$325.29
19285 reports the first ultrasound-guided lesion; 19286 reports each additional lesion localized with ultrasound during the procedure.
On this page
CMS RVU26D · Effective 2026-10-01
19286 Breast localization Medicare reimbursement rates in Ohio
Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure. Compare 19286 office and facility rates across CMS payment localities in Ohio.
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 19286 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$264.34
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$35.63
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
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.
Breast imaging procedure
About 19286: Additional ultrasound-guided breast localization
Report this add-on for percutaneous placement of a breast localization device at each additional lesion guided by ultrasound during the same procedure.
This code represents percutaneous placement of a localization device at an additional breast lesion, using ultrasound guidance. It is used when a clinician places devices to mark separate targets, commonly before breast-conserving surgery or another planned breast procedure. The ultrasound-guided placement, rather than a diagnostic ultrasound examination alone, is the service captured by this code.
Report it for each qualifying additional lesion after the first ultrasound-guided lesion, with the primary ultrasound-guided placement code 19285 on the claim. The record should support the separate lesion treated, its location, the percutaneous device placement, and ultrasound guidance. This is an add-on code: it is not billed alone and is paid within the global period of the primary procedure. The first lesion is reported with 19285; this code represents additional lesions, not additional devices placed at the same lesion.
CMS billing rules for 19286
- 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 RVU0.83 · 10%
- Practice expense (office) RVU7.66 · 89%
- Malpractice RVU0.09 · 1%
2.6K
Medicare services in 2024 · #2269 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.
19286 compared with similar codes
Office rates for Ohio, from the same CMS release.
$153.44
Both represent additional breast lesions, but 19282 is for mammographic guidance rather than ultrasound guidance.
$169.09
Both are add-on codes for additional lesions; 19284 applies when stereotactic guidance is used.
$421.19
Both cover additional lesions, but 19288 is for MRI-guided placement rather than ultrasound-guided placement.
Compare 19286 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.
1 of 1 payment localities
Ohio →
Office / nonfacility
$264.34
Facility
$35.63
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19286 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,678
- Code
- 19286
- Physician work
- 0.83
- Practice expense
- 7.66
- Malpractice
- 0.09
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 7.66 | × 0.913 | 6.9936 |
| Malpractice | 0.09 | × 1.008 | 0.0907 |
| Total RVUs | 7.9143 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$264.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1 |
| Practice expense | 7.66 | 0.913 |
| Malpractice | 0.09 | 1.008 |
(0.83 × 1 + 7.66 × 0.913 + 0.09 × 1.008) × $33.4009 = $264.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1 |
| Practice expense | 0.16 | 0.913 |
| Malpractice | 0.09 | 1.008 |
(0.83 × 1 + 0.16 × 0.913 + 0.09 × 1.008) × $33.4009 = $35.63
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
19286 billing questions
When is 19286 reported instead of 19285?
Use 19285 for the first lesion localized with ultrasound guidance. Report 19286 for each additional lesion localized during the procedure.
Can 19286 be billed without 19285?
No. It is an add-on code and must be reported with the primary ultrasound-guided placement code, 19285.
Does 19286 count additional devices or additional lesions?
It represents each additional lesion, not each extra device placed at one lesion. The record should distinguish the separately localized targets.
Is ultrasound guidance separately reported for the placement?
The code represents placement with ultrasound guidance. Document the guidance used for the additional lesion rather than reporting this code for device placement without ultrasound.
What documentation supports the additional-lesion unit?
Document the additional target's location, percutaneous device placement, and ultrasound guidance, as well as the first lesion reported with 19285.
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.
1,67519283,,Perq dev breast 1st strtctc,A,,1.95,5.33,,0.36,,0.21,7.49,2.52,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67619284,,Perq dev breast add strtctc,A,,0.98,4.35,,0.18,,0.11,5.44,1.27,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67719285,,Perq dev breast 1st us imag,A,,1.66,8.65,,0.31,,0.18,10.49,2.15,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67819286,,Perq dev breast add us imag,A,,0.83,7.66,,0.16,,0.09,8.58,1.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67919287,,Perq dev breast 1st mr guide,A,,2.49,15.22,,0.45,,0.23,17.94,3.17,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68019288,,Perq dev breast add mr guide,A,,1.25,12.31,,0.23,,0.12,13.68,1.60,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68119294,,Prepj tum cav iort prtl mast,A,,2.93,0.74,NA,0.74,,0.76,4.43,4.43,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703