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CPT 19285: Ultrasound-Guided Breast Lesion Localization, First Lesion

CPT code 19285 covers ultrasound-guided placement of a localization device for a breast lesion — including clips, metallic pellets, wires/needles, or radioactive seeds — and applies to the first lesion treated. This procedure supports accurate localization prior to biopsy or surgical excision and is a common component of breast imaging and surgical workups. Nationally, proper coding of image-guided localization affects care coordination, procedural tracking, and payment for outpatient breast services.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for localization procedures, the typical sites of service where 19285 is reported, and the principal payers commonly involved in coverage and claims processing for these services. The publication summarizes common modifiers encountered in practice and highlights related billing considerations.

This article provides: a clear definition of the service represented by 19285; expected clinical and operational settings; payer coverage landscape; and guidance on where to look for additional policy and reimbursement details. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes is noted where applicable.

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Billing Code Overview

CPT code 19285 describes ultrasound-guided placement of a device for breast lesion localization, such as a clip, metallic pellet, wire/needle, or radioactive seeds. This code is used for the placement procedure when performed on the first lesion identified for localization.

Service type: Image-guided breast lesion localization procedure
Typical site of service: Outpatient imaging suite, breast clinic procedure room, or ambulatory surgery center where ultrasound guidance and minor localization devices are available.

Data not available in the input.

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CPT 19285: Ultrasound-Guided Breast Lesion Localization, First Lesion

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Get alerted when payer policies referencing 19285 are released or updated.

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Billing Code Overview

Service type: Image-guided breast lesion localization procedure
Typical site of service: Outpatient imaging suite, breast clinic procedure room, or ambulatory surgery center where ultrasound guidance and minor localization devices are available.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 54-year-old woman with a suspicious, non-palpable breast lesion identified on diagnostic ultrasound is scheduled for ultrasound-guided localization. The patient previously underwent mammography and targeted ultrasound that demonstrated a 9-mm hypoechoic mass in the left breast. The surgeon requests placement of a localization device (clip or wire) immediately prior to a lumpectomy to assist intraoperative identification. In the outpatient breast imaging suite, a breast radiologist performs real-time ultrasound guidance to insert a localization device (such as a clip, metallic pellet, wire/needle, or radioactive seed) into the lesion. The procedure includes patient positioning, sterile preparation, local anesthesia, device placement with sonographic confirmation of position, and brief post-placement imaging and documentation. The localization is billed using 19285 for the first lesion localized. Typical workflow includes pre-procedure consent and review of images, coordination with breast surgery for operating room timing (if wire or seed), and communication of device type and laterality in the report. Typical site of service is an outpatient imaging center, hospital outpatient department, or ambulatory surgical center.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s interpretation or performance distinct from the technical component (rare for localization but applicable if only interpretation is billed).
`50`	Bilateral procedure	Use when identical procedure is performed on both breasts during the same session (bilateral localization).
`51`	Multiple procedures	Use when multiple CPT procedures are billed on the same day and payer requires a multiple procedure modifier (if another reported procedure is reduced by payer policy).
`52`	Reduced services	Use when the localization procedure is partially reduced or not fully performed as described.
`53`	Discontinued procedure	Use when the procedure is started but halted due to patient or clinical circumstances.
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed on the same day that is not ordinarily reported with the localization (e.g., separate biopsy site).
`76`	Repeat procedure by same physician	Use when the same physician repeats the localization procedure later the same day.
`78`	Unplanned return to the operating/procedure room by same physician following initial procedure for a related procedure during the postoperative period	Use if localization requires an unplanned reintervention in the same operative session or postoperative period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when the localization is unrelated to the original procedure during global period.
`TC`	Technical component	Use when reporting only technical services (equipment, radiology technologist) for the localization procedure.
`LT`	Left side	Use to indicate procedure performed on the left breast.
`RT`	Right side	Use to indicate procedure performed on the right breast.
`XE`	Separate encounter, a service that is distinct because it occurred during a separate encounter	Use when localization is performed at a separate encounter from another procedure.
`XS`	Separate structure, a service that is distinct because it was performed on a separate anatomic site	Use when localization is performed on a different breast/site distinct from another same-day service.

