CPT 19083
Global 000 ActiveBx breast 1st lesion us imag
CPT 19083 Billing & Documentation Guide
CPT code 19083 (Bx breast 1st lesion us imag) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.02, a non-facility practice expense RVU of 10.88, and a malpractice RVU of 0.34, a total non-facility RVU of 14.24 and facility RVU of 3.91. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $491.91, though rates vary from $418.88 to $642.08 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19083, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 19083 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 19083 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 19083
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.02 | 3.02 |
| Practice Expense RVU | 10.88 | 0.55 |
| Malpractice RVU | 0.34 | 0.34 |
| Total RVU | 14.24 | 3.91 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19083
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $540.65 | $132.38 | $506.96 - $642.08 | 29 |
| Florida | $487.59 | $141.41 | $465.35 - $507.89 | 3 |
| Georgia | $461.29 | $132.14 | $438.56 - $484.03 | 2 |
| Illinois | $474.06 | $140.68 | $450.41 - $494.91 | 4 |
| Michigan | $458.09 | $134.1 | $445.48 - $470.7 | 2 |
| North Carolina | $447.18 | $125.27 | $447.18 - $447.18 | 1 |
| New York | $526.5 | $141.59 | $454.09 - $560.5 | 5 |
| Ohio | $444.1 | $129.09 | $444.1 - $444.1 | 1 |
| Pennsylvania | $469.88 | $131.92 | $445.21 - $494.54 | 2 |
| Texas | $469.74 | $130.06 | $442.12 - $495.61 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 19083
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19083 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 19083
What does CPT code 19083 mean? +
CPT code 19083 represents: Bx breast 1st lesion us imag. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 19083? +
The 2026 Medicare national average non-facility payment for CPT 19083 is $491.91. Rates range from $418.88 to $642.08 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19083? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 19083? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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