CPT code 19285: Breast localization2026 Medicare rate & RVUs in Oklahoma
Report percutaneous placement of a breast localization device for the first lesion when ultrasound guides targeting, commonly before surgical excision.
Medicare pays $318.12 for 19285 in the office in Oklahoma (Oklahoma). 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 19285 covers
A breast radiologist or other qualified physician places a localization device in or near a breast lesion that can be targeted with ultrasound. The service is commonly performed in a breast imaging department before surgery to help the surgeon find a nonpalpable lesion. It includes the imaging guidance used to direct placement; it is localization, not tissue sampling such as a core biopsy.
Report this code for the first lesion localized with ultrasound. For each additional lesion localized with ultrasound, 19286 is the related add-on code. Documentation should identify the target, ultrasound guidance, device placement, and lesion count. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral services, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
19285 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $318.12 | $69.36 |
How the 19285 rate is calculated
Each of 19285’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 · 19285
RVUs × geographic indexes × conversion factor
Work1.66
1.66 RVUs× 1.000 GPCI
Practice expense8.65
8.65 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
10.4900
Conversion factor
$33.4009
Medicare rate
$350.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19285
The CMS indicators that decide how 19285 is paid alongside other services.
CMS payment indicators · 19285
Breast localization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19285 without 50 · national office
$350.38
Breast localization
19285-50 · Bilateral: 150%
$525.57
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
19285 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 19286Breast localization
- 19285 covers the first ultrasound-guided lesion; 19286 covers each additional lesion localized with ultrasound.
- 19283Breast localization
- Both cover first-lesion localization, but 19283 uses stereotactic guidance rather than ultrasound.
- 19287Breast localization
- 19287 is for first-lesion localization with MRI guidance; 19285 is for ultrasound guidance.
- 19281Breast localization
- 19281 is for first-lesion placement without imaging guidance, while 19285 includes ultrasound guidance.
19285 billing questions
When should 19285 be used instead of 19283?
Use 19285 when ultrasound guides placement for the first lesion. Code 19283 is for first-lesion placement using stereotactic guidance.
How is a second ultrasound-localized lesion reported?
Report 19286 for each additional lesion localized with ultrasound, following 19285 for the first lesion.
Can the ultrasound guidance be billed separately?
The imaging guidance used to place the localization device is included in 19285.
Does 19285 include a breast biopsy?
No. It reports placement of a localization device, not tissue sampling. A separately performed biopsy is a distinct service when supported by the applicable coding and documentation.
What documentation supports reporting 19285?
Document the breast target, ultrasound guidance, device placement, and that this was the first lesion localized with that guidance modality.
How is bilateral placement handled?
For a bilateral service, CMS pays 19285 with modifier 50 at 150%. Same-session procedures are also subject to the standard multiple-procedure reduction.
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
Show the CMS file lines behind this rate
Fee sheets
Put 19285 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →