CPT 19281
Global 000 ActivePerq device breast 1st imag
CPT 19281 Billing & Documentation Guide
CPT code 19281 (Perq device breast 1st imag) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.95, a non-facility practice expense RVU of 4.89, and a malpractice RVU of 0.19, a total non-facility RVU of 7.03 and facility RVU of 2.49. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $242.35, though rates vary from $208.7 to $311.22 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19281, 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 19281 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 19281 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 19281
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.95 | 1.95 |
| Practice Expense RVU | 4.89 | 0.35 |
| Malpractice RVU | 0.19 | 0.19 |
| Total RVU | 7.03 | 2.49 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19281
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 | $264.17 | $84.74 | $248.65 - $311.22 | 29 |
| Florida | $241.36 | $89.22 | $230.81 - $251.21 | 3 |
| Georgia | $228.64 | $83.98 | $218.39 - $238.89 | 2 |
| Illinois | $235.31 | $88.78 | $224.17 - $244.57 | 4 |
| Michigan | $227.44 | $85.04 | $221.42 - $233.45 | 2 |
| North Carolina | $221.57 | $80.09 | $221.57 - $221.57 | 1 |
| New York | $259.06 | $89.89 | $224.76 - $275.28 | 5 |
| Ohio | $220.65 | $82.2 | $220.65 - $220.65 | 1 |
| Pennsylvania | $232.49 | $83.95 | $221.07 - $243.9 | 2 |
| Texas | $232.18 | $82.9 | $219.66 - $243.69 | 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 19281
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19281 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 |
| 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 |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 19281
What does CPT code 19281 mean? +
CPT code 19281 represents: Perq device breast 1st imag. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 19281? +
The 2026 Medicare national average non-facility payment for CPT 19281 is $242.35. Rates range from $208.7 to $311.22 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19281? +
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 19281? +
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 May 31, 2026.
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