Billing code 19081: Breast biopsyMedicare rate & RVUs in Ohio
Percutaneous stereotactic biopsy obtains breast tissue from a mammographic target, such as suspicious calcifications, when stereotactic guidance is used for the first lesion.
In Ohio, Medicare pays $447.13 for 19081 in the office and $136.69 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Ohio 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). Ohio pays $447.13. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Ohio · this page$447.13
- Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) · California$544.54+$97.41
- Dc + Md/Va Suburbs · District of Columbia$549.38+$102.25
- Miami · Florida$510.91+$63.78
- Chicago · Illinois$495.99+$48.86
- Manhattan · New York$550.24+$103.11
- Alaska* · Alaska$550.02+$102.89
Other areas in Ohio first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $428.30 | $130.78 |
| ArkansasArkansas | $421.96 | $129.88 |
| ArizonaArizona | $465.48 | $136.00 |
| BakersfieldCalifornia | $510.27 | $137.61 |
| ChicoCalifornia | $509.20 | $136.54 |
| El CentroCalifornia | $509.26 | $136.60 |
| FresnoCalifornia | $509.20 | $136.54 |
| Hanford-CorcoranCalifornia | $509.20 | $136.54 |
| MaderaCalifornia | $509.20 | $136.54 |
| 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 |
| SalinasCalifornia | $533.34 | $139.26 |
| San Diego-Chula Vista-CarlsbadCalifornia | $546.60 | $139.94 |
| San Francisco-Oakland-Berkeley (Marin Cnty)California | $629.51 | $150.08 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)California | $629.12 | $149.69 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty)California | $643.52 | $153.21 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)California | $641.90 | $151.59 |
| San Luis Obispo-Paso RoblesCalifornia | $524.65 | $137.37 |
| Santa Cruz-WatsonvilleCalifornia | $552.40 | $139.27 |
| Santa Maria-Santa BarbaraCalifornia | $535.54 | $139.07 |
| Santa Rosa-PetalumaCalifornia | $558.03 | $140.49 |
| StocktonCalifornia | $509.20 | $136.54 |
| VallejoCalifornia | $593.02 | $144.87 |
| VisaliaCalifornia | $509.20 | $136.54 |
| Yuba CityCalifornia | $509.20 | $136.54 |
| ColoradoColorado | $500.03 | $138.25 |
| ConnecticutConnecticut | $510.57 | $144.37 |
| DelawareDelaware | $473.34 | $137.40 |
| Fort LauderdaleFlorida | $492.42 | $147.98 |
| Rest Of FloridaFlorida | $468.37 | $143.31 |
| AtlantaGeorgia | $486.72 | $141.26 |
| Rest Of GeorgiaGeorgia | $441.73 | $138.43 |
| Hawaii, GuamHawaii | $522.62 | $136.01 |
| IowaIowa | $440.70 | $129.58 |
| IdahoIdaho | $443.39 | $130.57 |
| East St. LouisIllinois | $461.40 | $148.58 |
| Rest Of IllinoisIllinois | $453.62 | $143.18 |
| Suburban ChicagoIllinois | $497.78 | $148.58 |
| IndianaIndiana | $446.06 | $130.86 |
| KansasKansas | $438.00 | $130.62 |
| KentuckyKentucky | $437.41 | $135.14 |
| New OrleansLouisiana | $458.69 | $138.73 |
| Rest Of LouisianaLouisiana | $436.48 | $135.56 |
| Metropolitan BostonMassachusetts | $551.13 | $145.15 |
| Rest Of MassachusettsMassachusetts | $496.69 | $138.65 |
| Baltimore/Surr. CntysMaryland | $509.02 | $144.18 |
| Rest Of MarylandMaryland | $482.73 | $138.63 |
| Rest Of MaineMaine | $445.13 | $132.31 |
| Southern MaineMaine | $470.75 | $133.79 |
| DetroitMichigan | $473.74 | $145.62 |
| Rest Of MichiganMichigan | $448.54 | $138.10 |
| MinnesotaMinnesota | $480.49 | $130.61 |
| Metropolitan Kansas CityMissouri | $456.11 | $136.83 |
| Metropolitan St. LouisMissouri | $461.07 | $137.37 |
| Rest Of MissouriMissouri | $428.40 | $135.30 |
| MississippiMississippi | $425.29 | $132.54 |
| Montana**Montana | $478.28 | $138.26 |
| North CarolinaNorth Carolina | $450.00 | $132.76 |
| North Dakota**North Dakota | $471.36 | $131.34 |
| NebraskaNebraska | $443.36 | $129.52 |
