Billing code 19083: Breast biopsyMedicare rate & RVUs in Texas
Percutaneous ultrasound-guided biopsy of the first breast lesion in a session, including marker placement and specimen imaging when performed.
Medicare pays $442.12–$495.61 for 19083 in the office in Texas, from Beaumont to Austin. 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 19083 covers
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.
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.
Where 19083 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$442.12 to $495.61
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $495.61 | $130.57 |
| Beaumont | $442.12 | $128.14 |
| Brazoria | $470.67 | $128.74 |
| Dallas | $473.47 | $129.82 |
| Fort Worth | $469.98 | $129.78 |
| Galveston | $471.94 | $129.32 |
| Houston | $478.16 | $135.55 |
| Rest Of Texas | $455.99 | $128.56 |
How the 19083 rate is calculated
Each of 19083’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 · 19083
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.02Practice expense 10.88Malpractice 0.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19083
The CMS indicators that decide how 19083 is paid alongside other services.
CMS payment indicators · 19083
Breast biopsy
| 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
19083 without 50 · national office
$475.63
Breast biopsy
19083-50 · Bilateral: 150%
$713.45
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).
19083 compared with similar codes
Compare codes
19083 vs 19081 vs 19084 vs 19085 vs 19082: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19081Breast biopsy
- Both cover biopsy of the first lesion, but 19081 is selected for stereotactic guidance; 19083 is selected for ultrasound guidance.
- 19084Breast biopsy
- 19083 reports the first ultrasound-guided lesion in the session. 19084 reports each additional lesion biopsied using ultrasound guidance.
- 19085Breast biopsy
- 19085 is for the first lesion biopsied with MRI guidance; 19083 is for the first lesion biopsied with ultrasound guidance.
- 19082Breast biopsy
- 19082 reports an additional lesion biopsied with stereotactic guidance. For an additional ultrasound-guided lesion, use 19084.
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 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
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