CPT code 77081: Bone density, appendicular skeleton2026 Medicare rate & RVUs in Missouri
Reports DXA measurement of bone mineral density at one or more peripheral skeletal sites, such as the forearm, rather than the spine or hip.
Medicare pays $28.35–$30.56 for 77081 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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 77081 covers
This service uses dual-energy X-ray absorptiometry to measure bone mineral density at an appendicular, or peripheral, skeletal site. A common example is measurement at the forearm. The test may be part of an osteoporosis evaluation when a peripheral measurement is needed; the acquisition is typically performed by radiology or bone-density staff, with interpretation by a physician or other qualified professional. The report should identify the site examined and include the findings and interpretation.
Report this code for the peripheral DXA study, not for central measurements of the spine or hip. The CMS physician fee schedule recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff service, and no modifier represents the global service. Documentation should support the appendicular site measured and the service actually furnished. The descriptor encompasses one or more peripheral sites as a single study.
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 77081 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$28.35 to $30.56
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $30.23 | Unavailable |
| Metropolitan St. Louis, MO | $30.56 | Unavailable |
| Rest of Missouri | $28.35 | Unavailable |
How the 77081 rate is calculated
Each of 77081’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 · 77081
RVUs × geographic indexes × conversion factor
Work0.20
0.20 RVUs× 1.000 GPCI
Practice expense0.73
0.73 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.9500
Conversion factor
$33.4009
Medicare rate
$31.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77081
The CMS indicators that decide how 77081 is paid alongside other services.
CMS payment indicators · 77081
Bone density, appendicular skeleton
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
77081 without 26 · national office
$31.73
Bone density, appendicular skeleton
77081-26 · Professional component
$9.35
Pays only the interpretation and report.
77081 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77080DXA bone density scanAxial skeleton, spine or hip
- Choose 77081 for an appendicular site such as the forearm; choose 77080 for central DXA measurements, such as the spine or hip.
- 77085DXA bone densityAxial with fracture assessment
- 77085 combines axial DXA with vertebral fracture assessment. This code describes peripheral DXA and does not identify that axial fracture-assessment service.
- 77078CT bone densityAxial skeleton
- 77078 measures axial bone density using CT. This code is for DXA measurement at a peripheral skeletal site.
77081 billing questions
How does this differ from 77080?
This code is for DXA measurement at an appendicular, or peripheral, site. Code 77080 is for central DXA measurement, such as at the spine or hip.
Which modifiers identify the components?
Append modifier 26 for the professional interpretation or TC for the technical service, including equipment and staff. Report the global service without either modifier.
Can more than one peripheral site be included?
The service covers one or more appendicular sites. Document the site or sites measured; the code describes the study rather than a separate charge for each site.
What documentation supports reporting this code?
The record should identify the peripheral skeletal site measured and include the DXA findings and interpretation. The documentation should make clear that the study evaluated an appendicular site, not the spine or hip.
Should this code be used when vertebral fracture assessment is also performed?
Code 77085 describes axial DXA with vertebral fracture assessment. Use this code for a peripheral DXA study; the services should not be treated as interchangeable.
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
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