CPT code 77085: DXA bone density, axial with fracture assessment2026 Medicare rate & RVUs in Georgia

Reports axial DXA of the hips, pelvis, or spine with vertebral fracture assessment when bone density and vertebral fracture evaluation are performed together.

CMS RVU26DEffective Oct 1, 20262 payment localities110.6K Medicare services in 2024

Medicare pays $50.01–$55.44 for 77085 in the office in Georgia, from Rest of Georgia to Atlanta, GA. Which amount applies depends on the service address.

$50.01–$55.44Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Georgia
  2. What 77085 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 77085 covers

This service combines DXA bone density measurement of the axial skeleton, such as the hips, pelvis, or spine, with evaluation for vertebral fractures. It is commonly performed in outpatient imaging centers and hospitals for patients being evaluated for osteoporosis or vertebral fracture risk. Imaging staff acquire the study, and a qualified interpreting professional reviews the bone density and fracture-assessment findings and prepares a report.

Report 77085 when the axial DXA study includes vertebral fracture assessment; the documentation should identify the sites examined and support both the bone-density study and its interpretation. The code may be billed globally, or the interpretation may be reported with modifier 26 and the equipment-and-staff portion with modifier TC. The record should make clear which portion the billing entity furnished when a component modifier is used.

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 77085 pays more and less in Georgia

77085 office and facility rates by payment locality
Payment localityOfficeFacility
Atlanta, GA$55.44Unavailable
Rest of Georgia$50.01Unavailable

How the 77085 rate is calculated

Each of 77085’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 · 77085

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.29

0.29 RVUs× 1.000 GPCI

Practice expense1.30

1.30 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

1.6300

Conversion factor

$33.4009

Medicare rate

$54.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 77085

The CMS indicators that decide how 77085 is paid alongside other services.

CMS payment indicators · 77085

DXA bone density, axial with fracture assessment

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

77085 without 26 · national office

$54.44

DXA bone density, axial with fracture assessment

77085-26 · Professional component

$14.36

Pays only the interpretation and report.

When to use modifier 26

77085 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 77085

    DXA bone density, axial with fracture assessment0.29 wRVU

    $54.44

  • 77080

    DXA bone density scan, axial skeleton, spine or hip0.2 wRVU

    $39.41−$15.03

  • 77086

    Vertebral fracture assessment, DXA imaging only0.17 wRVU

    $34.74−$19.70

  • 77081

    Bone density, appendicular skeleton0.2 wRVU

    $31.73−$22.71

  • 77078

    CT bone density, axial skeleton0.24 wRVU

    $98.87+$44.43

How to choose

77080DXA bone density scanAxial skeleton, spine or hip
Both describe axial DXA, but 77085 includes vertebral fracture assessment. Choose 77080 when that assessment is not part of the study.
77086Vertebral fracture assessmentDXA imaging only
77086 represents vertebral fracture assessment via DXA, while 77085 combines that assessment with axial bone-density measurement.
77081Bone densityAppendicular skeleton
77081 is for appendicular DXA, such as a forearm site; 77085 is for axial sites such as the hips, pelvis, or spine.
77078CT bone densityAxial skeleton
77078 uses CT to assess bone density. 77085 is the DXA service that includes axial bone-density measurement and vertebral fracture assessment.

77085 billing questions

When should 77085 be used instead of 77080?

Use 77085 when axial DXA is performed with vertebral fracture assessment. Use 77080 for axial DXA without that assessment.

Can 77086 also be reported for the same vertebral fracture assessment?

77085 includes vertebral fracture assessment with the axial DXA. Do not report 77086 again for that same included assessment.

How do modifiers 26 and TC apply?

Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical portion involving equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports reporting 77085?

Document the axial sites examined, the DXA findings, the vertebral fracture assessment, and the interpreting professional’s report.

Is a DXA of the forearm reported with 77085?

No. 77085 describes axial sites such as the hips, pelvis, or spine; appendicular DXA, such as a forearm study, is reported with 77081.

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
RVUs for 77085PPRRVU2026_Oct_nonQPP.csv, line 9,016 (RVU26D)

Open CMS sourceHow we calculate rates

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