CPT code 77078: CT bone density, axial skeleton2026 Medicare rate & RVUs

Medicare pays $98.87 for 77078 nationally in the office. Local office rates run $85.83–$139.30.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 77078 covers

This service uses computed tomography and quantitative analysis to assess bone mineral density at one or more axial-skeleton sites, commonly the spine. It is used in osteoporosis evaluation and may be selected when spinal degenerative changes could complicate interpretation of a DXA measurement. A technologist typically acquires the images, and a qualified practitioner interprets the study and reports the findings in an imaging or outpatient setting.

Report 77078 for the CT bone-density study of the axial skeleton, not for DXA or a peripheral-site study. Documentation should identify the axial site examined, the CT-based measurement method, and the interpretation. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and billing without either modifier represents the global service.

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 77078 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

77078 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 77078 rate is calculated

Each of 77078’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.

Payment rules and modifiers for 77078

The CMS indicators that decide how 77078 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

77078 compared with similar codes

How to choose

77080DXA bone density scanAxial skeleton, spine or hip

Both assess axial bone density, but 77078 is CT-based and 77080 is DXA-based. Select the code for the method actually performed.

77085DXA bone densityAxial with fracture assessment

77085 reports axial DXA with vertebral fracture assessment. 77078 reports CT-based axial bone-density measurement.

77081Bone densityAppendicular skeleton

77081 is for DXA assessment of the appendicular skeleton, while 77078 is for CT-based assessment of the axial skeleton.

Codes related to 77078

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates