy, not by the number of tissue cores taken from one target.
Report 19084 for each additional lesion beyond the first ultrasound-guided breast biopsy target, with 19083 serving as the primary code for the first lesion. The record should identify each separately sampled target and support ultrasound guidance for the additional biopsy. Multiple cores from one lesion do not represent multiple lesions. As an add-on code, 19084 is billed only with a primary procedure and its payment falls 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 19084 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$312.27 to $493.77
109 of 109 payment localities
19084 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
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$312.27
$439.25
Color shows the midpoint of each state’s locality range.
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| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $399.81 | 1 |
| AL | $317.37 | 1 |
| AR | $312.27 | 1 |
| AZ | $347.27 | 1 |
| CA | $384.72–$493.77 | 29 |
| CO | $376.13 | 1 |
| CT | $382.74 | 1 |
| DC | $414.40 | 1 |
| DE | $353.48 | 1 |
| FL | $346.81–$377.93 | 3 |
| GA | $325.84–$363.44 | 2 |
| GU | $396.46 | 1 |
| HI | $396.46 | 1 |
| IA | $328.53 | 1 |
| ID | $330.44 | 1 |
| IL | $334.16–$370.01 | 4 |
| IN | $332.63 | 1 |
| KS | $325.78 | 1 |
| KY | $323.46 | 1 |
| LA | $322.48–$340.32 | 2 |
| MA | $373.10–$417.38 | 2 |
| MD | $361.08–$414.40 | 3 |
| ME | $331.24–$352.70 | 2 |
| MI | $331.84–$350.50 | 2 |
| MN | $362.37 | 1 |
| MO | $315.63–$342.92 | 3 |
| MS | $314.07 | 1 |
| MT | $357.38 | 1 |
| NC | $335.25 | 1 |
| ND | $354.22 | 1 |
| NE | $330.84 | 1 |
| NH | $369.09 | 1 |
| NJ | $387.67–$409.19 | 2 |
| NM | $333.43 | 1 |
| NV | $356.80 | 1 |
| NY | $340.72–$422.20 | 5 |
| OH | $331.19 | 1 |
| OK | $323.93 | 1 |
| OR | $354.60–$390.31 | 2 |
| PA | $332.36–$371.69 | 2 |
| PR | $360.63 | 1 |
| RI | $367.72 | 1 |
| SC | $333.67 | 1 |
| SD | $353.84 | 1 |
| TN | $327.47 | 1 |
| TX | $329.87–$374.37 | 8 |
| UT | $338.75 | 1 |
| VA | $350.69–$414.40 | 2 |
| VI | $360.63 | 1 |
| VT | $351.73 | 1 |
| WA | $372.75–$427.40 | 2 |
| WI | $341.02 | 1 |
| WV | $320.18 | 1 |
| WY | $356.00 | 1 |
How the 19084 rate is calculated
Each of 19084’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 · 19084
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.51Practice expense 9.03Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19084
The CMS indicators that decide how 19084 is paid alongside other services.
CMS payment indicators · 19084
Breast biopsy
| 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. |
19084 compared with similar codes
Compare codes
19084 vs 19083 vs 19082 vs 19086: national Medicare rates
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How to choose
- 19083Breast biopsy
- 19083 covers the first breast lesion biopsied with ultrasound guidance; 19084 covers each additional distinct lesion in the session.
- 19082Breast biopsy
- Both address an additional breast lesion, but 19082 is for stereotactic guidance and 19084 is for ultrasound guidance.
- 19086Breast biopsy
- Both address an additional breast lesion, but 19086 is for MRI guidance and 19084 is for ultrasound guidance.
19084 billing questions
When should 19084 be used instead of 19083?
Use 19083 for the first lesion biopsied with ultrasound guidance and 19084 for each additional distinct lesion biopsied with that guidance during the session.
Does each core from one lesion count as an additional lesion?
No. 19084 represents another distinct biopsy target, not additional tissue cores or passes from the same target.
What primary procedure is reported with 19084?
Report it with a primary breast biopsy procedure; 19083 is the corresponding primary code when the first lesion is biopsied under ultrasound guidance.
Are marker placement and specimen imaging included?
The service includes marker placement and specimen imaging when those steps are performed as part of the biopsy.
How does the global-period rule affect 19084?
It is an add-on code, not a stand-alone service, and its payment is within the global period of the associated primary procedure.
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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