Summary & Overview
CPT 19081: Stereotactic Percutaneous Breast Biopsy, Single Lesion
CPT code 19081 denotes a stereotactic-guided percutaneous breast biopsy for a single lesion, with optional concurrent placement of a localization device. This procedure is a common image-guided diagnostic intervention used to obtain tissue samples from suspicious breast lesions identified on mammography or digital breast tomosynthesis. Nationally, accurate coding of 19081 affects quality measurement, utilization tracking, and payment for radiology and breast-care services.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what 19081 represents clinically and operationally, typical sites of service, and the payer landscape addressed in the publication. The report summarizes standard billing considerations, common modifier usage provided in the input, and relevant related procedure groupings where available.
This publication offers benchmarks and policy context relevant to radiology and breast surgery stakeholders, plus practical details on coding classification and service definition. Data not available in the input is noted where applicable; the national focus aims to support billing staff, practice managers, and policy analysts in understanding how CPT code 19081 fits into diagnostic breast care workflows.
Billing Code Overview
CPT code 19081 describes a percutaneous stereotactic-guided breast biopsy of a single lesion, performed through the skin. The procedure involves obtaining breast tissue samples using stereotactic imaging guidance and may include placement of a localization device during the same encounter.
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Service type: Image-guided percutaneous breast biopsy
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Typical site of service: Outpatient radiology suite, breast center, or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman is referred to breast imaging after screening mammography identifies a suspicious calcified cluster in the upper outer quadrant of the right breast. Diagnostic stereotactic mammography confirms a single target lesion not visible on ultrasound. The interventional radiologist schedules a percutaneous stereotactic core needle breast biopsy under local anesthesia with the option to place a localization marker at the same time if pathology will guide surgery. The workflow includes pre-procedure consent and review of prior imaging, positioning in the stereotactic device, sterile preparation, administration of local anesthetic, imaging-guided placement of the biopsy needle with core tissue sampling, retrieval of samples for pathology, placement of a radiopaque clip or localization device if indicated, post-procedure imaging to document clip position, hemostasis, and brief observation with post-procedure discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician professional service separate from technical imaging components provided by the facility or radiology group. |
51 | Multiple procedures | Use when additional procedures are billed the same day and payer requires modifier for multiple procedure pricing. |
52 | Reduced services | Use when the biopsy is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to patient condition or adverse event. |
59 | Distinct procedural service | Use when another procedure on the same day is separate and distinct from the stereotactic biopsy (e.g., unrelated service at a different site). |
62 | Two surgeons | Use when two surgeons from different specialties perform distinct portions of the procedure concurrently. |
66 | Surgical team | Use when a surgical team approach is medically necessary and billed per payer policy. |
76 | Repeat procedure by same physician | Use when the same physician repeats the biopsy on the same day. |
77 | Repeat procedure by another physician | Use when a different physician repeats the biopsy on the same day. |
80 | Assistant surgeon | Use when an assistant surgeon is required and documented for the procedure. |
52 | Reduced services | Use when full biopsy protocol is not completed (listed again to highlight frequency of partial procedures). |
TC | Technical component | Use when billing only the technical component (facility or equipment) of the imaging-guided biopsy separate from the professional component. |
LT | Left side | Use to indicate the left breast when laterality is required. |
RT | Right side | Use to indicate the right breast when laterality is required. |
GA | Waiver of liability statement on file (payer-specific) | Use when a specific payer-required waiver is obtained and documented. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Radiology | Interventional radiologists and breast imagers commonly perform stereotactic breast biopsy. |
| 207K00000X | Diagnostic Radiology | Diagnostic radiologists with breast imaging expertise perform image-guided breast biopsies. |
| 207L00000X | Interventional Radiology | Providers performing percutaneous image-guided interventions. |
| 163WL0200X | Surgery — General (Breast Surgery) | Breast surgeons may perform localization and coordinate with biopsy workflow. |
| 208M00000X | Pathology | Pathologists do not perform the procedure but are essential for sample interpretation. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N63 | Unspecified lump in breast | Common indication for image-guided biopsy when a palpable or imaging-identified mass requires tissue diagnosis. |
R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | Used when mammographic findings are suspicious or inconclusive prompting stereotactic biopsy. |
D48.6 | Neoplasm of uncertain behavior of breast | Applied when imaging suggests an indeterminate lesion needing histologic classification. |
N60.3 | Fibrosclerosis of breast | Benign change that can produce suspicious imaging appearances requiring biopsy to exclude malignancy. |
C50.911 | Malignant neoplasm of unspecified site of right female breast | Used when biopsy is performed for diagnosis or localization related to confirmed or suspected malignancy in the right breast. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19083 | Stereotactic guidance for biopsy, with placement of breast localization device when performed; first lesion, including imaging guidance and placement of localization device | Alternative code when a localization device is placed with stereotactic guidance and the coding convention or payer guidance specifies this separate code for certain services; may be used if documentation aligns with its descriptor. |
19085 | Percutaneous breast biopsy, with image guidance, with placement of localization device for surgical excision; for open or percutaneous procedures (specific codes depend on guidance modality) | Used in workflows where a localization device is placed specifically to guide subsequent surgical excision; captures combined biopsy and localization procedures depending on payer rules. |
77031 | Magnetic resonance guidance for needle placement (interventional) | May be performed in lieu of stereotactic guidance for lesions better visualized on MRI; alternative image-guided modality in the diagnostic workflow. |
76000 | Fluoroscopic guidance for needle placement (separate procedure) | Used when fluoroscopic guidance is billed separately during localization or clip placement; relates to imaging guidance aspects of the procedure. |
11042 | Incision and drainage procedures (simple) | May be relevant if a separate minor surgical procedure (e.g., hematoma evacuation) becomes necessary as a complication; billed separately if performed. |