$506.96–$642.08
19083 covers the first breast lesion biopsied with ultrasound guidance; 19084 covers each additional distinct lesion in the session.
On this page
CMS RVU26D · Effective 2026-10-01
19084 Breast biopsy Medicare reimbursement rates in California
Reports ultrasound-guided core biopsy of an additional distinct breast lesion during a session in which a primary breast biopsy procedure is also performed. Compare 19084 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 19084 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$384.72–$493.77
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $109.05 per service.
Facility setting
$64.41–$72.33
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $7.92 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 19084 pays more and less in California
29 payment localities
$384.72 to $493.77
Breast imaging procedure
About 19084: Additional ultrasound-guided breast biopsy
Reports ultrasound-guided core biopsy of an additional distinct breast lesion during a session in which a primary breast biopsy procedure is also performed.
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.
CMS billing rules for 19084
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU1.51 · 14%
- Practice expense (office) RVU9.03 · 84%
- Malpractice RVU0.16 · 1%
13.8K
Medicare services in 2024 · #1298 by national volume
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.
19084 compared with similar codes
Office rates for California, from the same CMS release.
$390.86–$501.03
Both address an additional breast lesion, but 19082 is for stereotactic guidance and 19084 is for ultrasound guidance.
$598.37–$772.83
Both address an additional breast lesion, but 19086 is for MRI guidance and 19084 is for ultrasound guidance.
Compare 19084 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $385.21 | Facility $64.90 |
| Chico | Office $384.72 | Facility $64.41 |
| El Centro | Office $384.75 | Facility $64.43 |
| Fresno | Office $384.72 | Facility $64.41 |
| Hanford-Corcoran | Office $384.72 | Facility $64.41 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $412.86 | Facility $67.12 |
| Madera | Office $384.72 | Facility $64.41 |
| Merced | Office $384.72 | Facility $64.41 |
| Modesto | Office $384.72 | Facility $64.41 |
| Napa | Office $453.85 | Facility $68.65 |
| Oxnard-Thousand Oaks-Ventura | Office $411.68 | Facility $66.23 |
| Redding | Office $384.72 | Facility $64.41 |
| Rest Of California | Office $384.72 | Facility $64.41 |
| Riverside-San Bernardino-Ontario | Office $386.47 | Facility $66.15 |
| Sacramento-Roseville-Folsom | Office $405.89 | Facility $65.99 |
| Salinas | Office $404.43 | Facility $65.70 |
| San Diego-Chula Vista-Carlsbad | Office $415.57 | Facility $66.03 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $482.95 | Facility $70.87 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $482.77 | Facility $70.68 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $493.77 | Facility $72.33 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $493.03 | Facility $71.59 |
| San Luis Obispo-Paso Robles | Office $397.69 | Facility $64.81 |
| Santa Cruz-Watsonville | Office $420.82 | Facility $65.72 |
| Santa Maria-Santa Barbara | Office $406.39 | Facility $65.62 |
| Santa Rosa-Petaluma | Office $425.19 | Facility $66.30 |
| Stockton | Office $384.72 | Facility $64.41 |
| Vallejo | Office $453.59 | Facility $68.39 |
| Visalia | Office $384.72 | Facility $64.41 |
| Yuba City | Office $384.72 | Facility $64.41 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,65919081,,Bx breast 1st lesion strtctc,A,,3.21,10.76,,0.58,,0.35,14.32,4.14,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66019082,,Bx breast add lesion strtctc,A,,1.61,9.10,,0.30,,0.17,10.88,2.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66119083,,Bx breast 1st lesion us imag,A,,3.02,10.88,,0.55,,0.34,14.24,3.91,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66219084,,Bx breast add lesion us imag,A,,1.51,9.03,,0.28,,0.16,10.70,1.95,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66319085,,Bx breast 1st lesion mr imag,A,,3.55,17.62,,0.63,,0.35,21.52,4.53,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66419086,,Bx breast add lesion mr imag,A,,1.77,14.62,,0.32,,0.17,16.56,2.26,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66519100,,Bx breast percut w/o image,A,,1.24,3.35,,0.31,,0.30,4.89,1.85,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00