Billing code 19284: Breast localizationMedicare rate & RVUs in Guam
Report 19284 for percutaneous placement of a localization device in each additional breast lesion targeted with stereotactic imaging.
Medicare pays $200.06 for 19284 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 19284 covers
This add-on represents percutaneous placement of a localization device, such as a clip or marker, in an additional breast lesion using stereotactic imaging guidance. Breast radiologists and other clinicians who perform image-guided breast procedures commonly place these devices in a breast imaging center or hospital before surgical excision, including when more than one lesion needs localization.
Report 19284 for each additional lesion after the first stereotactically localized lesion, and pair it with 19283 for the first lesion. The record should identify the separately targeted lesions, the stereotactic guidance used, and the device placement at each site. The code includes the stereotactic guidance for the additional placement. CMS classifies 19284 as an add-on code: it is billed only with a primary procedure, and its payment falls 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.
19284 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $200.06 | $41.70 |
How the 19284 rate is calculated
Each of 19284’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 · 19284
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.98Practice expense 4.35Malpractice 0.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19284
The CMS indicators that decide how 19284 is paid alongside other services.
CMS payment indicators · 19284
Breast localization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
19284 compared with similar codes
Compare codes
19284 vs 19283 vs 19286 vs 19288 vs 19282: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19283Breast localization
- 19283 is for the first breast lesion localized with stereotactic guidance; 19284 is for each additional lesion and is reported with 19283.
- 19286Breast localization
- Both address additional breast lesions, but 19286 uses ultrasound guidance. Use 19284 when placement is stereotactically guided.
- 19288Breast localization
- 19288 covers an additional lesion localized with MRI guidance; 19284 is for stereotactic guidance.
- 19282Breast localization
- 19282 applies to an additional lesion placed without imaging guidance. Use 19284 when stereotactic guidance is used.
19284 billing questions
When should 19284 be reported instead of 19283?
Use 19283 for the first lesion localized with stereotactic guidance. Report 19284 for each additional lesion localized by that method.
What primary code must accompany 19284?
Report 19284 with 19283, which represents the first stereotactically localized lesion. The add-on code is not reported by itself.
Can 19284 be used for an ultrasound-guided lesion?
No. For an additional lesion localized with ultrasound guidance, use 19286 rather than 19284.
Is stereotactic guidance separately reported for the additional placement?
The stereotactic guidance is included in 19284. The code accounts for the guidance used to place the device in the additional lesion.
What documentation supports reporting multiple units?
Document each distinct lesion receiving a device and the stereotactic guidance used. Report 19284 for each additional lesion beyond the first, alongside 19283.
How does the global-period rule affect payment?
CMS treats 19284 as an add-on paid within the primary procedure's global period. It must accompany the primary procedure rather than stand alone.
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
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