CPT code 77049: Breast MRI, bilateral, without and with contrast2026 Medicare rate & RVUs in Rhode Island
Bilateral breast MRI performed before and after contrast, with computer-aided detection, for high-risk screening or diagnostic assessment of breast disease.
In Rhode Island, Medicare pays $349.10 for 77049 in the office.
Check a contract rate as a % of Medicare · 77049 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 77049 covers
This service images both breasts using MRI before and after contrast, with computer-aided detection included in the reported service. Radiologists interpret the images in hospital imaging departments and outpatient imaging centers. Common clinical situations include screening patients at elevated breast cancer risk and assessing known breast cancer, such as its extent or response to treatment.
Select this code when the study covers both breasts and includes imaging before and after contrast; the record should support the indication, bilateral examination, contrast protocol, and interpretation. CAD is included rather than reported as a separate service under this code. The code represents bilateral imaging, so modifier 50 does not increase payment. A radiologist may report the professional component with modifier 26, the facility may report the technical component with modifier TC, or one entity may bill the global service without either modifier. When multiple diagnostic imaging procedures are furnished, the CMS 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.
How Rhode Island compares for 77049
Across 109 of 109 payment localities, the office rate for 77049 runs from $300.50 in Arkansas to $460.15 in San Benito County, CA. Rhode Island pays $349.10. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Rhode Island · this page$349.10
- Los Angeles, CA · California$388.45+$39.35
- Washington, DC area · District of Columbia$390.53+$41.43
- Miami, FL · Florida$358.50+$9.40
- Chicago, IL · Illinois$348.43−$0.67
- Manhattan, NY · New York$389.65+$40.55
- Alaska · Alaska$391.57+$42.47
Other areas in Rhode Island first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $304.93 | — |
| ArkansasArkansas | $300.50 | — |
| ArizonaArizona | $330.87 | — |
| Bakersfield, CACalifornia | $363.93 | — |
| Chico, CACalifornia | $363.39 | — |
| El Centro, CACalifornia | $363.42 | — |
| Fresno, CACalifornia | $363.39 | — |
| Hanford, CACalifornia | $363.39 | — |
| Madera, CACalifornia | $363.39 | — |
| Merced, CACalifornia | $363.39 | — |
| Modesto, CACalifornia | $363.39 | — |
| Napa, CACalifornia | $424.30 | — |
| Oxnard, CACalifornia | $387.00 | — |
| Redding, CACalifornia | $363.39 | — |
| Rest of CaliforniaCalifornia | $363.39 | — |
| Riverside, CACalifornia | $365.16 | — |
| Sacramento, CACalifornia | $382.20 | — |
| Salinas, CACalifornia | $380.79 | — |
| San Diego, CACalifornia | $390.35 | — |
| Marin County, CACalifornia | $450.31 | — |
| San Francisco, CACalifornia | $450.13 | — |
| San Benito County, CACalifornia | $460.15 | — |
| Santa Clara County, CACalifornia | $459.40 | — |
| San Luis Obispo, CACalifornia | $374.55 | — |
| Santa Cruz, CACalifornia | $394.58 | — |
| Santa Maria, CACalifornia | $382.38 | — |
| Santa Rosa, CACalifornia | $398.62 | — |
| Stockton, CACalifornia | $363.39 | — |
| Vallejo, CACalifornia | $424.04 | — |
| Visalia, CACalifornia | $363.39 | — |
| Yuba City, CACalifornia | $363.39 | — |
| ColoradoColorado | $356.02 | — |
| ConnecticutConnecticut | $362.29 | — |
| DelawareDelaware | $336.41 | — |
| Fort Lauderdale, FLFlorida | $347.38 | — |
| Rest of FloridaFlorida | $330.96 | — |
| Atlanta, GAGeorgia | $345.14 | — |
| Rest of GeorgiaGeorgia | $312.68 | — |
