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See a sample rate comparisonHealthcare 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.
| 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 19286 |
| Medicaid Fee Schedule | View Medicaid rates for 19286 |
National average reimbursement for CPT 19286 by major payers:

$402.26

$508.61

$471.52

$152.13
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Reagan Street Surgery Center LLC
Digestive Health Specialists, P.A.
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Rate Benchmarking
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See a sample payer proposalCPT 19286 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19286 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 19286 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 |
|---|---|---|
| 19282-CPT | Moderate | Perq Device Breast Ea Imag, Placement Of Breast Localization Device S Eg Clip Metallic Pellet Wire Needle Radioactive Seeds Percutaneous Each Additional Lesion Including Mammographic Guidance List Separately In Addition To Code For Primary Procedure |
| 19283-CPT | Moderate | Surgery Put Device In Breast, A Device Such As A Clip Metallic Pellet Wire/Needle Or Radioactive Seeds Is Placed In The Breast To Mark The Location Of Tissue That Is To Be Removed And To Increase The Precision With Which The Surgeon Performs The Biopsy. |
| 19284-CPT | Moderate | Perq Dev Breast Add Strtctc, Placement Of Breast Localization Device S Eg Clip Metallic Pellet Wire Needle Radioactive Seeds Percutaneous Each Additional Lesion Including Stereotactic Guidance List Separately In Addition To Code For Primary Procedure |
| 19286-CPT | Moderate | Perq Dev Breast Add Us Imag, Placement Of Breast Localization Device S Eg Clip Metallic Pellet Wire Needle Radioactive Seeds Percutaneous Each Additional Lesion Including Ultrasound 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 19286. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19286 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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