$490.94
Both cover biopsy of the first lesion, but 19081 is selected for stereotactic guidance; 19083 is selected for ultrasound guidance.
On this page
CMS RVU26D · Effective 2026-10-01
19083 Breast biopsy Medicare reimbursement rates in Rhode Island
Percutaneous ultrasound-guided biopsy of the first breast lesion in a session, including marker placement and specimen imaging when performed. Compare 19083 office and facility rates across CMS payment localities in Rhode Island.
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 19083 in Rhode Island?
Rhode Island 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
$488.31
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$131.89
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 19083: Ultrasound-guided breast biopsy, first lesion
Percutaneous ultrasound-guided biopsy of the first breast lesion in a session, including marker placement and specimen imaging when performed.
Code 19083 describes percutaneous sampling of one breast lesion selected under ultrasound guidance. The clinician advances a biopsy device into the target while observing it with ultrasound; marker placement and imaging of the removed specimen are included when performed. Breast radiologists and other clinicians qualified to perform image-guided breast procedures use it for an ultrasound-visible mass or other target requiring tissue diagnosis, in office-based imaging suites or hospital imaging departments.
Report 19083 for the first lesion sampled with ultrasound guidance during the session; report 19084 for each additional lesion biopsied with that same guidance modality. The record should identify the target and side, ultrasound localization, biopsy technique, tissue obtained, and any marker placement. Ultrasound guidance and specimen imaging are included in the service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%; bilateral performance with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 19083
- 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 RVU3.02 · 21%
- Practice expense (office) RVU10.88 · 76%
- Malpractice RVU0.34 · 2%
105.8K
Medicare services in 2024 · #539 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.
19083 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$367.72
19083 reports the first ultrasound-guided lesion in the session. 19084 reports each additional lesion biopsied using ultrasound guidance.
$739.20
19085 is for the first lesion biopsied with MRI guidance; 19083 is for the first lesion biopsied with ultrasound guidance.
$373.84
19082 reports an additional lesion biopsied with stereotactic guidance. For an additional ultrasound-guided lesion, use 19084.
Compare 19083 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
Rhode Island →
Office / nonfacility
$488.31
Facility
$131.89
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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 19083 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
1,661
- Code
- 19083
- Physician work
- 3.02
- Practice expense
- 10.88
- Malpractice
- 0.34
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.02 | × 1.019 | 3.0774 |
| Practice expense | 10.88 | × 1.033 | 11.2390 |
| Malpractice | 0.34 | × 0.892 | 0.3033 |
| Total RVUs | 14.6197 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$488.31
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.02 | 1.019 |
| Practice expense | 10.88 | 1.033 |
| Malpractice | 0.34 | 0.892 |
(3.02 × 1.019 + 10.88 × 1.033 + 0.34 × 0.892) × $33.4009 = $488.31
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.02 | 1.019 |
| Practice expense | 0.55 | 1.033 |
| Malpractice | 0.34 | 0.892 |
(3.02 × 1.019 + 0.55 × 1.033 + 0.34 × 0.892) × $33.4009 = $131.89
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.
19083 billing questions
Does 19083 include ultrasound guidance?
Yes. The ultrasound guidance is included in the biopsy service, as are marker placement and imaging of the removed specimen when performed.
How is another ultrasound-guided lesion reported in the same session?
Report 19084 for each additional lesion biopsied with ultrasound guidance after the first lesion reported with 19083.
Can 19083 be reported for biopsies of both breasts?
For bilateral performance, use modifier 50; CMS pays the bilateral procedure at 150%.
When should 19081 be used instead?
Use 19081 when the first lesion is biopsied with stereotactic guidance. Code 19083 is for ultrasound-guided biopsy.
What documentation supports reporting 19083?
Document the breast target and side, ultrasound localization, biopsy technique, tissue obtained, and any marker placement.
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.
1,65819030,,Njx px only mam ducto/glcto,A,,1.49,3.13,,0.28,,0.15,4.77,1.92,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,65919081,,Bx breast 1st lesion strtctc,A,,3.21,10.76,,0.58,,0.35,14.32,4.14,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66019082,,Bx breast add lesion strtctc,A,,1.61,9.10,,0.30,,0.17,10.88,2.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,66119083,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537