Billing code 19286: Breast localizationMedicare rate & RVUs

Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.6K Medicare services in 2024

Medicare pays $286.58 for 19286 nationally in the office and $36.07 in a hospital or facility. Local office rates run $249.05–$401.32.

Medicare rate · 19286

Breast localization

Swap in your local Medicare rate.

Work RVUs
0.83
Total RVUs
8.58
Global days
ZZZ

National rate · 2026

$286.58

Office setting, before claim adjustments.

See every locality for 19286 → · 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 19286 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 19286 covers

This code represents percutaneous placement of a localization device at an additional breast lesion, using ultrasound guidance. It is used when a clinician places devices to mark separate targets, commonly before breast-conserving surgery or another planned breast procedure. The ultrasound-guided placement, rather than a diagnostic ultrasound examination alone, is the service captured by this code.

Report it for each qualifying additional lesion after the first ultrasound-guided lesion, with the primary ultrasound-guided placement code 19285 on the claim. The record should support the separate lesion treated, its location, the percutaneous device placement, and ultrasound guidance. This is an add-on code: it is not billed alone and is paid within the global period of the primary procedure. The first lesion is reported with 19285; this code represents additional lesions, not additional devices placed at the same lesion.

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 19286 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

$249.05 to $401.32

$249.05$325.19$401.32
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

19286 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$253.29$34.10
Alaska*$315.72$48.93
Arizona$278.22$35.47
Arkansas$249.05$33.86
Atlanta$291.36$36.85
Austin$301.13$36.10
Bakersfield$310.49$35.94
Baltimore/Surr. Cntys$306.41$37.62
Beaumont$263.34$35.38
Brazoria$283.84$35.59

19286 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.

$249.05

$355.77

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

View every state and territory as a table
19286 office rate range by state
State / territoryOffice rate rangeLocalities
AK$315.721
AL$253.291
AR$249.051
AZ$278.221
CA$310.22–$401.3229
CO$302.631
CT$307.471
DC$333.961
DE$283.341
FL$276.83–$301.673
GA$259.52–$291.362
GU$320.371
HI$320.371
IA$263.021
ID$264.531
IL$266.01–$296.004
IN$266.361
KS$260.531
KY$257.921
LA$257.03–$271.892
MA$299.97–$337.022
MD$289.68–$333.963
ME$264.98–$283.172
MI$264.71–$279.692
MN$291.881
MO$251.19–$274.303
MS$250.231
MT$286.571
NC$268.351
ND$284.791
NE$265.011
NH$296.691
NJ$311.52–$329.472
NM$265.951
NV$286.331
NY$272.89–$339.295
OH$264.341
OK$258.531
OR$284.66–$314.652
PA$265.43–$298.152
PR$289.351
RI$295.221
SC$266.681
SD$284.581
TN$261.911
TX$263.34–$301.138
UT$270.921
VA$281.35–$333.962
VI$289.351
VT$282.541
WA$299.78–$345.492
WI$273.751
WV$254.361
WY$285.801

How the 19286 rate is calculated

Each of 19286’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 · 19286

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.83Practice expense 7.66Malpractice 0.09

8.5800 adjusted RVUs×$33.4009 conversion factor=$286.58

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

Payment rules and modifiers for 19286

The CMS indicators that decide how 19286 is paid alongside other services.

CMS payment indicators · 19286

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.

19286 compared with similar codes

Compare codes

19286 vs 19285 vs 19282 vs 19284 vs 19288: national Medicare rates

Swap in your local Medicare rate.

  • 19286
    Breast localization · 0.83 wRVU
    $286.58
  • 19285
    Breast localization · 1.66 wRVU
    $350.38+$63.80
  • 19282
    Breast localization · 0.98 wRVU
    $164.67−$121.91
  • 19284
    Breast localization · 0.98 wRVU
    $181.70−$104.88
  • 19288
    Breast localization · 1.25 wRVU
    $456.92+$170.34

How to choose

19285Breast localization
19285 reports the first ultrasound-guided lesion; 19286 reports each additional lesion localized with ultrasound during the procedure.
19282Breast localization
Both represent additional breast lesions, but 19282 is for mammographic guidance rather than ultrasound guidance.
19284Breast localization
Both are add-on codes for additional lesions; 19284 applies when stereotactic guidance is used.
19288Breast localization
Both cover additional lesions, but 19288 is for MRI-guided placement rather than ultrasound-guided placement.

19286 billing questions

When is 19286 reported instead of 19285?

Use 19285 for the first lesion localized with ultrasound guidance. Report 19286 for each additional lesion localized during the procedure.

Can 19286 be billed without 19285?

No. It is an add-on code and must be reported with the primary ultrasound-guided placement code, 19285.

Does 19286 count additional devices or additional lesions?

It represents each additional lesion, not each extra device placed at one lesion. The record should distinguish the separately localized targets.

Is ultrasound guidance separately reported for the placement?

The code represents placement with ultrasound guidance. Document the guidance used for the additional lesion rather than reporting this code for device placement without ultrasound.

What documentation supports the additional-lesion unit?

Document the additional target's location, percutaneous device placement, and ultrasound guidance, as well as the first lesion reported with 19285.

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 19286PPRRVU2026_Oct_nonQPP.csv, line 1,678 (RVU26D)

Open CMS sourceHow we calculate rates

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