CPT code 77049: Breast MRI, bilateral, without and with contrast2026 Medicare rate & RVUs in Texas
Bilateral breast MRI performed before and after contrast, with computer-aided detection, for high-risk screening or diagnostic assessment of breast disease.
Medicare pays $315.95–$354.28 for 77049 in the office in Texas, from Beaumont, TX to Austin, TX. 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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On this page 9 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.
Where 77049 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$315.95 to $354.28
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $354.28 | Unavailable |
| Beaumont, TX | $315.95 | Unavailable |
| Brazoria, TX | $336.77 | Unavailable |
| Dallas, TX | $338.56 | Unavailable |
| Fort Worth, TX | $336.04 | Unavailable |
| Galveston, TX | $337.55 | Unavailable |
| Houston, TX | $340.48 | Unavailable |
| Rest of Texas | $325.93 | Unavailable |
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.
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.
77049 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77048Breast MRIUnilateral, with and without contrast
- Both describe breast MRI before and after contrast with CAD; 77049 is bilateral, while 77048 is unilateral.
- 77047Breast MRIBilateral, without contrast
- This code is for bilateral MRI without contrast. Choose 77049 when the bilateral examination includes imaging before and after contrast with CAD.
- 77066Diagnostic mammogramBilateral, including CAD
- 77066 is bilateral diagnostic mammography, not MRI. The modality and examination protocol determine which code describes the service performed.
- 77067Screening mammogramBilateral, CAD included
- 77067 is bilateral screening mammography. Use 77049 for the bilateral breast MRI service with contrast and CAD, not for mammography.
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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