Billing code 19288: Breast localizationMedicare rate & RVUs in Alaska

Reports MRI-guided percutaneous localization of each breast lesion beyond the first, typically to mark additional targets before breast-conserving surgery.

CMS RVU26DEffective Oct 1, 20261 payment locality71 Medicare services in 2024

Medicare pays $502.73 for 19288 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$502.73Office (non-facility)
$73.02Hospital or facility

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 19288 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 19288 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 19288 covers

An MRI-guided breast localization procedure places a marker or other localization device percutaneously at an MRI-visible target so the surgeon can identify it for excision. Breast radiologists commonly perform it in an MRI suite, often before surgery for a nonpalpable lesion that needs image-guided targeting.

Report 19288 for each lesion after the first addressed during the MRI-guided localization service, with 19287 for the first lesion. The imaging modality determines the code family: MRI guidance supports this add-on, while mammographic, stereotactic, or ultrasound guidance uses its own family. Documentation should identify the additional lesion, MRI guidance, percutaneous device placement, and connection to the first-lesion service. Imaging guidance is part of the localization service. CMS classifies 19288 as an add-on, so it is billed only with a primary procedure and paid 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.

19288 in Alaska*

19288 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$502.73$73.02

How the 19288 rate is calculated

Each of 19288’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 · 19288

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.25Practice expense 12.31Malpractice 0.12

13.6800 adjusted RVUs×$33.4009 conversion factor=$456.92

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

Payment rules and modifiers for 19288

The CMS indicators that decide how 19288 is paid alongside other services.

CMS payment indicators · 19288

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.

19288 compared with similar codes

Compare codes

19288 vs 19287 vs 19286 vs 19284 vs 19282: national Medicare rates

Swap in your local Medicare rate.

  • 19288
    Breast localization · 1.25 wRVU
    $456.92
  • 19287
    Breast localization · 2.49 wRVU
    $599.21+$142.29
  • 19286
    Breast localization · 0.83 wRVU
    $286.58−$170.34
  • 19284
    Breast localization · 0.98 wRVU
    $181.70−$275.22
  • 19282
    Breast localization · 0.98 wRVU
    $164.67−$292.25

How to choose

19287Breast localization
Use 19287 for the first lesion in an MRI-guided localization service. Use 19288 for each additional lesion.
19286Breast localization
Both represent additional breast lesions, but 19286 is for ultrasound guidance and 19288 is for MRI guidance.
19284Breast localization
19284 represents an additional lesion localized stereotactically; 19288 represents one localized with MRI guidance.
19282Breast localization
19282 is for an additional lesion with mammographic guidance. Select 19288 when MRI provides the guidance.

19288 billing questions

Can 19288 be billed by itself?

No. It is an add-on for an additional MRI-guided lesion and is reported with 19287 for the first lesion.

Are units based on the number of devices or lesions?

Report one unit for each additional lesion localized after the first, not for each device placed at a lesion.

Is MRI guidance separately reported?

No. MRI guidance is included in the breast localization service represented by this code.

When should 19286 be used instead?

Use 19286 for an additional lesion localized with ultrasound guidance. Code 19288 is for additional lesions localized with MRI guidance.

What documentation supports an additional unit?

Document the additional target or lesion, percutaneous device placement, MRI guidance, and the first-lesion service reported with 19287.

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 19288PPRRVU2026_Oct_nonQPP.csv, line 1,680 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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