Summary & Overview
CPT 19287: MRI-Guided Breast Lesion Localization
Headline: CPT code 19287 defines MRI-guided placement of a device to localize a breast lesion. Lead: CPT code 19287 is used for magnetic resonance image guidance to place a localization device — such as a clip, metallic pellet, wire/needle, or radioactive seed — for the first breast lesion. It is a key radiology procedure that supports targeted surgical planning and treatment.
CPT code 19287 represents image-guided breast lesion localization performed under MRI. The code matters nationally because MRI-guided localization is used when lesions are only visible with MRI or when other imaging modalities are insufficient, influencing surgical accuracy and care pathways. The procedure typically occurs in outpatient radiology suites or hospital outpatient breast imaging centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on the clinical context of MRI-guided localization, expected sites of service, and typical service characteristics. The publication provides benchmarks and coding context, highlights common modifiers used with this service, and explains how CPT code 19287 fits into breast imaging and preoperative localization workflows.
This summary is intended to orient clinicians, billing professionals, and policy analysts to the code’s purpose, clinical role, and payer relevance at a national level.
Billing Code Overview
CPT code 19287 describes magnetic resonance image (MRI) guidance for placement of a device to localize a breast lesion. The procedure covers placement of a localization device such as a clip, metallic pellet, wire/needle, or radioactive seeds for the first lesion.
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Service type: Image-guided breast lesion localization using MRI
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Typical site of service: Outpatient radiology suite or breast imaging center within a hospital outpatient department
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Clinical & Coding Specifications
Clinical Context
A 52-year-old woman with a suspicious focus seen only on breast MRI is scheduled for MRI-guided breast lesion localization to facilitate surgical excision. She has a prior diagnostic mammogram and ultrasound that are nondiagnostic for the MRI-detected lesion. On the day of service the patient is positioned prone in the MRI breast coil, intravenous access obtained, and MRI sequences are performed to identify and target the lesion. Under MRI guidance the radiologist places a localization device (e.g., metallic clip or needle/wire) into the lesion. Post-placement MRI or mammographic confirmation images are obtained. The localization is later used by the breast surgeon to guide lumpectomy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal/incremental service | Use when this procedure is the standard, uncomplicated service provided. |
22 | Increased procedural services | Use when work or time substantially exceeds usual for complex localization. |
52 | Reduced services | Use when the localization is partially reduced or incomplete. |
53 | Discontinued procedure | Use if the localization was started but stopped for patient safety or technical reasons. |
59 | Distinct procedural service | Use when another separate procedure is performed on the same day and not usually bundled. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons for a surgical localization requiring two attending surgeons. |
76 | Repeat procedure by same physician | Use when the same provider repeats MRI-guided localization later the same day. |
77 | Repeat procedure by another physician | Use when a different provider repeats the localization. |
LT | Left side | Use to indicate localization was performed on the left breast. |
RT | Right side | Use to indicate localization was performed on the right breast. |
QK | Medical direction of 2-4 assistants | Use when the physician medically directs qualified assistants during the procedure. |
QX | Qualified nonphysician assistant | Use when a qualified nonphysician assistant actually performs delegated services. |
XS | Separate structure or site | Use when a separate lesion in a different quadrant or separate breast is localized and needs separate reporting. |
XP | Separate practitioner | Use when services are performed by a different practitioner and require separate reporting. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Radiology | Diagnostic/interventional breast localization under MRI guidance. |
| 207XS0103X | Diagnostic Radiology | Imaging-guided procedural localization and image interpretation. |
| 207RH0000X | Vascular & Interventional Radiology | When an interventional radiologist performs percutaneous localization techniques. |
| 2080P0207X | General Surgery | Breast surgeons who use localization results for excision. |
| 207RP1001X | Diagnostic Radiology (MRI specialist) | Radiologists with subspecialty MRI expertise performing targeting and device placement. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C50.912 | Malignant neoplasm of unspecified site of left female breast | MRI-detected target for localization prior to surgical excision. |
C50.911 | Malignant neoplasm of unspecified site of right female breast | MRI-detected target for localization prior to surgical excision. |
N63 | Unspecified lump in breast | Common indication when a palpable or image-detected breast lump requires localization for biopsy or excision. |
R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | Indicates an MRI finding requiring targeted localization. |
D05.10 | Lobular carcinoma in situ of breast, unspecified breast | May prompt localization when MRI identifies areas of concern for surgical planning. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19295 | Preoperative placement of needle localization device (e.g., for breast lesion), mammographic or stereotactic guidance, each lesion | Used when radiographic (mammographic or stereotactic) rather than MRI guidance is used for localization; alternative guidance modality. |
19081 | Localization of lesion during intraoperative placement, percutaneous placement of localization device without imaging guidance (breast) | Performed in some workflows when intraoperative localization or non-image-guided placement is used instead of MRI guidance. |
76000 | Fluoroscopy (diagnostic) | May be used when adjunct fluoroscopic imaging is required for localization confirmation or seed placement. |
77021 | Magnetic resonance guidance for localization, percutaneous, including imaging and monitoring | Adjunct MRI guidance codes that may be reported for imaging guidance components in some reporting scenarios. |
19288 | Breast lesion localization, image guidance; for each additional lesion (List separately in addition to code for primary lesion) | Used when more than one lesion is localized under MRI guidance on the same day; reported in addition to 19287. |