$712.96–$783.02
19085 represents the first lesion sampled with MRI guidance and is the primary code. 19086 represents each additional MRI-guided lesion.
On this page
CMS RVU26D · Effective 2026-10-01
19086 Breast biopsy Medicare reimbursement rates in Oregon
Report this add-on for tissue sampling of an additional breast lesion using MRI guidance, alongside the primary MRI-guided breast biopsy code. Compare 19086 office and facility rates across CMS payment localities in Oregon.
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 19086 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$549.48–$606.81
2 of 2 localities have a supported rate.
Facility setting
$73.76–$76.16
2 of 2 localities have a supported rate.
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
About 19086: Additional MRI-guided breast biopsy
Report this add-on for tissue sampling of an additional breast lesion using MRI guidance, alongside the primary MRI-guided breast biopsy code.
This code covers needle sampling of an additional breast target identified and accessed with MRI guidance. It is typically performed by a radiologist or other qualified breast-imaging clinician in an outpatient imaging center or hospital MRI suite. The biopsy may include placement of a marker at the sampled site and imaging of the specimen when performed. The first MRI-guided lesion is reported separately with the primary code.
Report one unit for each additional lesion sampled under MRI guidance, supported by documentation identifying the targets and confirming MRI guidance and tissue sampling. Do not use this code by itself: it is an add-on reported with the primary MRI-guided breast biopsy procedure. Under the CMS rule for this code, payment is within the primary procedure’s global period. The documentation should distinguish each additional target from the first lesion and from targets sampled using another guidance method.
CMS billing rules for 19086
- 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 RVU1.77 · 11%
- Practice expense (office) RVU14.62 · 88%
- Malpractice RVU0.17 · 1%
1.6K
Medicare services in 2024 · #2623 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.
19086 compared with similar codes
Office rates for Oregon, from the same CMS release.
$354.60–$390.31
Use 19084 for an additional lesion sampled with ultrasound guidance; use 19086 when MRI provides the guidance.
$360.50–$396.55
19082 is for an additional lesion sampled with stereotactic guidance. 19086 applies when the additional target is sampled under MRI guidance.
Compare 19086 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.
2 of 2 payment localities
Portland →
Office / nonfacility
$606.81
Facility
$76.16
Rest Of Oregon →
Office / nonfacility
$549.48
Facility
$73.76
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19086 billing questions
When is this code reported instead of 19085?
Use 19085 for the first lesion sampled with MRI guidance. Report 19086 for each additional lesion sampled with MRI guidance during the procedure.
Can 19086 be billed by itself?
No. It is an add-on code and must be reported with the primary MRI-guided breast biopsy code, 19085.
How many units should be reported?
Report one unit for each additional lesion sampled. The first lesion is represented by 19085, not by an additional unit of 19086.
Is marker placement separately reported?
Marker placement at the biopsy site, when performed, is part of the MRI-guided biopsy service. Specimen imaging, when performed, is also included in the service.
How does 19086 differ from 19084?
Both represent sampling of an additional lesion, but 19086 is for MRI guidance and 19084 is for ultrasound guidance.
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.
1,66119083,,Bx breast 1st lesion us imag,A,,3.02,10.88,,0.55,,0.34,14.24,3.91,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66219084,,Bx breast add lesion us imag,A,,1.51,9.03,,0.28,,0.16,10.70,1.95,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66319085,,Bx breast 1st lesion mr imag,A,,3.55,17.62,,0.63,,0.35,21.52,4.53,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66419086,,Bx breast add lesion mr imag,A,,1.77,14.62,,0.32,,0.17,16.56,2.26,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66519100,,Bx breast percut w/o image,A,,1.24,3.35,,0.31,,0.30,4.89,1.85,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66619101,,Biopsy of breast open,A,,3.15,6.55,,2.54,,0.79,10.49,6.48,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66719105,,Cryosurg ablate fa each,A,,3.60,71.34,,1.22,,0.98,75.92,5.80,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00