Billing code 19084: Breast biopsyMedicare rate & RVUs in Chico

Reports ultrasound-guided core biopsy of an additional distinct breast lesion during a session in which a primary breast biopsy procedure is also performed.

CMS RVU26DEffective Oct 1, 2026One payment locality13.8K Medicare services in 2024

In Chico, Medicare pays $384.72 for 19084 in the office and $64.41 when it’s performed in a hospital or facility.

$384.72Office (non-facility)
$64.41Hospital or facility
+7.6%vs the national office rate ($357.39)

Check a contract rate as a % of Medicare · 19084 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 19084 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chico
  2. What 19084 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Chico compares for 19084

Across 109 of 109 payment localities, the office rate for 19084 runs from $312.27 in Arkansas to $493.77 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). Chico pays $384.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

19084 in Chico vs other payment areas
  1. Chico · this page$384.72
  2. Bakersfield · California$385.21+$0.49
  3. El Centro · California$384.75+$0.03
  4. Fresno · California$384.72
  5. Hanford-Corcoran · California$384.72
  6. Madera · California$384.72

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

19084 in every other Medicare payment locality
Payment localityOfficeFacility
MercedCalifornia$384.72$64.41
ModestoCalifornia$384.72$64.41
NapaCalifornia$453.85$68.65
Oxnard-Thousand Oaks-VenturaCalifornia$411.68$66.23
ReddingCalifornia$384.72$64.41
Rest Of CaliforniaCalifornia$384.72$64.41
Riverside-San Bernardino-OntarioCalifornia$386.47$66.15
Sacramento-Roseville-FolsomCalifornia$405.89$65.99

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.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$312.27

$439.25

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

View every state and territory as a table
19084 office rate range by state
State / territoryOffice rate rangeLocalities
AK$399.811
AL$317.371
AR$312.271
AZ$347.271
CA$384.72–$493.7729
CO$376.131
CT$382.741
DC$414.401
DE$353.481
FL$346.81–$377.933
GA$325.84–$363.442
GU$396.461
HI$396.461
IA$328.531
ID$330.441
IL$334.16–$370.014
IN$332.631
KS$325.781
KY$323.461
LA$322.48–$340.322
MA$373.10–$417.382
MD$361.08–$414.403
ME$331.24–$352.702
MI$331.84–$350.502
MN$362.371
MO$315.63–$342.923
MS$314.071
MT$357.381
NC$335.251
ND$354.221
NE$330.841
NH$369.091
NJ$387.67–$409.192
NM$333.431
NV$356.801
NY$340.72–$422.205
OH$331.191
OK$323.931
OR$354.60–$390.312
PA$332.36–$371.692
PR$360.631
RI$367.721
SC$333.671
SD$353.841
TN$327.471
TX$329.87–$374.378
UT$338.751
VA$350.69–$414.402
VI$360.631
VT$351.731
WA$372.75–$427.402
WI$341.021
WV$320.181
WY$356.001

See 19084 in every payment locality

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

10.7000 adjusted RVUs×$33.4009 conversion factor=$357.39

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

The exact Chico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,662

Code
19084
Physician work
1.51
Practice expense
9.03
Malpractice
0.16

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 19084 in Chico
ComponentRVULocality factorAdjusted
Physician work1.51× 1.0171.5357
Practice expense9.03× 1.0969.8969
Malpractice0.16× 0.5360.0858
Total RVUs11.5183
Conversion factor× 33.4009

Office rate, Chico$384.72

Office: (1.51 × 1.017 + 9.03 × 1.096 + 0.16 × 0.536) × $33.4009 = $384.72

Facility: (1.51 × 1.017 + 0.28 × 1.096 + 0.16 × 0.536) × $33.4009 = $64.41

Open 19084 in the RVU calculator

Payment rules and modifiers for 19084

The CMS indicators that decide how 19084 is paid alongside other services.

CMS payment indicators · 19084

Breast biopsy

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.

How 19084 has changed in Chico

19084 · Office / nonfacility

$384.72

Effective 2026-10-01

The base rate is $7.13 higher than on 2025-10-01, moving from $377.59 to $384.72 (1.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $377.59changed to$384.72

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.55 changed to 1.51
    • Practice expense RVU 9.16 changed to 9.03
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $377.59

    Held through RVU25B, RVU25C, RVU25D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$384.72$64.41RVU26D
2026-07-01$384.72$64.41RVU26C
2026-04-01$384.72$64.41RVU26B
2026-01-01$384.72$64.41RVU26A
2025-10-01$377.59$73.89RVU25D
2025-07-01$377.59$73.89RVU25C
2025-04-01$377.59$73.89RVU25B
2025-01-01$377.59$73.89RVU25A

Price 19084 for an earlier date of service

Where the Chico rate applies

Chico is a Medicare payment area, not a city. Our Census mapping connects it to 30 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in California

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

Show the CMS file lines behind this rate
RVUs for 19084PPRRVU2026_Oct_nonQPP.csv, line 1,662 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)

Open CMS sourceHow we calculate rates

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