CPT 19284
Global ZZZ ActivePerq dev breast add strtctc
CPT 19284 Billing & Documentation Guide
CPT code 19284 (Perq dev breast add strtctc) is classified under Anesthesia with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.98, a non-facility practice expense RVU of 4.35, and a malpractice RVU of 0.11, a total non-facility RVU of 5.44 and facility RVU of 1.27. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $188.18, though rates vary from $159.43 to $247.82 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19284, 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 19284 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 19284 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 19284
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 4.35 | 0.18 |
| Malpractice RVU | 0.11 | 0.11 |
| Total RVU | 5.44 | 1.27 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19284
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 | $207.82 | $43.01 | $194.5 - $247.82 | 29 |
| Florida | $185.67 | $45.92 | $177.16 - $193.28 | 3 |
| Georgia | $175.79 | $42.92 | $166.71 - $184.86 | 2 |
| Illinois | $180.26 | $45.68 | $171.13 - $188.69 | 4 |
| Michigan | $174.33 | $43.55 | $169.53 - $179.14 | 2 |
| North Carolina | $170.64 | $40.69 | $170.64 - $170.64 | 1 |
| New York | $201.37 | $45.99 | $173.34 - $214.41 | 5 |
| Ohio | $169.09 | $41.93 | $169.09 - $169.09 | 1 |
| Pennsylvania | $179.27 | $42.84 | $169.58 - $188.96 | 2 |
| Texas | $179.37 | $42.25 | $168.36 - $189.77 | 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 19284
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19284 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 | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 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 |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 19284
What does CPT code 19284 mean? +
CPT code 19284 represents: Perq dev breast add strtctc. It's in the Anesthesia category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 19284? +
The 2026 Medicare national average non-facility payment for CPT 19284 is $188.18. Rates range from $159.43 to $247.82 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19284? +
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 19284? +
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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