CPT code 77090: TBS processing, data preparation and transmission2026 Medicare rate & RVUs in California
Reports preparation and transfer of DXA data for trabecular bone score analysis, before the technical calculation and fracture-risk interpretation are performed.
Medicare pays $3.11–$4.03 for 77090 in the office in California, from Chico, CA to San Benito County, CA. 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 77090 covers
Trabecular bone score (TBS) is a software-based analysis of lumbar-spine DXA data that provides information about bone microarchitecture for fracture-risk assessment. Code 77090 covers the technical workflow of preparing the DXA data and transmitting it for analysis; it does not describe the resulting TBS calculation or a clinician’s interpretation. Imaging technologists or other bone-density staff typically handle this step in an outpatient densitometry workflow.
Select 77090 when the documented service is data preparation and transfer for TBS analysis, rather than calculation alone (77091) or interpretation and reporting (77092). Documentation should identify the source DXA data and show that the preparation and transmission were performed. CMS classifies 77090 as technical-component-only, with interpretation covered by a separate code. CMS assigns no physician-work RVUs to this 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 77090 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$3.11 to $4.03
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $3.13 | Unavailable |
| Chico, CA | $3.11 | Unavailable |
| El Centro, CA | $3.11 | Unavailable |
| Fresno, CA | $3.11 | Unavailable |
| Hanford, CA | $3.11 | Unavailable |
| Los Angeles, CA | $3.38 | Unavailable |
| Madera, CA | $3.11 | Unavailable |
| Marin County, CA | $3.92 | Unavailable |
| Merced, CA | $3.11 | Unavailable |
| Modesto, CA | $3.11 | Unavailable |
| Napa, CA | $3.69 | Unavailable |
| Oxnard, CA | $3.37 | Unavailable |
| Redding, CA | $3.11 | Unavailable |
| Rest of California | $3.11 | Unavailable |
| Riverside, CA | $3.21 | Unavailable |
| Sacramento, CA | $3.29 | Unavailable |
| Salinas, CA | $3.28 | Unavailable |
| San Benito County, CA | $4.03 | Unavailable |
| San Diego, CA | $3.38 | Unavailable |
| San Francisco, CA | $3.91 | Unavailable |
| San Luis Obispo, CA | $3.22 | Unavailable |
| Santa Clara County, CA | $3.99 | Unavailable |
| Santa Cruz, CA | $3.43 | Unavailable |
| Santa Maria, CA | $3.29 | Unavailable |
| Santa Rosa, CA | $3.46 | Unavailable |
| Stockton, CA | $3.11 | Unavailable |
| Vallejo, CA | $3.68 | Unavailable |
| Visalia, CA | $3.11 | Unavailable |
| Yuba City, CA | $3.11 | Unavailable |
How the 77090 rate is calculated
Each of 77090’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 · 77090
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.08
0.08 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.0900
Conversion factor
$33.4009
Medicare rate
$3.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77090
The CMS indicators that decide how 77090 is paid alongside other services.
CMS payment indicators · 77090
TBS processing, data preparation and transmission
| 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 | 3 | Technical component only. |
77090 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77091Trabecular bone scoreTechnical calculation only
- Choose 77090 for preparing and transferring DXA data for analysis; choose 77091 for the TBS technical calculation.
- 77092TBS interpretationProfessional component only
- 77090 covers data preparation and transmission. 77092 covers the clinician’s TBS interpretation and fracture-risk report.
- 77089Trabecular bone scoreComplete service with fracture-risk assessment
- 77089 covers TBS technical calculation with interpretation and reporting; 77090 is limited to data preparation and transmission.
77090 billing questions
How is 77090 different from 77091?
77090 covers preparing and transmitting data for TBS analysis. 77091 describes the technical calculation itself.
Does 77090 include the fracture-risk interpretation?
No. CMS identifies 77090 as technical-component-only; interpretation and reporting are covered by a separate code, 77092.
When would 77089 be considered instead?
77089 represents a TBS service that includes technical calculation with interpretation and reporting. 77090 describes the data-preparation and transmission step.
What documentation supports 77090?
Document the DXA data used and the technical work to prepare and transmit those data for TBS analysis.
Can 77090 be reported for the DXA scan itself?
No. 77090 describes preparing and transmitting data for TBS analysis, not acquiring the DXA images.
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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