$153.92–$171.07
19281 reports the first lesion localized with mammographic guidance; 19282 reports each additional lesion localized with that guidance.
On this page
CMS RVU26D · Effective 2026-10-01
19281 Breast localization Medicare reimbursement rates in Pennsylvania
Reports percutaneous placement of a breast localization device under mammographic guidance to mark the first lesion for surgical targeting. Compare 19281 office and facility rates across CMS payment localities in Pennsylvania.
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 19281 in Pennsylvania?
Pennsylvania 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
$221.07–$243.90
2 of 2 localities have a supported rate.
Facility setting
$81.86–$86.04
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 19281: Mammographic breast lesion localization
Reports percutaneous placement of a breast localization device under mammographic guidance to mark the first lesion for surgical targeting.
A breast imager, typically a radiologist, uses mammographic imaging to guide percutaneous placement of a localization device at a breast target that is difficult to find by palpation. The service commonly prepares a mammographically visible mass, architectural distortion, or calcification cluster for surgical excision; a wire or marker can identify the target for the surgeon. Report this code for the first lesion localized with mammographic guidance, not for each device placed around one target.
Documentation should identify the lesion, the mammographic guidance used, and the placement performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 19281
- 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 RVU1.95 · 28%
- Practice expense (office) RVU4.89 · 70%
- Malpractice RVU0.19 · 3%
20.8K
Medicare services in 2024 · #1132 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.
19281 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$235.19–$260.00
Both address the first lesion, but 19283 is selected when stereotactic guidance is used rather than mammographic guidance without stereotactic guidance.
$326.35–$364.38
19285 is for first-lesion localization guided by ultrasound; 19281 is for mammographic guidance.
$557.10–$623.03
19287 is for first-lesion localization guided by MRI; 19281 is for mammographic guidance.
Compare 19281 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
Metropolitan Philadelphia →
Office / nonfacility
$243.90
Facility
$86.04
Rest Of Pennsylvania →
Office / nonfacility
$221.07
Facility
$81.86
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19281 billing questions
When is 19281 reported instead of 19283?
Use 19281 for localization guided by mammographic imaging without stereotactic guidance. Use 19283 when stereotactic guidance is used.
How is an additional lesion reported?
19281 represents the first lesion localized with mammographic guidance. Report 19282 for each additional lesion localized with that guidance.
Are units based on devices or lesions?
The code distinguishes the first lesion from additional lesions, not the number of wires or markers placed around one lesion.
Can 19281 be used for ultrasound- or MRI-guided placement?
No. The guidance modality determines the code: 19285 is for ultrasound guidance and 19287 is for MRI guidance.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Separately performed procedures may be subject to the standard multiple procedure reduction.
When is modifier 50 appropriate?
For bilateral performance, CMS pays this procedure at 150% with modifier 50. Assistant-at-surgery payment requires documented medical necessity.
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.
1,67019120,,Removal of breast lesion,A,,5.77,9.94,,4.99,,1.45,17.16,12.21,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67119125,,Excision breast lesion,A,,6.52,10.81,,5.35,,1.68,19.01,13.55,0,090,0.10,0.71,0.19,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67219126,,Excision addl breast lesion,A,,2.86,0.72,NA,0.72,,0.73,4.31,4.31,0,ZZZ,0.00,0.00,0.00,0,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67319281,,Perq device breast 1st imag,A,,1.95,4.89,,0.35,,0.19,7.03,2.49,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67419282,,Perq device breast ea imag,A,,0.98,3.87,,0.18,,0.08,4.93,1.24,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67519283,,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