CPT code 77086: Vertebral fracture assessment, DXA imaging only2026 Medicare rate & RVUs in Montana
Reports DXA-based vertebral imaging used to identify vertebral fractures, typically during osteoporosis evaluation when fracture status will guide care.
In Montana, Medicare pays $34.74 for 77086 in the office.
Check a contract rate as a % of Medicare · 77086 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 77086 covers
This service uses a DXA scanner to obtain images of the vertebral spine for assessment of vertebral fractures. It is distinct from measuring bone density: the clinician evaluates the vertebrae for fracture findings, often in patients being assessed for osteoporosis or suspected to have an unrecognized vertebral fracture. A technologist typically acquires the images in a bone-density center or imaging department, and a qualified practitioner interprets them and prepares a report.
Report 77086 for the vertebral fracture assessment itself, supported by documentation of the DXA imaging and interpretation. When axial bone-density measurement and vertebral fracture assessment are both performed, distinguish this service from 77085, which combines axial DXA with vertebral fracture assessment. CMS recognizes professional and technical components: modifier 26 identifies interpretation and report, modifier TC identifies equipment and staff, and no 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.
How Montana compares for 77086
Across 109 of 109 payment localities, the office rate for 77086 runs from $30.41 in Arkansas to $47.60 in San Benito County, CA. Montana pays $34.74. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$34.74
- Los Angeles, CA · California$39.94+$5.20
- Washington, DC area · District of Columbia$40.17+$5.43
- Miami, FL · Florida$36.92+$2.18
- Chicago, IL · Illinois$35.78+$1.04
- Manhattan, NY · New York$40.09+$5.35
- Alaska · Alaska$39.12+$4.38
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $30.90 | — |
| ArkansasArkansas | $30.41 | — |
| ArizonaArizona | $33.76 | — |
| Bakersfield, CACalifornia | $37.31 | — |
| Chico, CACalifornia | $37.25 | — |
| El Centro, CACalifornia | $37.25 | — |
| Fresno, CACalifornia | $37.25 | — |
| Hanford, CACalifornia | $37.25 | — |
| Madera, CACalifornia | $37.25 | — |
| Merced, CACalifornia | $37.25 | — |
| Modesto, CACalifornia | $37.25 | — |
| Napa, CACalifornia | $43.79 | — |
| Oxnard, CACalifornia | $39.81 | — |
| Redding, CACalifornia | $37.25 | — |
| Rest of CaliforniaCalifornia | $37.25 | — |
| Riverside, CACalifornia | $37.47 | — |
| Sacramento, CACalifornia | $39.26 | — |
| Salinas, CACalifornia | $39.12 | — |
| San Diego, CACalifornia | $40.17 | — |
| Marin County, CACalifornia | $46.56 | — |
| San Francisco, CACalifornia | $46.53 | — |
| San Benito County, CACalifornia | $47.60 | — |
| Santa Clara County, CACalifornia | $47.51 | — |
| San Luis Obispo, CACalifornia | $38.47 | — |
| Santa Cruz, CACalifornia | $40.65 | — |
| Santa Maria, CACalifornia | $39.30 | — |
| Santa Rosa, CACalifornia | $41.07 | — |
