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CPT 19282 covers the placement of a marker device during a breast biopsy using imaging guidance (like ultrasound or mammography) to mark the biopsy site. This is done for each breast treated.

Showing rates for

National Average

Base Medicare rate

$162.70

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

PE RVU (NF)

3.95

MP RVU

0.08

Total RVU

5.03

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always verify whether procedure was performed in facility or non-facility setting before billing
Impact: Incorrect setting selection creates $115.80 reimbursement discrepancy (70% difference between $162.70 and $46.90)
Bill 19282 only once per breast regardless of number of markers placed in that breast during single session
Impact: Per-breast billing prevents denials for duplicate charges; multiple units for same breast will be denied resulting in zero payment for additional units
Document specific imaging modality used for guidance and permanent nature of marker device
Impact: Inadequate documentation leads to 15-25% denial rate; clear documentation of imaging type supports medical necessity
When billing with core biopsy codes (19083, 19084, 19085), ensure 19282 includes separate documentation of marker placement as distinct service
Impact: Bundling issues can reduce total reimbursement by $46.90-$162.70 if 19282 is denied as inclusive
For bilateral procedures, append modifier 50 rather than billing two line items with RT/LT modifiers
Impact: Proper bilateral modifier usage ensures payment at 150% rate versus potential 100% denial of second unit
Verify patient has not exceeded benefit limits for preventive versus diagnostic breast procedures
Impact: Exceeding limits triggers patient responsibility for full amount ($162.70 non-facility), leading to collection issues

Common denials

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Frequently asked questions

What is the CPT code 19282 used for?

CPT 19282 is used for percutaneous placement of a breast tissue marker device using imaging guidance during or after a breast biopsy. The marker serves as a permanent reference point to identify the biopsied area for future surgical procedures or imaging follow-up. It is billed once per breast treated, regardless of the number of markers placed in that breast.

How much does Medicare pay for CPT 19282 in 2025?

Medicare pays $162.70 for CPT 19282 in non-facility settings and $46.90 in facility settings for 2025. The significant difference reflects that facility settings provide equipment and support staff, while non-facility settings bear those costs. The code has a total RVU of 5.03 with a work RVU of 1.00.

Can CPT 19282 be billed with breast biopsy codes?

Yes, CPT 19282 is separately reportable with breast biopsy codes 19083, 19084, and 19085. It is not bundled into the biopsy procedure and represents the distinct service of marker placement. Documentation must clearly indicate marker placement as a separate procedure with its own imaging confirmation and device identification.

How do you bill CPT 19282 for bilateral marker placement?

For bilateral marker placement, append modifier 50 to CPT 19282, which typically results in reimbursement at 150% of the single procedure rate. Alternatively, some payers prefer two line items with RT and LT modifiers. Always verify payer-specific requirements, as bilateral billing rules vary by insurance carrier.

Is prior authorization required for CPT 19282?

Prior authorization requirements for CPT 19282 vary by payer. Most commercial insurance plans do not require separate authorization when performed with an authorized breast biopsy, as marker placement is considered standard of care. However, always verify with the specific payer, as some Medicare Advantage and managed care plans may have authorization requirements for breast procedures.

What modifiers are commonly used with CPT 19282?

Common modifiers for CPT 19282 include: 50 (bilateral procedure), RT/LT (right/left breast identification), 59 or XU (distinct procedural service to prevent bundling), and 76 (repeat procedure by same physician). Modifier 50 increases reimbursement to 150% for bilateral cases, while anatomical modifiers RT/LT are often required by payers for claims processing.

What documentation is needed to bill CPT 19282?

Required documentation includes: imaging modality used for guidance, specific breast treated, type and brand of marker device, number of markers placed per breast, imaging confirmation of marker position, medical indication for placement, and documentation distinguishing marker placement from the biopsy procedure itself. Inadequate documentation is a leading cause of denials for this code.