CPT code 77046: Breast MRI, unilateral, without contrast2026 Medicare rate & RVUs in Guam
Reports a noncontrast MRI examination of one breast, commonly used to assess breast implant integrity or another indication evaluated without contrast.
Medicare pays $234.16 for 77046 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 77046 covers
This code covers MRI imaging of one breast performed without contrast. A common use is evaluating a breast implant for possible rupture or other integrity concerns. A technologist typically acquires the images in an outpatient imaging center or hospital, and a radiologist interprets them. The code is specific to a unilateral, noncontrast examination; it does not describe a contrast-enhanced breast MRI protocol.
Select the code when the documented examination covers one breast and uses no contrast. The order, imaging record, laterality, protocol, and radiologist’s report should support those details and the clinical indication. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the global service. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
77046 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $234.16 | Unavailable |
How the 77046 rate is calculated
Each of 77046’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 77046
RVUs × geographic indexes × conversion factor
Work1.41
1.41 RVUs× 1.000 GPCI
Practice expense4.88
4.88 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
6.3800
Conversion factor
$33.4009
Medicare rate
$213.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77046
The CMS indicators that decide how 77046 is paid alongside other services.
CMS payment indicators · 77046
Breast MRI, unilateral, without contrast
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
77046 without 26 · national office
$213.10
Breast MRI, unilateral, without contrast
77046-26 · Professional component
$66.13
Pays only the interpretation and report.
77046 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77047Breast MRIBilateral, without contrast
- 77047 covers noncontrast MRI of both breasts; 77046 covers one breast.
- 77048Breast MRIUnilateral, with and without contrast
- 77048 is for a unilateral MRI performed without and with contrast, including CAD when performed. 77046 is a unilateral noncontrast examination.
- 77049Breast MRIBilateral, without and with contrast
- 77049 covers bilateral MRI performed without and with contrast, including CAD when performed. 77046 covers one breast without contrast.
- 77065Diagnostic mammogramOne breast, CAD included
- 77065 reports unilateral diagnostic mammography, not MRI. Choose based on the imaging modality and examination actually performed.
77046 billing questions
When should 77046 be used instead of 77047?
Use 77046 for a noncontrast MRI of one breast. Use 77047 when the noncontrast examination covers both breasts.
How does 77046 differ from 77048?
77046 is unilateral and performed without contrast. 77048 is unilateral and uses a without-and-with-contrast protocol, including CAD when performed.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; without either modifier, the claim represents the global service.
Does a multiple imaging reduction affect 77046?
CMS applies the diagnostic imaging multiple procedure reduction to both the professional and technical components.
What documentation supports reporting 77046?
The record should establish the clinical indication, the breast examined, the noncontrast protocol, the imaging performed, and the radiologist’s interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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