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CMS RVU26D · Effective 2026-10-01

19081 Breast biopsy Medicare reimbursement rates in Florida

Percutaneous stereotactic biopsy obtains breast tissue from a mammographic target, such as suspicious calcifications, when stereotactic guidance is used for the first lesion. Compare 19081 office and facility rates across CMS payment localities in Florida.

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 19081 in Florida?

Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

$468.37–$510.91

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $42.54 per service.

Facility setting

$143.31–$156.95

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $13.64 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.

Find 19081 in your payment locality →

Where 19081 pays more and less in Florida

3 payment localities

$468.37 to $510.91

$468.37$489.64$510.91
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Breast imaging procedures

About 19081: Stereotactic breast core biopsy

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

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.

CMS billing rules for 19081

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.21 · 22%
  • Practice expense (office) RVU10.76 · 75%
  • Malpractice RVU0.35 · 2%

55.1K

Medicare services in 2024 · #746 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.

19081 compared with similar codes

Office rates for Florida, from the same CMS release.

19082

Breast biopsy

Additional stereotactic lesion

$352.88–$384.55

19081 represents the first stereotactically biopsied lesion in the session. Use 19082 for each distinct additional stereotactic lesion.

19083

Breast biopsy

First lesion, ultrasound-guided

$465.35–$507.89

Both cover biopsy of a first breast lesion, but 19083 is selected when ultrasound provides the guidance instead of stereotactic imaging.

19085

Breast biopsy

First lesion, MRI guidance

$698.77–$760.79

Use 19085 when MRI guides the first-lesion biopsy; 19081 is for stereotactic guidance.

Compare 19081 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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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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 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.

RVUs for 19081PPRRVU2026_Oct_nonQPP.csv, line 1,659 (RVU26D)