Billing code 19281: Breast localizationMedicare rate & RVUs
Reports percutaneous placement of a breast localization device under mammographic guidance to mark the first lesion for surgical targeting.
Medicare pays $234.81 for 19281 nationally in the office and $83.17 in a hospital or facility. Local office rates run $208.70–$311.22.
Medicare rate · 19281
Breast localization
Swap in your local Medicare rate.
- Work RVUs
- 1.95
- Total RVUs
- 7.03
- Global days
- 000
National rate · 2026
$234.81
Office setting, before claim adjustments.
See every locality for 19281 → · 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 19281 covers
A breast imager, typically a radiologist, uses mammographic imaging to guide percutaneous placement of a localization device at a breast target that is difficult to find by palpation. The service commonly prepares a mammographically visible mass, architectural distortion, or calcification cluster for surgical excision; a wire or marker can identify the target for the surgeon. Report this code for the first lesion localized with mammographic guidance, not for each device placed around one target.
Documentation should identify the lesion, the mammographic guidance used, and the placement performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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 19281 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
$208.70 to $311.22
109 of 109 payment localities
19281 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.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$208.70
$279.94
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 | $275.14 | 1 |
| AL | $211.64 | 1 |
| AR | $208.70 | 1 |
| AZ | $228.83 | 1 |
| CA | $248.65–$311.22 | 29 |
| CO | $244.65 | 1 |
| CT | $250.02 | 1 |
| DC | $268.12 | 1 |
| DE | $232.53 | 1 |
| FL | $230.81–$251.21 | 3 |
| GA | $218.39–$238.89 | 2 |
| GU | $254.51 | 1 |
| HI | $254.51 | 1 |
| IA | $217.10 | 1 |
| ID | $218.40 | 1 |
| IL | $224.17–$244.57 | 4 |
| IN | $219.62 | 1 |
| KS | $215.98 | 1 |
| KY | $216.14 | 1 |
| LA | $215.76–$226.03 | 2 |
| MA | $243.22–$268.47 | 2 |
| MD | $236.90–$268.12 | 3 |
| ME | $219.34–$231.00 | 2 |
| MI | $221.42–$233.45 | 2 |
| MN | $235.08 | 1 |
| MO | $212.10–$226.98 | 3 |
| MS | $210.45 | 1 |
| MT | $234.80 | 1 |
| NC | $221.57 | 1 |
| ND | $231.04 | 1 |
| NE | $218.28 | 1 |
| NH | $240.71 | 1 |
| NJ | $253.06–$265.48 | 2 |
| NM | $222.53 | 1 |
| NV | $233.91 | 1 |
| NY | $224.76–$275.28 | 5 |
| OH | $220.65 | 1 |
| OK | $215.92 | 1 |
| OR | $232.27–$252.36 | 2 |
| PA | $221.07–$243.90 | 2 |
| PR | $236.51 | 1 |
| RI | $240.75 | 1 |
| SC | $221.44 | 1 |
| SD | $230.59 | 1 |
| TN | $217.01 | 1 |
| TX | $219.66–$243.69 | 8 |
| UT | $224.36 | 1 |
| VA | $230.17–$268.12 | 2 |
| VI | $236.51 | 1 |
| VT | $230.04 | 1 |
| WA | $242.79–$273.98 | 2 |
| WI | $223.56 | 1 |
| WV | $216.15 | 1 |
| WY | $233.16 | 1 |
How the 19281 rate is calculated
Each of 19281’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 · 19281
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.95Practice expense 4.89Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19281
The CMS indicators that decide how 19281 is paid alongside other services.
CMS payment indicators · 19281
Breast localization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19281 without 50 · national office
$234.81
Breast localization
19281-50 · Bilateral: 150%
$352.22
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
19281 compared with similar codes
Compare codes
19281 vs 19282 vs 19283 vs 19285 vs 19287: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19282Breast localization
- 19281 reports the first lesion localized with mammographic guidance; 19282 reports each additional lesion localized with that guidance.
- 19283Breast localization
- Both address the first lesion, but 19283 is selected when stereotactic guidance is used rather than mammographic guidance without stereotactic guidance.
- 19285Breast localization
- 19285 is for first-lesion localization guided by ultrasound; 19281 is for mammographic guidance.
- 19287Breast localization
- 19287 is for first-lesion localization guided by MRI; 19281 is for mammographic guidance.
19281 billing questions
When is 19281 reported instead of 19283?
Use 19281 for localization guided by mammographic imaging without stereotactic guidance. Use 19283 when stereotactic guidance is used.
How is an additional lesion reported?
19281 represents the first lesion localized with mammographic guidance. Report 19282 for each additional lesion localized with that guidance.
Are units based on devices or lesions?
The code distinguishes the first lesion from additional lesions, not the number of wires or markers placed around one lesion.
Can 19281 be used for ultrasound- or MRI-guided placement?
No. The guidance modality determines the code: 19285 is for ultrasound guidance and 19287 is for MRI guidance.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Separately performed procedures may be subject to the standard multiple procedure reduction.
When is modifier 50 appropriate?
For bilateral performance, CMS pays this procedure at 150% with modifier 50. Assistant-at-surgery payment requires documented medical necessity.
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
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