| Hawaii, Guam, HIHawaii | $372.99 | — |
| IowaIowa | $314.41 | — |
| IdahoIdaho | $316.11 | — |
| East St. Louis, ILIllinois | $324.34 | — |
| Rest of IllinoisIllinois | $320.12 | — |
| Suburban Chicago, ILIllinois | $351.34 | — |
| IndianaIndiana | $317.99 | — |
| KansasKansas | $312.12 | — |
| KentuckyKentucky | $310.43 | — |
| New Orleans, LALouisiana | $325.10 | — |
| Rest of LouisianaLouisiana | $309.62 | — |
| Metropolitan Boston, MAMassachusetts | $392.51 | — |
| Rest of MassachusettsMassachusetts | $353.55 | — |
| Baltimore area, MDMaryland | $361.10 | — |
| Rest of MarylandMaryland | $343.11 | — |
| Rest of MaineMaine | $316.91 | — |
| Southern Maine, MEMaine | $335.38 | — |
| Detroit, MIMichigan | $334.27 | — |
| Rest of MichiganMichigan | $317.80 | — |
| MinnesotaMinnesota | $343.45 | — |
| Metropolitan Kansas City, MOMissouri | $323.73 | — |
| Metropolitan St. Louis, MOMissouri | $327.24 | — |
| Rest of MissouriMissouri | $303.73 | — |
| MississippiMississippi | $302.22 | — |
| MontanaMontana | $339.68 | — |
| North CarolinaNorth Carolina | $320.37 | — |
| North DakotaNorth Dakota | $336.51 | — |
| NebraskaNebraska | $316.38 | — |
| New HampshireNew Hampshire | $349.66 | — |
| Northern New JerseyNew Jersey | $386.29 | — |
| Rest of New JerseyNew Jersey | $367.07 | — |
| New MexicoNew Mexico | $319.22 | — |
| NevadaNevada | $339.05 | — |
| NYC suburbs and Long Island, NYNew York | $398.11 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $368.83 | — |
| Queens, NYNew York | $394.07 | — |
| Rest of New YorkNew York | $325.12 | — |
| OhioOhio | $317.15 | — |
| OklahomaOklahoma | $310.73 | — |
| Portland, OROregon | $368.32 | — |
| Rest of OregonOregon | $337.06 | — |
| Metropolitan Philadelphia, PAPennsylvania | $352.71 | — |
| Rest of PennsylvaniaPennsylvania | $318.11 | — |
| Puerto RicoPuerto Rico | $342.46 | — |
| South CarolinaSouth Carolina | $319.16 | — |
| South DakotaSouth Dakota | $336.14 | — |
| TennesseeTennessee | $313.60 | — |
| Austin, TXTexas | $354.28 | — |
| Beaumont, TXTexas | $315.95 | — |
| Brazoria, TXTexas | $336.77 | — |
| Dallas, TXTexas | $338.56 | — |
| Fort Worth, TXTexas | $336.04 | — |
| Galveston, TXTexas | $337.55 | — |
| Houston, TXTexas | $340.48 | — |
| Rest of TexasTexas | $325.93 | — |
| UtahUtah | $323.57 | — |
| VirginiaVirginia | $333.70 | — |
| Virgin Islands, VIUnited States Virgin Islands | $342.46 | — |
| VermontVermont | $334.45 | — |
| Rest of WashingtonWashington | $353.14 | — |
| King County, WAWashington | $401.36 | — |
| WisconsinWisconsin | $325.09 | — |
| West VirginiaWest Virginia | $307.99 | — |
| WyomingWyoming | $338.30 | — |
77049 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$300.50
$411.77
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $391.57 | 1 |
| AL | $304.93 | 1 |
| AR | $300.50 | 1 |
| AZ | $330.87 | 1 |
| CA | $363.39–$460.15 | 29 |
| CO | $356.02 | 1 |
| CT | $362.29 | 1 |
| DC | $390.53 | 1 |
| DE | $336.41 | 1 |
| FL | $330.96–$358.50 | 3 |
| GA | $312.68–$345.14 | 2 |
| GU | $372.99 | 1 |
| HI | $372.99 | 1 |
| IA | $314.41 | 1 |
| ID | $316.11 | 1 |
| IL | $320.12–$351.34 | 4 |
| IN | $317.99 | 1 |
| KS | $312.12 | 1 |
| KY | $310.43 | 1 |
| LA | $309.62–$325.10 | 2 |
| MA | $353.55–$392.51 | 2 |
| MD | $343.11–$390.53 | 3 |
| ME | $316.91–$335.38 | 2 |
| MI | $317.80–$334.27 | 2 |
| MN | $343.45 | 1 |
| MO | $303.73–$327.24 | 3 |
| MS | $302.22 | 1 |
| MT | $339.68 | 1 |
| NC | $320.37 | 1 |
| ND | $336.51 | 1 |
| NE | $316.38 | 1 |
| NH | $349.66 | 1 |
| NJ | $367.07–$386.29 | 2 |
| NM | $319.22 | 1 |
| NV | $339.05 | 1 |
| NY | $325.12–$398.11 | 5 |
| OH | $317.15 | 1 |
| OK | $310.73 | 1 |
| OR | $337.06–$368.32 | 2 |
| PA | $318.11–$352.71 | 2 |
| PR | $342.46 | 1 |
| RI | $349.10 | 1 |
| SC | $319.16 | 1 |
| SD | $336.14 | 1 |
| TN | $313.60 | 1 |
| TX | $315.95–$354.28 | 8 |
| UT | $323.57 | 1 |
| VA | $333.70–$390.53 | 2 |
| VI | $342.46 | 1 |
| VT | $334.45 | 1 |
| WA | $353.14–$401.36 | 2 |
| WI | $325.09 | 1 |
| WV | $307.99 | 1 |
| WY | $338.30 | 1 |
How the 77049 rate is calculated
Each of 77049’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 · 77049
RVUs × geographic indexes × conversion factor
Work2.24
2.24 RVUs× 1.000 GPCI
Practice expense7.77
7.77 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
10.1700
Conversion factor
$33.4009
Medicare rate
$339.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Rhode Island inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,958
- Code
- 77049
- Physician work
- 2.24
- Practice expense
- 7.77
- Malpractice
- 0.16
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.24 | × 1.019 | 2.2826 |
| Practice expense | 7.77 | × 1.033 | 8.0264 |
| Malpractice | 0.16 | × 0.892 | 0.1427 |
| Total RVUs | 10.4517 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Rhode Island$349.10
Office: (2.24 × 1.019 + 7.77 × 1.033 + 0.16 × 0.892) × $33.4009 = $349.10
Payment rules and modifiers for 77049
The CMS indicators that decide how 77049 is paid alongside other services.
CMS payment indicators · 77049
Breast MRI, bilateral, without and with 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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
77049 without 26 · national office
$339.69
Breast MRI, bilateral, without and with contrast
77049-26 · Professional component
$105.88
Pays only the interpretation and report.
How 77049 has changed in Rhode Island
77049 · Office / nonfacility
$349.10
Effective 2026-10-01
The base rate is $1.27 higher than on 2025-10-01, moving from $347.83 to $349.10 (0.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$347.83changed to$349.10
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.30 changed to 2.24
- Practice expense RVU 7.95 changed to 7.77
- Work GPCI 1.025 changed to 1.019
- Practice expense GPCI 1.039 changed to 1.033
- Malpractice GPCI 0.849 changed to 0.892
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$363.55changed to$347.83
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.12 changed to 7.95
- Malpractice RVU 0.15 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$357.62changed to$363.55
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$378.33changed to$357.62
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.30 changed to 8.12
- Malpractice RVU 0.16 changed to 0.15
- Work GPCI 1.023 changed to 1.025
- Practice expense GPCI 1.044 changed to 1.039
- Malpractice GPCI 0.915 changed to 0.849
January 1, 2023
RVU23A
$390.69changed to$378.33
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.41 changed to 8.30
- Malpractice RVU 0.13 changed to 0.16
- Work GPCI 1.021 changed to 1.023
- Practice expense GPCI 1.048 changed to 1.044
- Malpractice GPCI 0.981 changed to 0.915
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$412.21changed to$390.69
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.91 changed to 8.41
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$421.28changed to$412.21
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.76 changed to 8.91
- Work GPCI 1.024 changed to 1.021
- Practice expense GPCI 1.049 changed to 1.048
- Malpractice GPCI 0.990 changed to 0.981
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$428.83changed to$421.28
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.94 changed to 8.76
- Malpractice RVU 0.15 changed to 0.13
- Work GPCI 1.027 changed to 1.024
