Billing code 19081: Breast biopsyMedicare rate & RVUs in Fresno

Percutaneous stereotactic biopsy obtains breast tissue from a mammographic target, such as suspicious calcifications, when stereotactic guidance is used for the first lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality55.1K Medicare services in 2024

In Fresno, Medicare pays $509.20 for 19081 in the office and $136.54 when it’s performed in a hospital or facility.

$509.20Office (non-facility)
$136.54Hospital or facility
+6.5%vs the national office rate ($478.30)

Check a contract rate as a % of Medicare · 19081 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 19081 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Fresno
  2. What 19081 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 19081 covers

A radiologist typically performs this percutaneous breast biopsy by using mammographic stereotactic targeting to guide a needle into an abnormality and collect tissue samples. Common targets include suspicious calcifications or another mammographic finding that is not well seen with ultrasound. Marker placement and specimen imaging, when performed, are part of the service. The code covers the first lesion biopsied with stereotactic guidance during the session; a distinct additional lesion may be reported with 19082.

Select this code when stereotactic imaging guides the biopsy, rather than ultrasound or MRI. The report should identify the target and guidance method and document tissue sampling; include details of marker placement or specimen imaging when performed. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces other procedures to 50%. Modifier 50 for bilateral performance 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.

How Fresno compares for 19081

Across 109 of 109 payment localities, the office rate for 19081 runs from $421.96 in Arkansas to $643.52 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). Fresno pays $509.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

19081 in Fresno vs other payment areas
  1. Fresno · this page$509.20
  2. Bakersfield · California$510.27+$1.07
  3. Chico · California$509.20
  4. El Centro · California$509.26+$0.06
  5. Hanford-Corcoran · California$509.20
  6. Madera · California$509.20

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

Every other payment area

19081 in every other Medicare payment locality
Payment localityOfficeFacility
MercedCalifornia$509.20$136.54
ModestoCalifornia$509.20$136.54
NapaCalifornia$593.59$145.44
Oxnard-Thousand Oaks-VenturaCalifornia$542.31$140.40
ReddingCalifornia$509.20$136.54
Rest Of CaliforniaCalifornia$509.20$136.54
Riverside-San Bernardino-OntarioCalifornia$513.01$140.35
Sacramento-Roseville-FolsomCalifornia$535.32$139.87

19081 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.

$421.96

$576.36

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

View every state and territory as a table
19081 office rate range by state
State / territoryOffice rate rangeLocalities
AK$550.021
AL$428.301
AR$421.961
AZ$465.481
CA$509.20–$643.5229
CO$500.031
CT$510.571
DC$549.381
DE$473.341
FL$468.37–$510.913
GA$441.73–$486.722
GU$522.621
HI$522.621
IA$440.701
ID$443.391
IL$453.62–$497.784
IN$446.061
KS$438.001
KY$437.411
LA$436.48–$458.692
MA$496.69–$551.132
MD$482.73–$549.383
ME$445.13–$470.752
MI$448.54–$473.742
MN$480.491
MO$428.40–$461.073
MS$425.291
MT$478.281
NC$450.001
ND$471.361
NE$443.361
NH$491.571
NJ$516.79–$543.352
NM$450.821
NV$476.711
NY$456.86–$563.115
OH$447.131
OK$437.241
OR$473.39–$516.922
PA$448.19–$497.222
PR$482.081
RI$490.941
SC$449.231
SD$470.541
TN$440.181
TX$445.13–$498.038
UT$455.541
VA$468.75–$549.382
VI$482.081
VT$468.931
WA$495.95–$563.102
WI$455.121
WV$436.261
WY$475.261

See 19081 in every payment locality

How the 19081 rate is calculated

Each of 19081’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 · 19081

RVUs × geographic indexes × conversion factor

Work3.21

3.21 RVUs× 1.000 GPCI

Practice expense10.76

10.76 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

14.3200

Conversion factor

$33.4009

Medicare rate

$478.30

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Fresno inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,659

Code
19081
Physician work
3.21
Practice expense
10.76
Malpractice
0.35

GPCI2026.csv

11

Locality
Fresno
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 19081 in Fresno
ComponentRVULocality factorAdjusted
Physician work3.21× 1.0173.2646
Practice expense10.76× 1.09611.7930
Malpractice0.35× 0.5360.1876
Total RVUs15.2451
Conversion factor× 33.4009

Office rate, Fresno$509.20

Office: (3.21 × 1.017 + 10.76 × 1.096 + 0.35 × 0.536) × $33.4009 = $509.20

Facility: (3.21 × 1.017 + 0.58 × 1.096 + 0.35 × 0.536) × $33.4009 = $136.54

Open 19081 in the RVU calculator

Payment rules and modifiers for 19081

The CMS indicators that decide how 19081 is paid alongside other services.

