How much does Medicare pay for CPT 19285?

Medicare allowed an average of $123.36 per service and paid $96.44 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $953.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 19285?

Placement of locating device in breast using ultrasound guidance, first growth. It was billed 11,035 times to 10,978 Medicare beneficiaries by 653 providers in 2024.

Does 19285 pay differently in an office than a hospital?

Yes. The allowed amount averaged $258.40 in an office setting and $71.94 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 19285 most?

Diagnostic Radiology, with 8,817 services from 554 clinicians. Next are General Surgery, Surgical Oncology, Interventional Radiology.

CPT 19285

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

$123.36Medicare-allowed amount per service, averaged across 11,035 services

Providers submitted

$953.38

Asking price, not received

Medicare allowed

$123.36

The fee schedule figure

Medicare paid

$96.44

Balance is patient coinsurance

Providers submitted an average of $953.38 for this code and Medicare allowed $123.36 — 7.7× 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 $96.44 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $258.40
Hospital / facility: $71.94

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. 3,043 services were billed in an office setting and 7,992 in a facility.

Services: 11,035
Beneficiaries: 10,978
Providers billing it: 653
Total allowed: $1,361,278

What Medicare pays for CPT 19285

Across 11,035 services billed by 653 providers to 10,978 beneficiaries, Medicare allowed an average of $123.36 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 19285

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	8,817	8,778	$132.76	554
General Surgery	1,829	1,813	$82.75	77
Surgical Oncology	177	176	$42.90	10
Interventional Radiology	80	80	$156.86	5
Physician Assistant	70	69	$53.02	3
Independent Diagnostic Testing Facility (IDTF)	36	36	$386.16	2
Nuclear Medicine	14	14	$79.10	1
Obstetrics & Gynecology	12	12	$40.68	1

19285 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	1,440	$147.17	$94.06	79
Florida	969	$151.49	$113.27	57
New York	744	$134.32	$89.86	45
Virginia	713	$79.11	$56.54	35
Texas	649	$136.18	$91.15	39
Pennsylvania	459	$69.59	$53.69	26
North Carolina	410	$209.33	$161.86	23
Arizona	405	$172.67	$132.76	22
Maryland	400	$188.07	$131.61	19
Ohio	391	$76.50	$55.98	25
Illinois	326	$90.90	$64.91	19
Indiana	300	$89.65	$72.14	15
Missouri	271	$69.58	$52.97	16
Georgia	257	$99.93	$70.95	16
Washington	249	$224.64	$161.39	16
Massachusetts	235	$90.78	$71.67	16
South Carolina	207	$92.52	$68.10	15
District of Columbia	183	$93.38	$62.89	9
Michigan	176	$69.42	$47.90	9
Kentucky	175	$88.09	$65.52	10
New Jersey	172	$144.80	$98.93	12
Colorado	146	$139.16	$92.63	10
Tennessee	146	$98.54	$79.83	10
Minnesota	128	$130.54	$94.69	10
Oklahoma	109	$99.48	$78.46	7
Kansas	108	$78.77	$61.53	6
New Hampshire	94	$89.57	$70.34	7
Louisiana	90	$75.56	$60.26	7
Wisconsin	87	$103.96	$75.98	6
Mississippi	86	$44.53	$34.51	3
Delaware	80	$78.92	$48.16	5
Oregon	75	$122.60	$90.99	6
New Mexico	73	$209.03	$168.86	5
Arkansas	71	$170.72	$108.50	5
Nebraska	67	$74.53	$48.69	5
Rhode Island	66	$132.61	$85.62	5
Idaho	64	$124.00	$85.00	5
Alabama	59	$73.29	$43.27	3
Maine	54	$81.25	$56.54	3
West Virginia	53	$66.28	$47.81	4
Iowa	46	$58.08	$44.02	3
Connecticut	46	$70.56	$55.86	3
Montana	41	$79.26	$46.28	3
Vermont	32	$68.15	$49.18	2
Wyoming	27	$232.57	$172.51	2
Alaska	22	$105.93	$59.97	2
North Dakota	12	$78.11	$42.79	1
Hawaii	11	$78.97	$52.74	1
Nevada	11	$39.90	$32.13	1

Related codes

19281Placement of locating device in breast$120.17

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.