- Practice expense GPCI 1.050 changed to 1.049
- Malpractice GPCI 0.999 changed to 0.990
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$428.83
Held through RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $349.10 | Not available in this setting | RVU26D |
| 2026-07-01 | $349.10 | Not available in this setting | RVU26C |
| 2026-04-01 | $349.10 | Not available in this setting | RVU26B |
| 2026-01-01 | $349.10 | Not available in this setting | RVU26A |
| 2025-10-01 | $347.83 | Not available in this setting | RVU25D |
| 2025-07-01 | $347.83 | Not available in this setting | RVU25C |
| 2025-04-01 | $347.83 | Not available in this setting | RVU25B |
| 2025-01-01 | $347.83 | Not available in this setting | RVU25A |
| 2024-10-01 | $363.55 | Not available in this setting | RVU24D |
| 2024-07-01 | $363.55 | Not available in this setting | RVU24C |
| 2024-04-01 | $363.55 | Not available in this setting | RVU24B |
| 2024-03-09 | $363.55 | Not available in this setting | RVU24AR |
| 2024-01-01 | $357.62 | Not available in this setting | RVU24A |
| 2023-10-01 | $378.33 | Not available in this setting | RVU23D |
| 2023-07-01 | $378.33 | Not available in this setting | RVU23C |
| 2023-04-01 | $378.33 | Not available in this setting | RVU23B |
| 2023-01-01 | $378.33 | Not available in this setting | RVU23A |
| 2022-10-01 | $390.69 | Not available in this setting | RVU22D |
| 2022-07-01 | $390.69 | Not available in this setting | RVU22C |
| 2022-04-01 | $390.69 | Not available in this setting | RVU22B |
| 2022-01-01 | $390.69 | Not available in this setting | RVU22A |
| 2021-10-01 | $412.21 | Not available in this setting | RVU21D |
| 2021-07-01 | $412.21 | Not available in this setting | RVU21C |
| 2021-04-01 | $412.21 | Not available in this setting | RVU21B |
| 2021-01-01 | $412.21 | Not available in this setting | RVU21A |
| 2020-10-01 | $421.28 | Not available in this setting | RVU20D |
| 2020-07-01 | $421.28 | Not available in this setting | RVU20C |
| 2020-04-01 | $421.28 | Not available in this setting | RVU20B |
| 2020-01-01 | $421.28 | Not available in this setting | RVU20A |
| 2019-10-01 | $428.83 | Not available in this setting | RVU19D |
| 2019-07-01 | $428.83 | Not available in this setting | RVU19C |
| 2019-04-01 | $428.83 | Not available in this setting | RVU19B |
| 2019-01-01 | $428.83 | Not available in this setting | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Rhode Island rate applies
Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.
- Ashaway
- Bradford
- Carolina
- Central Falls
- Charlestown
- Chepachet
- Clayville
- Cranston
77049 billing questions
When should 77049 be selected instead of 77048?
Use 77049 for a bilateral breast MRI performed before and after contrast with CAD. Code 77048 describes the corresponding unilateral examination.
Is CAD reported separately with 77049?
No. CAD is included in this code’s service; do not report a separate CAD code for the same breast MRI.
Can the radiologist and imaging facility report separate components?
Yes. The interpreting professional may report modifier 26, and the entity providing the equipment and staff may report modifier TC. Without either modifier, the claim represents the global service.
Should modifier 50 be appended for the two breasts?
The code already represents bilateral imaging. CMS pricing does not increase when modifier 50 is appended.
How does the multiple-procedure reduction affect this code?
When the CMS diagnostic imaging multiple-procedure reduction applies, it affects both the professional and technical components of 77049.
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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