CPT 19285
Global 000 ActivePerq dev breast 1st us imag
CPT 19285 Billing & Documentation Guide
CPT code 19285 (Perq dev breast 1st us imag) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.66, a non-facility practice expense RVU of 8.65, and a malpractice RVU of 0.18, a total non-facility RVU of 10.49 and facility RVU of 2.15. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $363.25, though rates vary from $306.72 to $481.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19285, 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 19285 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 19285 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 19285
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.66 | 1.66 |
| Practice Expense RVU | 8.65 | 0.31 |
| Malpractice RVU | 0.18 | 0.18 |
| Total RVU | 10.49 | 2.15 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19285
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 | $402.56 | $72.95 | $376.26 - $481.39 | 29 |
| Florida | $357.03 | $77.54 | $340.69 - $371.41 | 3 |
| Georgia | $338.35 | $72.6 | $320.33 - $356.37 | 2 |
| Illinois | $346.3 | $77.14 | $328.62 - $363.21 | 4 |
| Michigan | $335.21 | $73.63 | $326.02 - $344.39 | 2 |
| North Carolina | $328.85 | $68.95 | $328.85 - $328.85 | 1 |
| New York | $388.56 | $77.8 | $334.14 - $413.68 | 5 |
| Ohio | $325.29 | $70.96 | $325.29 - $325.29 | 1 |
| Pennsylvania | $345.37 | $72.51 | $326.35 - $364.38 | 2 |
| Texas | $345.78 | $71.53 | $323.95 - $366.56 | 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 19285
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19285 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 19285
What does CPT code 19285 mean? +
CPT code 19285 represents: Perq dev breast 1st us imag. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 19285? +
The 2026 Medicare national average non-facility payment for CPT 19285 is $363.25. Rates range from $306.72 to $481.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19285? +
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 19285? +
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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