No office rate
Choose 19296 for postoperative catheter placement after partial mastectomy; 19297 describes the intraoperative placement pathway.
On this page
CMS RVU26D · Effective 2026-10-01
19296 Breast catheter placement Medicare reimbursement rates in Ohio
Reports postoperative placement of an expandable breast catheter after partial mastectomy to support interstitial radiation treatment of the surgical site. Compare 19296 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 19296 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
$3659.13
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$190.01
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 surgery
About 19296: Postoperative breast radiation catheter placement
Reports postoperative placement of an expandable breast catheter after partial mastectomy to support interstitial radiation treatment of the surgical site.
This service places an expandable afterloading catheter into the breast after partial mastectomy so a radiation source can later deliver interstitial treatment to the surgical site. A surgeon or other qualified physician typically performs the placement, often using imaging guidance to position the catheter. This is the postoperative placement pathway, distinct from catheter placement during the breast operation.
Report the code for postoperative placement, documenting the prior partial mastectomy, catheter placement and target site; imaging guidance performed as part of placement is included. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 19296
- 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 RVU3.54 · 3%
- Practice expense (office) RVU115.12 · 96%
- Malpractice RVU0.90 · 1%
376
Medicare services in 2024 · #3786 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.
19296 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
19294 addresses preparation of the tumor cavity for intraoperative radiation. 19296 places a catheter for later interstitial radiation.
$325.29
19285 reports ultrasound-guided placement of a breast localization device, not a catheter for interstitial radiation.
Compare 19296 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
$3659.13
Facility
$190.01
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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 19296 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,682
- Code
- 19296
- Physician work
- 3.54
- Practice expense
- 115.12
- Malpractice
- 0.90
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.54 | × 1.000 | 3.5400 |
| Practice expense | 115.12 | × 0.913 | 105.1046 |
| Malpractice | 0.90 | × 1.008 | 0.9072 |
| Total RVUs | 109.5518 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$3659.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.54 | 1 |
| Practice expense | 115.12 | 0.913 |
| Malpractice | 0.9 | 1.008 |
(3.54 × 1 + 115.12 × 0.913 + 0.9 × 1.008) × $33.4009 = $3659.13
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.54 | 1 |
| Practice expense | 1.36 | 0.913 |
| Malpractice | 0.9 | 1.008 |
(3.54 × 1 + 1.36 × 0.913 + 0.9 × 1.008) × $33.4009 = $190.01
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.
19296 billing questions
How does this differ from 19297?
19296 is for postoperative catheter placement. Use 19297 for the intraoperative placement pathway.
Is imaging guidance separately reported?
Imaging guidance performed as part of catheter placement is included in this service.
Does the code include radiation treatment?
No. It reports placement of the catheter for later interstitial radiation; it does not report delivery of the radiation treatment.
What global period applies?
CMS assigns a 0-day global period. Same-day preoperative and postoperative care is included.
How is bilateral placement reported?
CMS pays bilateral reporting with modifier 50 at 150%. Document placement on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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.
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
1,68219296,,Place po breast cath for rad,A,,3.54,115.12,,1.36,,0.90,119.56,5.80,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68319297,,Place breast cath for rad,A,,1.68,0.40,NA,0.40,,0.41,2.49,2.49,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68419298,,Place breast rad tube/caths,A,,5.61,19.44,,1.84,,0.44,25.49,7.89,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68519300,,Mastectomy for gynecomastia,A,,5.18,12.69,,6.36,,1.21,19.08,12.75,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,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