| Stockton, CACalifornia | $37.25 | — |
| Vallejo, CACalifornia | $43.76 | — |
| Visalia, CACalifornia | $37.25 | — |
| Yuba City, CACalifornia | $37.25 | — |
| ColoradoColorado | $36.48 | — |
| ConnecticutConnecticut | $37.18 | — |
| DelawareDelaware | $34.36 | — |
| Fort Lauderdale, FLFlorida | $35.65 | — |
| Rest of FloridaFlorida | $33.82 | — |
| Atlanta, GAGeorgia | $35.34 | — |
| Rest of GeorgiaGeorgia | $31.80 | — |
| Hawaii, Guam, HIHawaii | $38.35 | — |
| IowaIowa | $31.92 | — |
| IdahoIdaho | $32.11 | — |
| East St. Louis, ILIllinois | $33.14 | — |
| Rest of IllinoisIllinois | $32.64 | — |
| Suburban Chicago, ILIllinois | $36.06 | — |
| IndianaIndiana | $32.32 | — |
| KansasKansas | $31.68 | — |
| KentuckyKentucky | $31.53 | — |
| New Orleans, LALouisiana | $33.15 | — |
| Rest of LouisianaLouisiana | $31.44 | — |
| Metropolitan Boston, MAMassachusetts | $40.40 | — |
| Rest of MassachusettsMassachusetts | $36.20 | — |
| Baltimore area, MDMaryland | $37.06 | — |
| Rest of MarylandMaryland | $35.08 | — |
| Rest of MaineMaine | $32.21 | — |
| Southern Maine, MEMaine | $34.23 | — |
| Detroit, MIMichigan | $34.20 | — |
| Rest of MichiganMichigan | $32.35 | — |
| MinnesotaMinnesota | $35.09 | — |
| Metropolitan Kansas City, MOMissouri | $32.99 | — |
| Metropolitan St. Louis, MOMissouri | $33.38 | — |
| Rest of MissouriMissouri | $30.80 | — |
| MississippiMississippi | $30.62 | — |
| North CarolinaNorth Carolina | $32.59 | — |
| North DakotaNorth Dakota | $34.34 | — |
| NebraskaNebraska | $32.14 | — |
| New HampshireNew Hampshire | $35.82 | — |
| Northern New JerseyNew Jersey | $39.68 | — |
| Rest of New JerseyNew Jersey | $37.64 | — |
| New MexicoNew Mexico | $32.51 | — |
| NevadaNevada | $34.65 | — |
| NYC suburbs and Long Island, NYNew York | $41.04 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $37.83 | — |
| Queens, NYNew York | $40.56 | — |
| Rest of New YorkNew York | $33.12 | — |
| OhioOhio | $32.27 | — |
| OklahomaOklahoma | $31.55 | — |
| Portland, OROregon | $37.81 | — |
| Rest of OregonOregon | $34.42 | — |
| Metropolitan Philadelphia, PAPennsylvania | $36.13 | — |
| Rest of PennsylvaniaPennsylvania | $32.37 | — |
| Puerto RicoPuerto Rico | $35.04 | — |
| Rhode IslandRhode Island | $35.71 | — |
| South CarolinaSouth Carolina | $32.48 | — |
| South DakotaSouth Dakota | $34.29 | — |
| TennesseeTennessee | $31.84 | — |
| Austin, TXTexas | $36.32 | — |
| Beaumont, TXTexas | $32.13 | — |
| Brazoria, TXTexas | $34.38 | — |
| Dallas, TXTexas | $34.58 | — |
| Fort Worth, TXTexas | $34.30 | — |
| Galveston, TXTexas | $34.47 | — |
| Houston, TXTexas | $34.83 | — |
| Rest of TexasTexas | $33.22 | — |
| UtahUtah | $32.97 | — |
| VirginiaVirginia | $34.06 | — |
| Virgin Islands, VIUnited States Virgin Islands | $35.04 | — |
| VermontVermont | $34.12 | — |
| Rest of WashingtonWashington | $36.16 | — |
| King County, WAWashington | $41.34 | — |
| WisconsinWisconsin | $33.08 | — |
| West VirginiaWest Virginia | $31.31 | — |
| WyomingWyoming | $34.56 | — |
77086 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.
