Summary & Overview
CPT 19083: Ultrasound-Guided Percutaneous Breast Biopsy, Single Lesion
CPT code 19083 identifies an ultrasound-guided, percutaneous breast biopsy of a single lesion and may include placement of a localization device. This procedure is a common diagnostic step for evaluating suspicious breast findings detected on imaging or clinical exam and plays an important role in cancer diagnosis and management across the United States. Accurate coding for 19083 affects claims adjudication, clinical documentation, and downstream care coordination.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of how 19083 is used in practice, the typical clinical and service settings where it occurs, and the elements that influence billing and coverage decisions. The publication provides benchmarks and context on utilization patterns, common modifier usage, and relevant policy updates where available. It also summarizes clinical considerations tied to ultrasound guidance versus other imaging modalities and notes implications for site-of-service selection and post-procedure management.
This summary is intended for billing managers, practice administrators, radiology and breast surgeons, and health policy analysts seeking a national-level overview of CPT code 19083 and its operational and reimbursement context.
Billing Code Overview
CPT code 19083 describes a percutaneous breast biopsy performed under ultrasound guidance on a single lesion. The procedure involves obtaining breast tissue samples through the skin (percutaneous) while using real-time ultrasound imaging to target the lesion. The provider may place a localization device at the same time as the biopsy.
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Service type: Image-guided percutaneous breast needle biopsy with possible concurrent localization
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Typical site of service: Outpatient imaging or breast clinic setting, including ambulatory surgery centers and hospital outpatient departments
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Clinical & Coding Specifications
Clinical Context
A 52-year-old woman presents to the breast imaging clinic after screening mammography and diagnostic ultrasound identified a single suspicious mass in the right breast. The radiologist recommends a percutaneous core needle biopsy under real-time ultrasound guidance to obtain tissue for histopathology. The patient is positioned supine or slightly oblique in the ultrasound suite; local anesthesia is administered. The radiologist uses ultrasound to target the lesion, obtains multiple core samples with a spring-loaded or vacuum-assisted device from the single lesion, and may deploy a metallic localization clip at the biopsy site for future correlation or surgical planning. Post-procedure ultrasound confirms hemostasis and clip placement. The specimen is sent to pathology with pertinent clinical history and imaging findings. Billing is for an ultrasound-guided percutaneous breast biopsy of a single lesion, with potential addition of a localization device placement during the same encounter when documented.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's interpretation/biopsy service separate from technical services. |
TC | Technical component |