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See a sample rate comparisonCPT 19086 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 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
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19086 |
| Medicaid Fee Schedule | View Medicaid rates for 19086 |
National average reimbursement for CPT 19086 by major payers:
$748.19
$988.36
$914.18
$304.29
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CPT 19086
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers LLC
$4,613.00Published rateSurgcenter Of White Marsh, LLC
$555.00Published rateNorth Georgia Endoscopy Center Inc
$275.00Published rateGeorgia Urology, PA, Georgia Urology Asc Conyers
$171.00Published rateUniversity Of Maryland Surgcial Assoc PA, University Of Maryland Urological Surgery Center
University Of Maryland Surgical Associates P A
$75.00Published rate
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See a sample payer proposalCPT 19086 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19086 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 19086 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 19086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19086 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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