$30.41
$42.43
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 | $39.12 | 1 |
| AL | $30.90 | 1 |
| AR | $30.41 | 1 |
| AZ | $33.76 | 1 |
| CA | $37.25–$47.60 | 29 |
| CO | $36.48 | 1 |
| CT | $37.18 | 1 |
| DC | $40.17 | 1 |
| DE | $34.36 | 1 |
| FL | $33.82–$36.92 | 3 |
| GA | $31.80–$35.34 | 2 |
| GU | $38.35 | 1 |
| HI | $38.35 | 1 |
| IA | $31.92 | 1 |
| ID | $32.11 | 1 |
| IL | $32.64–$36.06 | 4 |
| IN | $32.32 | 1 |
| KS | $31.68 | 1 |
| KY | $31.53 | 1 |
| LA | $31.44–$33.15 | 2 |
| MA | $36.20–$40.40 | 2 |
| MD | $35.08–$40.17 | 3 |
| ME | $32.21–$34.23 | 2 |
| MI | $32.35–$34.20 | 2 |
| MN | $35.09 | 1 |
| MO | $30.80–$33.38 | 3 |
| MS | $30.62 | 1 |
| MT | $34.74 | 1 |
| NC | $32.59 | 1 |
| ND | $34.34 | 1 |
| NE | $32.14 | 1 |
| NH | $35.82 | 1 |
| NJ | $37.64–$39.68 | 2 |
| NM | $32.51 | 1 |
| NV | $34.65 | 1 |
| NY | $33.12–$41.04 | 5 |
| OH | $32.27 | 1 |
| OK | $31.55 | 1 |
| OR | $34.42–$37.81 | 2 |
| PA | $32.37–$36.13 | 2 |
| PR | $35.04 | 1 |
| RI | $35.71 | 1 |
| SC | $32.48 | 1 |
| SD | $34.29 | 1 |
| TN | $31.84 | 1 |
| TX | $32.13–$36.32 | 8 |
| UT | $32.97 | 1 |
| VA | $34.06–$40.17 | 2 |
| VI | $35.04 | 1 |
| VT | $34.12 | 1 |
| WA | $36.16–$41.34 | 2 |
| WI | $33.08 | 1 |
| WV | $31.31 | 1 |
| WY | $34.56 | 1 |
How the 77086 rate is calculated
Each of 77086’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 · 77086
RVUs × geographic indexes × conversion factor
Work0.17
0.17 RVUs× 1.000 GPCI
Practice expense0.85
0.85 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.0400
Conversion factor
$33.4009
Medicare rate
$34.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,019
- Code
- 77086
- Physician work
- 0.17
- Practice expense
- 0.85
- Malpractice
- 0.02
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.17 | × 1.000 | 0.1700 |
| Practice expense | 0.85 | × 1.000 | 0.8500 |
| Malpractice | 0.02 | × 0.998 | 0.0200 |
| Total RVUs | 1.0400 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$34.74
Office: (0.17 × 1 + 0.85 × 1 + 0.02 × 0.998) × $33.4009 = $34.74
Payment rules and modifiers for 77086
The CMS indicators that decide how 77086 is paid alongside other services.
CMS payment indicators · 77086
Vertebral fracture assessment, DXA imaging only
| 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
77086 without 26 · national office
$34.74
Vertebral fracture assessment, DXA imaging only
77086-26 · Professional component
$8.02
Pays only the interpretation and report.
How 77086 has changed in Montana
77086 · Office / nonfacility
$34.74
Effective 2026-10-01
The base rate is $1.44 higher than on 2025-10-01, moving from $33.30 to $34.74 (4.3%).
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
$33.30changed to$34.74
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.84 changed to 0.85
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$33.61changed to$33.30
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.82 changed to 0.84
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$33.06changed to$33.61
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$33.53changed to$33.06
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.80 changed to 0.82
January 1, 2023
RVU23A
$33.55changed to$33.53
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.78 changed to 0.80
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$34.18changed to$33.55
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.79 changed to 0.78
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$35.23changed to$34.18
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.78 changed to 0.79
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$36.13changed to$35.23
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.80 changed to 0.78
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$37.53changed to$36.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.84 changed to 0.80
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$36.20changed to$37.53
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.81 changed to 0.84
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$35.97changed to$36.20
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$36.10changed to$35.97
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$35.92changed to$36.10
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$35.92
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $34.74 | Not available in this setting | RVU26D |