Taxonomy Code	Specialty	Notes
207RP0200X	Radiology	Breast imaging and interventional radiologists commonly perform ultrasound-guided localization.
207Q00000X	Diagnostic Radiology	Diagnostic radiologists with breast focus perform localization and image guidance.
363LF0000X	Physician Assistant	PAs in breast imaging or surgery may assist in the procedure under supervision per state rules.
207V00000X	Surgery	Breast surgeons may perform or coordinate localization, particularly wire localization in operative settings.
207H00000X	Diagnostic Radiology (Interventional)	Interventional radiologists perform image-guided localization and marker placement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N63`	Unspecified lump in breast	Common indication for localization of a non-palpable breast lesion identified on imaging.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Used when imaging shows abnormality requiring localization for targeted excision.
`R92.1`	Other abnormal and inconclusive mammogram	Imaging abnormality prompting localization for surgical planning.
`D50.9`	Iron deficiency anemia, unspecified	Data not directly related; include only if clinical comorbidity affects procedure planning.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Malignant diagnosis prompting precise localization for breast-conserving surgery.
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Malignant diagnosis prompting localization on the right side when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19290`	Placement of localization device(s) (eg, clip, metallic pellet, wire, needle), radiology or other modality, for first lesion when performed under stereotactic guidance	Alternative localization technique using stereotactic guidance rather than ultrasound; used when lesion is mammographically seen and requires stereotactic placement.
`19081`	Percutaneous needle core biopsy, breast, without localization, first lesion, including imaging guidance and placement of localization device when performed	Performed when tissue diagnosis is obtained; clip placement often occurs at time of biopsy and may be billed with this code when applicable.
`19083`	Biopsy, percutaneous, needle, with placement of clip, each additional lesion	Additional biopsy with clip placement for multiple lesions; relates when more than one lesion requires marking.
`39330`	Insertion of radioactive implant; for localization or treatment (note: example radiation code may vary)	In settings where radioactive seed localization is used, radioactive device handling and related facility workflow intersect with `19285`.
`19120`	Excision of breast lesion identified by preoperative placement of radiological marker (e.g., wire localization)	Surgical excision performed after localization; the localization facilitates intraoperative lesion removal.

CPT 19281: Breast Lesion Localization Under Mammographic Guidance

CPT-19282-BREAST-LOCALIZATION-DEVICE-PLACEMENT-MAMMOGRAPHIC-GUIDANCE

CPT 19282: Mammographic-Guided Breast Localization Device Placement

CPT-19283-STEREOTACTIC-BREAST-LESION-LOCALIZATION-FIRST-LESION

CPT 19283: Stereotactic-Guided Breast Lesion Localization, First Lesion

CPT-19284-STEREOTACTIC-BREAST-LOCALIZATION-ADD-ON

CPT 19284: Stereotactic Breast Localization, Additional Lesion

CPT-19286-ULTRASOUND-GUIDED-BREAST-LOCALIZATION-ADD-ON

CPT 19286: Ultrasound-Guided Breast Localization, Add-On

CPT-19287-MRI-GUIDED-BREAST-LESION-LOCALIZATION

CPT 19287: MRI-Guided Breast Lesion Localization

CPT-19288-MRI-GUIDED-ADD-ON-BREAST-LOCALIZATION

CPT 19288: MRI-Guided Add-On Breast Localization

CPT-19294-TUMOR-CAVITY-PREPARATION-IORT-PARTIAL-MASTECTOMY

CPT 19294: Tumor Cavity Preparation for IORT During Partial Mastectomy

CPT-19296-BALLOON-CATHETER-PLACEMENT-BRACHYTHERAPY-PARTIAL-MASTECTOMY

CPT 19296: Balloon Catheter Placement for Breast Brachytherapy

CPT-19297-BALLOON-CATHETER-PLACEMENT-PARTIAL-MASTECTOMY-RADIOTHERAPY

CPT 19297: Balloon Catheter Placement During Partial Mastectomy, Image-Guided

Showing 1–10 of 11

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s interpretation or performance distinct from the technical component (rare for localization but applicable if only interpretation is billed).
`50`	Bilateral procedure	Use when identical procedure is performed on both breasts during the same session (bilateral localization).
`51`	Multiple procedures	Use when multiple CPT procedures are billed on the same day and payer requires a multiple procedure modifier (if another reported procedure is reduced by payer policy).
`52`	Reduced services	Use when the localization procedure is partially reduced or not fully performed as described.
`53`	Discontinued procedure	Use when the procedure is started but halted due to patient or clinical circumstances.
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed on the same day that is not ordinarily reported with the localization (e.g., separate biopsy site).
`76`	Repeat procedure by same physician	Use when the same physician repeats the localization procedure later the same day.
`78`	Unplanned return to the operating/procedure room by same physician following initial procedure for a related procedure during the postoperative period	Use if localization requires an unplanned reintervention in the same operative session or postoperative period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when the localization is unrelated to the original procedure during global period.
`TC`	Technical component	Use when reporting only technical services (equipment, radiology technologist) for the localization procedure.
`LT`	Left side	Use to indicate procedure performed on the left breast.
`RT`	Right side	Use to indicate procedure performed on the right breast.
`XE`	Separate encounter, a service that is distinct because it occurred during a separate encounter	Use when localization is performed at a separate encounter from another procedure.
`XS`	Separate structure, a service that is distinct because it was performed on a separate anatomic site	Use when localization is performed on a different breast/site distinct from another same-day service.

