19083 Bx breast 1st lesion us imag
What 19083 is
CMS fee schedule short descriptor: Bx breast 1st lesion us imag.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 19083 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.02 | 10.88 | 0.34 | 14.24 | $475.63 |
| Facility (hospital, ASC) | 3.02 | 0.55 | 0.34 | 3.91 | $130.60 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).
Medically Unlikely Edit (MUE)
Medicare caps 19083 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 19083? These codes are bundled into it
19083 is a Column 1 code in 245 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
00400 | Anes integumentary sys nos | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0694T | 3d vol img&rcnstj brst/ax | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
10005 | Fna bx w/us gdn 1st les | 1 - modifier may bypass | Check pair |
10007 | Fna bx w/fluor gdn 1st les | 1 - modifier may bypass | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 - modifier may bypass | Check pair |
10011 | Fna bx w/mr gdn 1st les | 1 - modifier may bypass | Check pair |
10021 | Fna bx w/o img gdn 1st les | 1 - modifier may bypass | Check pair |
10035 | Plmt sft tiss loclzj dev 1st | 1 - modifier may bypass | Check pair |
10036 | Plmt sft tiss loclzj dev ea | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
Showing 30 of 245 column 2 codes. Use the pair checker for any specific combination.
19083 is bundled into these codes
19083 appears as a Column 2 code in 19 active edits. Reported with one of these Column 1 codes on the same date of service, 19083 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
19110 | Nipple exploration | 1 | Check pair |
19112 | Excise breast duct fistula | 1 | Check pair |
19120 | Removal of breast lesion | 1 | Check pair |
19125 | Excision breast lesion | 1 | Check pair |
19126 | Excision addl breast lesion | 1 | Check pair |
19300 | Mastectomy for gynecomastia | 1 | Check pair |
19301 | Partial mastectomy | 1 | Check pair |
19302 | P-mastectomy w/ln removal | 1 | Check pair |
19303 | Mast simple complete | 1 | Check pair |
19305 | Mast radical | 1 | Check pair |
19306 | Mast rad urban type | 1 | Check pair |
19307 | Mast mod rad | 1 | Check pair |
19318 | Breast reduction | 1 | Check pair |
19328 | Rmvl intact breast implant | 1 | Check pair |
19330 | Rmvl ruptured breast implant | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.