How much does Medicare pay for CPT 19083?

Medicare allowed an average of $269.45 per service and paid $209.37 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1653.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 19083?

Biopsy of breast and placement of locating device using ultrasound, first growth. It was billed 76,534 times to 75,626 Medicare beneficiaries by 3,377 providers in 2024.

Does 19083 pay differently in an office than a hospital?

Yes. The allowed amount averaged $423.84 in an office setting and $151.23 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 19083 most?

Diagnostic Radiology, with 69,221 services from 3,112 clinicians. Next are General Surgery, Independent Diagnostic Testing Facility (IDTF), Interventional Radiology.

CPT 19083

Biopsy of breast and placement of locating device using ultrasound, first growth

$269.45Medicare-allowed amount per service, averaged across 76,534 services

Providers submitted

$1653.38

Asking price, not received

Medicare allowed

$269.45

The fee schedule figure

Medicare paid

$209.37

Balance is patient coinsurance

Providers submitted an average of $1653.38 for this code and Medicare allowed $269.45 — 6.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $209.37 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $423.84
Hospital / facility: $151.23

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 33,190 services were billed in an office setting and 43,344 in a facility.

Services: 76,534
Beneficiaries: 75,626
Providers billing it: 3,377
Total allowed: $20,622,086

What Medicare pays for CPT 19083

Across 76,534 services billed by 3,377 providers to 75,626 beneficiaries, Medicare allowed an average of $269.45 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 19083

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	69,221	68,477	$257.38	3,112
General Surgery	4,695	4,588	$374.51	177
Independent Diagnostic Testing Facility (IDTF)	596	586	$465.54	15
Interventional Radiology	558	549	$250.60	22
Surgical Oncology	444	437	$438.96	16
Ambulatory Surgical Center	394	375	$637.90	6
Radiation Oncology	118	117	$231.58	5
Obstetrics & Gynecology	102	100	$474.02	5
Physician Assistant	94	93	$228.34	3
Family Practice	72	71	$479.52	3
Internal Medicine	44	44	$144.38	3
Nuclear Medicine	39	39	$138.41	2
Emergency Medicine	36	32	$147.44	1
Pediatric Medicine	34	33	$430.90	1
Gynecological Oncology	18	18	$121.51	1

19083 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	7,589	$318.99	$224.43	314
New York	6,121	$370.68	$256.22	250
Florida	5,929	$319.81	$250.52	229
Texas	4,294	$234.23	$185.50	187
Pennsylvania	3,395	$190.96	$144.84	155
Illinois	3,195	$189.70	$140.40	156
North Carolina	2,719	$303.72	$246.37	124
Virginia	2,643	$256.57	$200.61	113
New Jersey	2,604	$336.55	$237.31	111
Ohio	2,503	$168.96	$130.57	126
Massachusetts	2,219	$206.96	$154.83	106
Georgia	2,120	$251.85	$199.70	93
Maryland	2,000	$449.39	$334.02	70
Michigan	1,880	$174.37	$131.24	95
Washington	1,863	$319.49	$241.69	82
Arizona	1,862	$383.64	$306.83	72
Missouri	1,709	$180.48	$140.32	75
Tennessee	1,623	$258.50	$217.94	77
South Carolina	1,518	$182.29	$149.19	66
Colorado	1,341	$312.62	$238.29	52
Indiana	1,318	$194.74	$157.30	52
Oklahoma	1,292	$171.53	$138.19	56
Minnesota	1,036	$283.86	$220.75	62
Arkansas	993	$240.30	$204.52	39
Kentucky	933	$179.58	$143.86	46
Louisiana	812	$177.77	$144.40	31
Wisconsin	809	$206.32	$166.65	51
Alabama	716	$173.42	$146.08	34
Mississippi	677	$239.10	$207.32	33
District of Columbia	669	$321.62	$226.03	27
Oregon	661	$276.29	$219.62	37
Iowa	633	$263.75	$219.86	29
Kansas	629	$276.76	$229.89	31
Connecticut	562	$260.77	$193.09	32
Nebraska	548	$230.88	$188.86	29
Rhode Island	532	$272.73	$199.95	24
North Dakota	411	$152.94	$119.24	20
Delaware	410	$267.11	$209.46	16
South Dakota	409	$199.67	$154.24	17
New Mexico	397	$373.27	$305.65	17
Nevada	394	$389.57	$314.11	18
New Hampshire	383	$244.53	$187.00	16
Utah	342	$174.32	$139.59	20
West Virginia	342	$146.23	$112.98	16
Maine	277	$157.15	$119.99	15
Idaho	264	$140.01	$112.34	11
Hawaii	207	$292.14	$223.00	10
Montana	190	$142.72	$110.87	11
Vermont	177	$142.73	$108.30	11
Alaska	175	$282.25	$170.78	5
Wyoming	93	$344.85	$281.43	4
Guam	51	$523.49	$374.12	1
AP	37	$348.42	$229.70	1
Puerto Rico	28	$482.26	$385.79	2

Related codes

19081Biopsy of breast and placement of locating device$288.07
19085Biopsy of breast and placement of locating device$425.90

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.