19101 Biopsy of breast open
Also known as: open breast biopsy, excisional biopsy
Open surgical biopsy of breast lesion with complete excision and histopathological examination for diagnostic purposes.
In Plain Language
Surgical removal of breast lump for diagnosis; Surgical breast biopsy
Clinical Context
Performed when percutaneous techniques are non-diagnostic or when lesion requires complete excision. Standard diagnostic approach for uncertain findings.
RVU Breakdown
| Work RVU | 3.15 |
| Total RVU | 3.15 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 10-day global period — follow-up visits within 10 days of the procedure are included in the reimbursement. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 3.15, this code ranks in the 22nd percentile among Surgery codes — 2.5x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 19101?
CPT 19101 (Biopsy of breast open) is a Surgery code. Open surgical biopsy of breast lesion with complete excision and histopathological examination for diagnostic purposes.
What is the wRVU value for CPT 19101?
The work RVU for CPT 19101 is 3.15. This code is primarily used by Breast Surgery, Surgical Oncology. It has a 10-day global period.
When is CPT 19101 used?
Performed when percutaneous techniques are non-diagnostic or when lesion requires complete excision. Standard diagnostic approach for uncertain findings.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.