| New HampshireNew Hampshire | $491.57 | $137.61 |
| Northern NjNew Jersey | $543.35 | $148.93 |
| Rest Of New JerseyNew Jersey | $516.79 | $145.48 |
| New MexicoNew Mexico | $450.82 | $139.02 |
| Nevada**Nevada | $476.71 | $136.35 |
| Nyc Suburbs/Long IslandNew York | $563.11 | $158.82 |
| Poughkpsie/N Nyc SuburbsNew York | $519.72 | $147.40 |
| QueensNew York | $555.74 | $153.83 |
| Rest Of New YorkNew York | $456.86 | $133.84 |
| OklahomaOklahoma | $437.24 | $133.60 |
| PortlandOregon | $516.92 | $139.15 |
| Rest Of OregonOregon | $473.39 | $134.73 |
| Metropolitan PhiladelphiaPennsylvania | $497.22 | $143.26 |
| Rest Of PennsylvaniaPennsylvania | $448.19 | $136.05 |
| Puerto RicoPuerto Rico | $482.08 | $138.32 |
| Rhode IslandRhode Island | $490.94 | $139.69 |
| South CarolinaSouth Carolina | $449.23 | $135.05 |
| South Dakota**South Dakota | $470.54 | $130.52 |
| TennesseeTennessee | $440.18 | $131.10 |
| AustinTexas | $498.03 | $138.29 |
| BeaumontTexas | $445.13 | $135.71 |
| BrazoriaTexas | $473.35 | $136.39 |
| DallasTexas | $476.17 | $137.51 |
| Fort WorthTexas | $472.73 | $137.47 |
| GalvestonTexas | $474.63 | $136.99 |
| HoustonTexas | $481.04 | $143.40 |
| Rest Of TexasTexas | $458.84 | $136.16 |
| UtahUtah | $455.54 | $135.92 |
| VirginiaVirginia | $468.75 | $134.51 |
| Virgin IslandsUnited States Virgin Islands | $482.08 | $138.32 |
| VermontVermont | $468.93 | $132.31 |
| Rest Of WashingtonWashington | $495.95 | $137.91 |
| Seattle (King Cnty)Washington | $563.10 | $145.90 |
| WisconsinWisconsin | $455.12 | $129.38 |
| West VirginiaWest Virginia | $436.26 | $140.78 |
| Wyoming**Wyoming | $475.26 | $135.24 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $550.02 | 1 |
| AL | $428.30 | 1 |
| AR | $421.96 | 1 |
| AZ | $465.48 | 1 |
| CA | $509.20–$643.52 | 29 |
| CO | $500.03 | 1 |
| CT | $510.57 | 1 |
| DC | $549.38 | 1 |
| DE | $473.34 | 1 |
| FL | $468.37–$510.91 | 3 |
| GA | $441.73–$486.72 | 2 |
| GU | $522.62 | 1 |
| HI | $522.62 | 1 |
| IA | $440.70 | 1 |
| ID | $443.39 | 1 |
| IL | $453.62–$497.78 | 4 |
| IN | $446.06 | 1 |
| KS | $438.00 | 1 |
| KY | $437.41 | 1 |
| LA | $436.48–$458.69 | 2 |
| MA | $496.69–$551.13 | 2 |
| MD | $482.73–$549.38 | 3 |
| ME | $445.13–$470.75 | 2 |
| MI | $448.54–$473.74 | 2 |
| MN | $480.49 | 1 |
| MO | $428.40–$461.07 | 3 |
| MS | $425.29 | 1 |
| MT | $478.28 | 1 |
| NC | $450.00 | 1 |
| ND | $471.36 | 1 |
| NE | $443.36 | 1 |
| NH | $491.57 | 1 |
| NJ | $516.79–$543.35 | 2 |
| NM | $450.82 | 1 |
| NV | $476.71 | 1 |
| NY | $456.86–$563.11 | 5 |
| OH | $447.13 | 1 |
| OK | $437.24 | 1 |
| OR | $473.39–$516.92 | 2 |
| PA | $448.19–$497.22 | 2 |
| PR | $482.08 | 1 |
| RI | $490.94 | 1 |
| SC | $449.23 | 1 |
| SD | $470.54 | 1 |
| TN | $440.18 | 1 |
| TX | $445.13–$498.03 | 8 |
| UT | $455.54 | 1 |
| VA | $468.75–$549.38 | 2 |
| VI | $482.08 | 1 |
| VT | $468.93 | 1 |
| WA | $495.95–$563.10 | 2 |
| WI | $455.12 | 1 |
| WV | $436.26 | 1 |
| WY | $475.26 | 1 |
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 Ohio 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
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.21 | × 1.000 | 3.2100 |
| Practice expense | 10.76 | × 0.913 | 9.8239 |
| Malpractice | 0.35 | × 1.008 | 0.3528 |
| Total RVUs | 13.3867 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Ohio$447.13
Office: (3.21 × 1 + 10.76 × 0.913 + 0.35 × 1.008) × $33.4009 = $447.13
Facility: (3.21 × 1 + 0.58 × 0.913 + 0.35 × 1.008) × $33.4009 = $136.69
Payment rules and modifiers for 19081
The CMS indicators that decide how 19081 is paid alongside other services.
CMS payment indicators · 19081
Breast biopsy
| 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
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).