| 2026-07-01 | $34.74 | Not available in this setting | RVU26C |
| 2026-04-01 | $34.74 | Not available in this setting | RVU26B |
| 2026-01-01 | $34.74 | Not available in this setting | RVU26A |
| 2025-10-01 | $33.30 | Not available in this setting | RVU25D |
| 2025-07-01 | $33.30 | Not available in this setting | RVU25C |
| 2025-04-01 | $33.30 | Not available in this setting | RVU25B |
| 2025-01-01 | $33.30 | Not available in this setting | RVU25A |
| 2024-10-01 | $33.61 | Not available in this setting | RVU24D |
| 2024-07-01 | $33.61 | Not available in this setting | RVU24C |
| 2024-04-01 | $33.61 | Not available in this setting | RVU24B |
| 2024-03-09 | $33.61 | Not available in this setting | RVU24AR |
| 2024-01-01 | $33.06 | Not available in this setting | RVU24A |
| 2023-10-01 | $33.53 | Not available in this setting | RVU23D |
| 2023-07-01 | $33.53 | Not available in this setting | RVU23C |
| 2023-04-01 | $33.53 | Not available in this setting | RVU23B |
| 2023-01-01 | $33.53 | Not available in this setting | RVU23A |
| 2022-10-01 | $33.55 | Not available in this setting | RVU22D |
| 2022-07-01 | $33.55 | Not available in this setting | RVU22C |
| 2022-04-01 | $33.55 | Not available in this setting | RVU22B |
| 2022-01-01 | $33.55 | Not available in this setting | RVU22A |
| 2021-10-01 | $34.18 | Not available in this setting | RVU21D |
| 2021-07-01 | $34.18 | Not available in this setting | RVU21C |
| 2021-04-01 | $34.18 | Not available in this setting | RVU21B |
| 2021-01-01 | $34.18 | Not available in this setting | RVU21A |
| 2020-10-01 | $35.23 | Not available in this setting | RVU20D |
| 2020-07-01 | $35.23 | Not available in this setting | RVU20C |
| 2020-04-01 | $35.23 | Not available in this setting | RVU20B |
| 2020-01-01 | $35.23 | Not available in this setting | RVU20A |
| 2019-10-01 | $36.13 | Not available in this setting | RVU19D |
| 2019-07-01 | $36.13 | Not available in this setting | RVU19C |
| 2019-04-01 | $36.13 | Not available in this setting | RVU19B |
| 2019-01-01 | $36.13 | Not available in this setting | RVU19A |
| 2018-10-01 | $37.53 | Not available in this setting | RVU18D |
| 2018-07-01 | $37.53 | Not available in this setting | RVU18C |
| 2018-04-01 | $37.53 | Not available in this setting | RVU18B |
| 2018-01-01 | $37.53 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $36.20 | Not available in this setting | RVU17D |
| 2017-07-01 | $36.20 | Not available in this setting | RVU17C |
| 2017-04-01 | $36.20 | Not available in this setting | RVU17B |
| 2017-01-01 | $36.20 | Not available in this setting | RVU17A |
| 2016-10-01 | $35.97 | Not available in this setting | RVU16D |
| 2016-07-01 | $35.97 | Not available in this setting | RVU16C |
| 2016-04-01 | $35.97 | Not available in this setting | RVU16B |
| 2016-01-01 | $35.97 | Not available in this setting | RVU16A |
| 2015-10-01 | $36.10 | Not available in this setting | RVU15D |
| 2015-07-01 | $36.10 | Not available in this setting | RVU15C |
| 2015-04-01 | $35.92 | Not available in this setting | RVU15B |
| 2015-01-01 | $35.92 | Not available in this setting | 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 Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
77086 billing questions
How is 77086 different from 77085?
77086 represents DXA-based vertebral fracture assessment. Code 77085 represents axial DXA bone-density measurement together with vertebral fracture assessment, so do not report 77086 separately for the same assessment included in 77085.
Can 77086 be reported with 77080?
77080 represents axial DXA bone-density measurement, while 77086 represents vertebral fracture assessment. The record should identify each service actually performed and interpreted.
Which modifier identifies the interpretation?
Append modifier 26 for the professional component, which is the interpretation and report. Modifier TC identifies the technical component, including equipment and staff.
What does billing 77086 without a modifier represent?
An unmodified claim represents the global service, including both the professional interpretation and the technical component.
What documentation supports 77086?
Document the DXA-based vertebral imaging, the clinical reason for assessing vertebral fracture status, and the interpreting practitioner's findings and report.
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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