Taxonomy Code	Specialty	Notes
207RP0200X	Radiology	Breast imaging and interventional radiologists commonly perform ultrasound-guided localization.
207Q00000X	Diagnostic Radiology	Diagnostic radiologists with breast focus perform localization and image guidance.
363LF0000X	Physician Assistant	PAs in breast imaging or surgery may assist in the procedure under supervision per state rules.
207V00000X	Surgery	Breast surgeons may perform or coordinate localization, particularly wire localization in operative settings.
207H00000X	Diagnostic Radiology (Interventional)	Interventional radiologists perform image-guided localization and marker placement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N63`	Unspecified lump in breast	Common indication for localization of a non-palpable breast lesion identified on imaging.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Used when imaging shows abnormality requiring localization for targeted excision.
`R92.1`	Other abnormal and inconclusive mammogram	Imaging abnormality prompting localization for surgical planning.
`D50.9`	Iron deficiency anemia, unspecified	Data not directly related; include only if clinical comorbidity affects procedure planning.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Malignant diagnosis prompting precise localization for breast-conserving surgery.
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Malignant diagnosis prompting localization on the right side when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19290`	Placement of localization device(s) (eg, clip, metallic pellet, wire, needle), radiology or other modality, for first lesion when performed under stereotactic guidance	Alternative localization technique using stereotactic guidance rather than ultrasound; used when lesion is mammographically seen and requires stereotactic placement.
`19081`	Percutaneous needle core biopsy, breast, without localization, first lesion, including imaging guidance and placement of localization device when performed	Performed when tissue diagnosis is obtained; clip placement often occurs at time of biopsy and may be billed with this code when applicable.
`19083`	Biopsy, percutaneous, needle, with placement of clip, each additional lesion	Additional biopsy with clip placement for multiple lesions; relates when more than one lesion requires marking.
`39330`	Insertion of radioactive implant; for localization or treatment (note: example radiation code may vary)	In settings where radioactive seed localization is used, radioactive device handling and related facility workflow intersect with `19285`.
`19120`	Excision of breast lesion identified by preoperative placement of radiological marker (e.g., wire localization)	Surgical excision performed after localization; the localization facilitates intraoperative lesion removal.

CPT 19281: Breast Lesion Localization Under Mammographic Guidance

CPT-19282-BREAST-LOCALIZATION-DEVICE-PLACEMENT-MAMMOGRAPHIC-GUIDANCE

CPT 19282: Mammographic-Guided Breast Localization Device Placement

CPT-19283-STEREOTACTIC-BREAST-LESION-LOCALIZATION-FIRST-LESION

CPT 19283: Stereotactic-Guided Breast Lesion Localization, First Lesion

CPT-19284-STEREOTACTIC-BREAST-LOCALIZATION-ADD-ON

CPT 19284: Stereotactic Breast Localization, Additional Lesion

CPT-19286-ULTRASOUND-GUIDED-BREAST-LOCALIZATION-ADD-ON

CPT 19286: Ultrasound-Guided Breast Localization, Add-On

CPT-19287-MRI-GUIDED-BREAST-LESION-LOCALIZATION

CPT 19287: MRI-Guided Breast Lesion Localization

CPT-19288-MRI-GUIDED-ADD-ON-BREAST-LOCALIZATION

CPT 19288: MRI-Guided Add-On Breast Localization

CPT-19294-TUMOR-CAVITY-PREPARATION-IORT-PARTIAL-MASTECTOMY

CPT 19294: Tumor Cavity Preparation for IORT During Partial Mastectomy

CPT-19296-BALLOON-CATHETER-PLACEMENT-BRACHYTHERAPY-PARTIAL-MASTECTOMY

CPT 19296: Balloon Catheter Placement for Breast Brachytherapy

CPT-19297-BALLOON-CATHETER-PLACEMENT-PARTIAL-MASTECTOMY-RADIOTHERAPY

CPT 19297: Balloon Catheter Placement During Partial Mastectomy, Image-Guided

Showing 1–10 of 11

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 19285: Ultrasound-Guided Breast Lesion Localization, First Lesion

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Billing Code Overview

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CPT 19285: Ultrasound-Guided Breast Lesion Localization, First Lesion

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References