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19286 Perq dev breast add us imag

What 19286 is

CMS fee schedule short descriptor: Perq dev breast add 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 19286 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.837.660.098.58$286.58
Facility (hospital, ASC)0.830.160.091.08$36.07

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: Add-on code: global period of the primary procedure applies.

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Medically Unlikely Edit (MUE)

Medicare caps 19286 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 19286? These codes are bundled into it

19286 is a Column 1 code in 207 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 codeShort descriptionModifier indicator
00400Anes integumentary sys nos0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair
12031Intmd rpr s/a/t/ext 2.5 cm/<1 - modifier may bypassCheck pair
12032Intmd rpr s/a/t/ext 2.6-7.51 - modifier may bypassCheck pair
12034Intmd rpr s/tr/ext 7.6-12.51 - modifier may bypassCheck pair
12035Intmd rpr s/a/t/ext 12.6-201 - modifier may bypassCheck pair
12036Intmd rpr s/a/t/ext 20.1-301 - modifier may bypassCheck pair
12037Intmd rpr s/tr/ext >30.0 cm1 - modifier may bypassCheck pair
12041Intmd rpr n-hf/genit 2.5cm/<1 - modifier may bypassCheck pair
12042Intmd rpr n-hf/genit2.6-7.51 - modifier may bypassCheck pair
12044Intmd rpr n-hf/genit7.6-12.51 - modifier may bypassCheck pair
12045Intmd rpr n-hf/genit12.6-201 - modifier may bypassCheck pair

Showing 30 of 207 column 2 codes. Use the pair checker for any specific combination.

19286 is bundled into these codes

19286 appears as a Column 2 code in 16 active edits. Reported with one of these Column 1 codes on the same date of service, 19286 is the code that denies.

Column 1 codeShort descriptionModifier indicator
10035Plmt sft tiss loclzj dev 1st1Check pair
10036Plmt sft tiss loclzj dev ea1Check pair
19081Bx breast 1st lesion strtctc1Check pair
19082Bx breast add lesion strtctc1Check pair
19083Bx breast 1st lesion us imag1Check pair
19084Bx breast add lesion us imag1Check pair
19085Bx breast 1st lesion mr imag1Check pair
19086Bx breast add lesion mr imag1Check pair
19300Mastectomy for gynecomastia1Check pair
19301Partial mastectomy1Check pair
19302P-mastectomy w/ln removal1Check pair
19303Mast simple complete1Check pair
19305Mast radical1Check pair
19306Mast rad urban type1Check pair
19307Mast mod rad1Check 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.