CMS payment indicators · 19081

Breast biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

19081 without 50 · national office

$478.30

Breast biopsy

19081-50 · Bilateral: 150%

$717.45

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).

When to use modifier 50

How 19081 has changed in Fresno

19081 · Office / nonfacility

$509.20

Effective 2026-10-01

The base rate is $8.53 higher than on 2025-10-01, moving from $500.67 to $509.20 (1.7%).

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

    $500.67changed to$509.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.29 changed to 3.21
    • Practice expense RVU 10.94 changed to 10.76
    • Malpractice RVU 0.33 changed to 0.35
    • 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

    $525.78changed to$500.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.23 changed to 10.94

    Held through RVU25B, RVU25C, RVU25D.

  3. October 1, 2024

    RVU24D

    $555.69changed to$525.78

    • Conversion factor 34.6062 changed to 33.2875
    • Practice expense RVU 11.72 changed to 11.23
    • Work GPCI 1.027 changed to 1.014
    • Practice expense GPCI 1.065 changed to 1.093
    • Malpractice GPCI 0.597 changed to 0.560
  4. July 1, 2022

    RVU22C

    $617.32changed to$555.69

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.26 changed to 11.72
    • Malpractice RVU 0.32 changed to 0.33
  5. January 1, 2021

    RVU21A

    $658.48changed to$617.32

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 13.73 changed to 13.26
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B.

  6. January 1, 2020

    RVU20A

    $699.92changed to$658.48

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.77 changed to 13.73
    • Malpractice RVU 0.36 changed to 0.32
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  7. January 1, 2019

    RVU19A

    $745.93changed to$699.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 15.98 changed to 14.77

    Held through RVU19B, RVU19C, RVU19D.

  8. January 1, 2018

    RVU18AR1

    $747.82changed to$745.93

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.37 changed to 0.36
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  9. January 1, 2017

    RVU17A

    No ratechanged to$747.82

    Held through RVU17B, RVU17C, RVU17D.

  10. January 1, 2014

    RVU14A

    No ratechanged toNo rate

    Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$509.20$136.54RVU26D
2026-07-01$509.20$136.54RVU26C
2026-04-01$509.20$136.54RVU26B
2026-01-01$509.20$136.54RVU26A
2025-10-01$500.67$156.31RVU25D
2025-07-01$500.67$156.31RVU25C
2025-04-01$500.67$156.31RVU25B
2025-01-01$500.67$156.31RVU25A
2024-10-01$525.78$159.77RVU24D
2022-07-01$555.69$167.60RVU22C
2021-04-01$617.32$168.79RVU21B
2021-01-01$617.32$168.79RVU21A
2020-10-01$658.48$175.01RVU20D
2020-07-01$658.48$175.01RVU20C
2020-04-01$658.48$175.01RVU20B
2020-01-01$658.48$175.01RVU20A
2019-10-01$699.92$174.68RVU19D
2019-07-01$699.92$174.68RVU19C
2019-04-01$699.92$174.68RVU19B
2019-01-01$699.92$174.68RVU19A
2018-10-01$745.93$174.49RVU18D
2018-07-01$745.93$174.49RVU18C
2018-04-01$745.93$174.49RVU18B
2018-01-01$745.93$174.49RVU18AR1
2017-10-01$747.82$176.64RVU17D
2017-07-01$747.82$176.64RVU17C
2017-04-01$747.82$176.64RVU17B
2017-01-01$747.82$176.64RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 19081 for an earlier date of service

Where the Fresno rate applies

Fresno is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in California

19081 billing questions

When should 19081 be selected instead of 19083?

Report 19081 when stereotactic imaging guides the biopsy. Use 19083 when ultrasound guides the first-lesion biopsy.

How is a second stereotactic lesion reported?

Report 19082 for a distinct additional lesion biopsied with stereotactic guidance during the session. The first stereotactic lesion is reported with 19081.

Are marker placement and specimen imaging separately reported?

They are included in the service when performed. The biopsy documentation should indicate whether a marker was placed or specimen imaging was obtained.

Can modifier 50 be used for bilateral biopsies?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the bilateral work performed.

What same-day care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care for the biopsy.

When is an assistant at surgery payable?

CMS pays an assistant at surgery only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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 19081PPRRVU2026_Oct_nonQPP.csv, line 1,659 (RVU26D)
Geographic factors for FresnoGPCI2026.csv, line 11 (RVU26D)

Open CMS sourceHow we calculate rates

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