CPT 19101 Biopsy of breast; open, incisional
Last reviewed: May 17, 2026
RVU Values (CMS PFS RVU26C July 2026)
Common Modifiers
-LT, -RT
Related ICD-10 Codes
N63.10, N63.20, R92.8
Billing Tips
When billing CPT 19101, ensure your operative note clearly documents the procedure performed, clinical indication, and any complications or additional work that would support modifier usage. Always verify the code against the current AMA CPT Professional Edition before claim submission.
For multi-procedure cases, use our Case Builder to automatically calculate adjusted wRVUs with proper MPPR ranking.
Documentation and Coding Notes
AdSense readiness coding note: CPT 19101 should be treated as an educational starting point, not a final billing instruction. For biopsy of breast; open, incisional, the operative note or procedure note should clearly support the approach, anatomic site, laterality when relevant, clinical indication, and any separately reportable services.
Before submitting a claim or logging the case, compare CPT 19101 with adjacent codes in the same family, confirm current AMA CPT language, check CMS/NCCI edits, and verify payer-specific bundling rules. Modifier use should be tied to documentation rather than added only to bypass an edit.
Common audit checks for breast surgery cases include whether the documented work matches the code descriptor, whether add-on services are separately supported, whether a global period applies, and whether ICD-10 diagnosis pairing supports medical necessity.
Related CPT Codes in Breast Surgery
CPT 19083 — Biopsy, breast, with placement of breast localization device CPT 19301 — Mastectomy, partial CPT 19302 — Mastectomy, partial, with axillary lymphadenectomy CPT 19125 — Excision of breast lesion identified by preoperative placeme CPT 19303 — Mastectomy, simple, complete CPT 19307 — Mastectomy, modified radical, including axillary lymph nodesUse our free interactive decision tree with 500+ codes across 30 specialties
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