Billing code 19284: Breast localizationMedicare rate & RVUs

Report 19284 for percutaneous placement of a localization device in each additional breast lesion targeted with stereotactic imaging.

CMS RVU26DEffective Oct 1, 2026109 payment localities504 Medicare services in 2024

Medicare pays $181.70 for 19284 nationally in the office and $42.42 in a hospital or facility. Local office rates run $159.43–$247.82.

Medicare rate · 19284

Breast localization

Swap in your local Medicare rate.

Work RVUs
0.98
Total RVUs
5.44
Global days
ZZZ

National rate · 2026

$181.70

Office setting, before claim adjustments.

See every locality for 19284 → · 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
  1. Medicare rate
  2. What 19284 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 19284 covers

This add-on represents percutaneous placement of a localization device, such as a clip or marker, in an additional breast lesion using stereotactic imaging guidance. Breast radiologists and other clinicians who perform image-guided breast procedures commonly place these devices in a breast imaging center or hospital before surgical excision, including when more than one lesion needs localization.

Report 19284 for each additional lesion after the first stereotactically localized lesion, and pair it with 19283 for the first lesion. The record should identify the separately targeted lesions, the stereotactic guidance used, and the device placement at each site. The code includes the stereotactic guidance for the additional placement. CMS classifies 19284 as an add-on code: it 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 19284 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

$159.43 to $247.82

$159.43$203.63$247.82
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

19284 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$161.94$40.07
Alaska*$205.86$57.53
Arizona$176.67$41.70
Arkansas$159.43$39.79
Atlanta$184.86$43.35
Austin$189.77$42.41
Bakersfield$194.83$42.18
Baltimore/Surr. Cntys$193.70$44.25
Beaumont$168.36$41.62
Brazoria$179.85$41.82

19284 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.

$159.43

$221.16

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

View every state and territory as a table
19284 office rate range by state
State / territoryOffice rate rangeLocalities
AK$205.861
AL$161.941
AR$159.431
AZ$176.671
CA$194.50–$247.8229
CO$190.591
CT$194.311
DC$209.751
DE$179.751
FL$177.16–$193.283
GA$166.71–$184.862
GU$200.061
HI$200.061
IA$167.141
ID$168.141
IL$171.13–$188.694
IN$169.211
KS$165.931
KY$165.261
LA$164.84–$173.632
MA$189.18–$210.832
MD$183.47–$209.753
ME$168.69–$179.042
MI$169.53–$179.142
MN$183.331
MO$161.55–$174.733
MS$160.551
MT$181.691
NC$170.641
ND$179.521
NE$168.231
NH$187.201
NJ$196.73–$207.262
NM$170.381
NV$181.231
NY$173.34–$214.415
OH$169.091
OK$165.341
OR$180.03–$197.412
PA$169.58–$188.962
PR$183.241
RI$186.721
SC$170.111
SD$179.261
TN$166.781
TX$168.36–$189.778
UT$172.611
VA$178.15–$209.752
VI$183.241
VT$178.431
WA$188.95–$215.652
WI$173.061
WV$164.251
WY$180.751

How the 19284 rate is calculated

Each of 19284’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 · 19284

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.98Practice expense 4.35Malpractice 0.11

5.4400 adjusted RVUs×$33.4009 conversion factor=$181.70

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 19284

The CMS indicators that decide how 19284 is paid alongside other services.

CMS payment indicators · 19284

Breast localization

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.

19284 compared with similar codes

Compare codes

19284 vs 19283 vs 19286 vs 19288 vs 19282: national Medicare rates

Swap in your local Medicare rate.

  • 19284
    Breast localization · 0.98 wRVU
    $181.70
  • 19283
    Breast localization · 1.95 wRVU
    $250.17+$68.47
  • 19286
    Breast localization · 0.83 wRVU
    $286.58+$104.88
  • 19288
    Breast localization · 1.25 wRVU
    $456.92+$275.22
  • 19282
    Breast localization · 0.98 wRVU
    $164.67−$17.03

How to choose

19283Breast localization
19283 is for the first breast lesion localized with stereotactic guidance; 19284 is for each additional lesion and is reported with 19283.
19286Breast localization
Both address additional breast lesions, but 19286 uses ultrasound guidance. Use 19284 when placement is stereotactically guided.
19288Breast localization
19288 covers an additional lesion localized with MRI guidance; 19284 is for stereotactic guidance.
19282Breast localization
19282 applies to an additional lesion placed without imaging guidance. Use 19284 when stereotactic guidance is used.

19284 billing questions

When should 19284 be reported instead of 19283?

Use 19283 for the first lesion localized with stereotactic guidance. Report 19284 for each additional lesion localized by that method.

What primary code must accompany 19284?

Report 19284 with 19283, which represents the first stereotactically localized lesion. The add-on code is not reported by itself.

Can 19284 be used for an ultrasound-guided lesion?

No. For an additional lesion localized with ultrasound guidance, use 19286 rather than 19284.

Is stereotactic guidance separately reported for the additional placement?

The stereotactic guidance is included in 19284. The code accounts for the guidance used to place the device in the additional lesion.

What documentation supports reporting multiple units?

Document each distinct lesion receiving a device and the stereotactic guidance used. Report 19284 for each additional lesion beyond the first, alongside 19283.

How does the global-period rule affect payment?

CMS treats 19284 as an add-on paid within the primary procedure's global period. It must accompany the primary procedure rather than stand alone.

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 19284PPRRVU2026_Oct_nonQPP.csv, line 1,676 (RVU26D)

Open CMS sourceHow we calculate rates

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