How much does Medicare pay for CPT 19281?

Medicare allowed an average of $120.17 per service and paid $93.32 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $849.77, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 19281?

Placement of locating device in breast using imaging guidance, first growth. It was billed 6,940 times to 6,906 Medicare beneficiaries by 406 providers in 2024.

Does 19281 pay differently in an office than a hospital?

Yes. The allowed amount averaged $162.77 in an office setting and $97.22 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 19281 most?

Diagnostic Radiology, with 6,762 services from 397 clinicians. Next are Interventional Radiology, General Surgery, Physician Assistant.

CPT 19281

Placement of locating device in breast using imaging guidance, first growth

$120.17Medicare-allowed amount per service, averaged across 6,940 services

Providers submitted

$849.77

Asking price, not received

Medicare allowed

$120.17

The fee schedule figure

Medicare paid

$93.32

Balance is patient coinsurance

Providers submitted an average of $849.77 for this code and Medicare allowed $120.17 — 7.1× 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 $93.32 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $162.77
Hospital / facility: $97.22

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. 2,430 services were billed in an office setting and 4,510 in a facility.

Services: 6,940
Beneficiaries: 6,906
Providers billing it: 406
Total allowed: $833,980

What Medicare pays for CPT 19281

Across 6,940 services billed by 406 providers to 6,906 beneficiaries, Medicare allowed an average of $120.17 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 19281

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	6,762	6,728	$120.27	397
Interventional Radiology	79	79	$142.12	4
General Surgery	39	39	$46.77	1
Physician Assistant	24	24	$78.36	2
Dermatology	22	22	$110.75	1
Family Practice	14	14	$241.49	1

19281 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
New York	1,374	$117.35	$71.19	75
California	610	$121.93	$74.54	38
New Jersey	534	$124.03	$76.99	29
Florida	526	$110.42	$73.47	31
Massachusetts	493	$99.82	$65.10	25
Pennsylvania	362	$117.38	$83.66	23
Virginia	279	$93.30	$53.86	14
Maryland	266	$188.25	$103.31	17
Arizona	194	$196.26	$154.02	10
Illinois	174	$98.10	$57.66	11
Iowa	172	$113.92	$83.24	9
North Carolina	163	$140.56	$101.69	12
South Carolina	157	$90.97	$64.72	9
Texas	147	$115.03	$71.65	10
Indiana	135	$124.27	$88.91	9
Georgia	129	$109.45	$59.71	9
Kentucky	119	$95.95	$48.17	5
Missouri	110	$94.04	$66.25	8
Rhode Island	97	$98.69	$69.60	6
Michigan	97	$95.43	$57.77	6
Washington	85	$164.30	$108.23	6
Mississippi	75	$91.89	$59.23	4
Connecticut	72	$98.17	$46.42	4
Delaware	62	$127.41	$82.25	3
Oregon	55	$201.87	$151.35	3
Tennessee	53	$88.20	$69.92	4
New Hampshire	39	$93.30	$73.28	2
Nebraska	36	$214.11	$172.86	2
North Dakota	34	$90.85	$58.67	2
Minnesota	33	$145.93	$102.45	2
Hawaii	29	$182.12	$132.97	2
Arkansas	26	$89.88	$70.90	2
Ohio	26	$94.74	$75.23	2
South Dakota	25	$91.04	$51.14	2
Guam	24	$249.86	$172.31	1
Wisconsin	23	$89.53	$62.20	2
New Mexico	22	$229.99	$178.21	1
Alabama	18	$88.87	$73.15	1
Montana	15	$220.27	$187.75	1
Louisiana	13	$89.44	$72.47	1
Idaho	13	$90.40	$52.61	1
Kansas	13	$92.82	$69.57	1
District of Columbia	11	$103.70	$54.80	1

Related codes

19285Placement of locating device in breast$123.36

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.