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See a sample rate comparisonCPT 19085 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Bx Breast 1st Lesion Mr Imag, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous First Lesion Including Magnetic Resonance Guidance
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19085 |
| Medicaid Fee Schedule | View Medicaid rates for 19085 |
National average reimbursement for CPT 19085 by major payers:
$981.03
$1,243.70
$1,185.41
$478.81
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CPT 19085
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$3,611.00Published rateUniversity Surgery Center Ltd
$1,276.00Published rateExecutive Endoscopy, Inc, Endoscopy Center Of San Jose
Executive Endoscopy Inc
$750.00Published rateCataract Institute Of Oklahoma LLC
Cataract Institute Of Oklahoma LLC 401(K) Plan And Trust
$539.00Published rateSoutheastern Gastroenterology Endoscopy Center, PA
Southeastern Gastroenterology Endoscopy Center PA
$403.00Published rate
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See a sample payer proposalCPT 19085 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19085 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 19085 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 19083-CPT | Moderate | Bx Breast 1st Lesion Us Imag, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous First Lesion Including Ultrasound Guidance |
| 19084-CPT | Moderate | Bx Breast Add Lesion Us Imag, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous Each Additional Lesion Including Ultrasound Guidance List Separately In Addition To Code For Primary Procedure |
| 19085-CPT | Moderate | Bx Breast 1st Lesion Mr Imag, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous First Lesion Including Magnetic Resonance Guidance |
| 19086-CPT | Moderate | Bx Breast Add Lesion Mr Imag, Biopsy Breast With Placement Of Breast Localization Device S Eg Clip Metallic Pellet When Performed And Imaging Of The Biopsy Specimen When Performed Percutaneous Each Additional Lesion Including Magnetic Resonance Guidance List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19085. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19085 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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