How 19081 has changed in Ohio
19081 · Office / nonfacility
$447.13
Effective 2026-10-01
The base rate is $7.31 higher than on 2025-10-01, moving from $439.82 to $447.13 (1.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$439.82changed to$447.13
- 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
- Practice expense GPCI 0.911 changed to 0.913
- Malpractice GPCI 1.033 changed to 1.008
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$461.41changed to$439.82
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 11.23 changed to 10.94
Held through RVU25B, RVU25C, RVU25D.
October 1, 2024
RVU24D
$496.65changed to$461.41
- Conversion factor 34.6062 changed to 33.2875
- Practice expense RVU 11.72 changed to 11.23
- Practice expense GPCI 0.913 changed to 0.911
- Malpractice GPCI 1.094 changed to 1.033
July 1, 2022
RVU22C
$549.44changed to$496.65
- 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
January 1, 2021
RVU21A
$584.24changed to$549.44
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 13.73 changed to 13.26
- Practice expense GPCI 0.915 changed to 0.913
- Malpractice GPCI 1.049 changed to 1.094
Held through RVU21B.
January 1, 2020
RVU20A
$619.72changed to$584.24
- 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
- Practice expense GPCI 0.917 changed to 0.915
- Malpractice GPCI 1.005 changed to 1.049
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$658.99changed to$619.72
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 15.98 changed to 14.77
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$657.81changed to$658.99
- Conversion factor 35.8887 changed to 35.9996
- Malpractice RVU 0.37 changed to 0.36
- Practice expense GPCI 0.918 changed to 0.917
- Malpractice GPCI 0.999 changed to 1.005
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$658.21changed to$657.81
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 16.02 changed to 15.98
- Malpractice RVU 0.39 changed to 0.37
- Malpractice GPCI 0.993 changed to 0.999
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$632.72changed to$658.21
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 15.24 changed to 16.02
- Malpractice RVU 0.33 changed to 0.39
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$629.57changed to$632.72
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$643.70changed to$629.57
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 15.02 changed to 15.24
- Malpractice RVU 0.73 changed to 0.33
- Practice expense GPCI 0.923 changed to 0.918
- Malpractice GPCI 1.117 changed to 0.993
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$643.70
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $447.13 | $136.69 | RVU26D |
| 2026-07-01 | $447.13 | $136.69 | RVU26C |
| 2026-04-01 | $447.13 | $136.69 | RVU26B |
| 2026-01-01 | $447.13 | $136.69 | RVU26A |
| 2025-10-01 | $439.82 | $152.81 | RVU25D |
| 2025-07-01 | $439.82 | $152.81 | RVU25C |
| 2025-04-01 | $439.82 | $152.81 | RVU25B |
| 2025-01-01 | $439.82 | $152.81 | RVU25A |
| 2024-10-01 | $461.41 | $156.34 | RVU24D |
| 2022-07-01 | $496.65 | $163.95 | RVU22C |
| 2021-04-01 | $549.44 | $164.92 | RVU21B |
| 2021-01-01 | $549.44 | $164.92 | RVU21A |
| 2020-10-01 | $584.24 | $170.81 | RVU20D |
| 2020-07-01 | $584.24 | $170.81 | RVU20C |
| 2020-04-01 | $584.24 | $170.81 | RVU20B |
| 2020-01-01 | $584.24 | $170.81 | RVU20A |
| 2019-10-01 | $619.72 | $171.27 | RVU19D |
| 2019-07-01 | $619.72 | $171.27 | RVU19C |
| 2019-04-01 | $619.72 | $171.27 | RVU19B |
| 2019-01-01 | $619.72 | $171.27 | RVU19A |
| 2018-10-01 | $658.99 | $171.08 | RVU18D |
| 2018-07-01 | $658.99 | $171.08 | RVU18C |
| 2018-04-01 | $658.99 | $171.08 | RVU18B |
| 2018-01-01 | $658.99 | $171.08 | RVU18AR1 |
| 2017-10-01 | $657.81 | $171.86 | RVU17D |
| 2017-07-01 | $657.81 | $171.86 | RVU17C |
| 2017-04-01 | $657.81 | $171.86 | RVU17B |
| 2017-01-01 | $657.81 | $171.86 | RVU17A |
| 2016-10-01 | $658.21 | $171.76 | RVU16D |
| 2016-07-01 | $658.21 | $171.76 | RVU16C |
| 2016-04-01 | $658.21 | $171.76 | RVU16B |
| 2016-01-01 | $658.21 | $171.76 | RVU16A |
| 2015-10-01 | $632.72 | $170.24 | RVU15D |
| 2015-07-01 | $632.72 | $170.24 | RVU15C |
| 2015-04-01 | $629.57 | $169.39 | RVU15B |
| 2015-01-01 | $629.57 | $169.39 | RVU15A |
| 2014-10-01 | $643.70 | $187.08 | RVU14D |
| 2014-07-01 | $643.70 | $187.08 | RVU14C |
| 2014-04-01 | $643.70 | $187.08 | RVU14B |
| 2014-01-01 | $643.70 | $187.08 | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Ohio rate applies
Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.
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
Fee sheets
Put 19081 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →