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Billing code 77046: Breast MRIMedicare rate & RVUs

Reports a noncontrast MRI examination of one breast, commonly used to assess breast implant integrity or another indication evaluated without contrast.

CMS RVU26DEffective Oct 1, 2026109 payment localities288 Medicare services in 2024

Medicare pays $213.10 for 77046 nationally in the office. Local office rates run $188.66–$288.93.

Medicare rate · 77046

Breast MRI

Swap in your local Medicare rate.

Work RVUs
1.41
Total RVUs
6.38
Global days
XXX

National rate · 2026

$213.10

Office setting, before claim adjustments.

See every locality for 77046 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 77046 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 77046 covers

This code covers MRI imaging of one breast performed without contrast. A common use is evaluating a breast implant for possible rupture or other integrity concerns. A technologist typically acquires the images in an outpatient imaging center or hospital, and a radiologist interprets them. The code is specific to a unilateral, noncontrast examination; it does not describe a contrast-enhanced breast MRI protocol.

Select the code when the documented examination covers one breast and uses no contrast. The order, imaging record, laterality, protocol, and radiologist’s report should support those details and the clinical indication. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the global service. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.

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 77046 pays more and less

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

109 payment localities

$188.66 to $288.93

$188.66$238.80$288.93
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

77046 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$191.42Unavailable
Alaska*$245.89Unavailable
Arizona$207.61Unavailable
Arkansas$188.66Unavailable
Atlanta$216.45Unavailable
Austin$222.30Unavailable
Bakersfield$228.46Unavailable
Baltimore/Surr. Cntys$226.46Unavailable
Beaumont$198.21Unavailable
Brazoria$211.35Unavailable

77046 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$188.66

$258.54

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
77046 office rate range by state
State / territoryOffice rate rangeLocalities
AK$245.891
AL$191.421
AR$188.661
AZ$207.611
CA$228.15–$288.9329
CO$223.441
CT$227.221
DC$244.991
DE$211.071
FL$207.44–$224.383
GA$196.07–$216.452
GU$234.161
HI$234.161
IA$197.431
ID$198.471
IL$200.61–$220.154
IN$199.651
KS$195.961
KY$194.751
LA$194.23–$203.892
MA$221.88–$246.322
MD$215.28–$244.993
ME$198.92–$210.522
MI$199.30–$209.462
MN$215.711
MO$190.53–$205.283
MS$189.661
MT$213.091
NC$201.091
ND$211.311
NE$198.681
NH$219.401
NJ$230.27–$242.352
NM$200.171
NV$212.761
NY$204.06–$249.495
OH$198.941
OK$194.991
OR$211.55–$231.172
PA$199.57–$221.212
PR$214.851
RI$219.051
SC$200.261
SD$211.101
TN$196.871
TX$198.21–$222.308
UT$203.011
VA$209.44–$244.992
VI$214.851
VT$209.981
WA$221.63–$251.902
WI$204.171
WV$193.041
WY$212.321

How the 77046 rate is calculated

Each of 77046’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 · 77046

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.41Practice expense 4.88Malpractice 0.09

6.3800 adjusted RVUs×$33.4009 conversion factor=$213.10

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 77046

The CMS indicators that decide how 77046 is paid alongside other services.

CMS payment indicators · 77046

Breast MRI

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
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

77046 without 26 · national office

$213.10

Breast MRI

77046-26 · Professional component

$66.13

Pays only the interpretation and report.

When to use modifier 26

77046 compared with similar codes

Compare codes

77046 vs 77047 vs 77048 vs 77049 vs 77065: national Medicare rates

Swap in your local Medicare rate.

  • 77046
    Breast MRI · 1.41 wRVU
    $213.10
  • 77047
    Breast MRI · 1.56 wRVU
    $216.44+$3.34
  • 77048
    Breast MRI · 2.05 wRVU
    $334.01+$120.91
  • 77049
    Breast MRI · 2.24 wRVU
    $339.69+$126.59
  • 77065
    Diagnostic mammogram · 0.79 wRVU
    $123.92−$89.18

How to choose

77047Breast MRI
77047 covers noncontrast MRI of both breasts; 77046 covers one breast.
77048Breast MRI
77048 is for a unilateral MRI performed without and with contrast, including CAD when performed. 77046 is a unilateral noncontrast examination.
77049Breast MRI
77049 covers bilateral MRI performed without and with contrast, including CAD when performed. 77046 covers one breast without contrast.
77065Diagnostic mammogram
77065 reports unilateral diagnostic mammography, not MRI. Choose based on the imaging modality and examination actually performed.

Codes related to 77046

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

Codes related to 77046
CodeHow it relatesNational office range
Same family
77047Breast MRIBilateral counterpart for breast MRI performed without contrast.$192.12–$291.78
Used instead
77048Breast MRIUnilateral breast MRI with and without contrast, including CAD when performed.$294.84–$454.37
77049Breast MRIBilateral breast MRI with and without contrast, including CAD when performed.$300.50–$460.15
77065Diagnostic mammogramUnilateral diagnostic mammography, a different breast-imaging method.$109.48–$168.11
77066Diagnostic mammogramBilateral diagnostic mammography, a different breast-imaging method.$138.55–$213.08

77046 billing questions

When should 77046 be used instead of 77047?

Use 77046 for a noncontrast MRI of one breast. Use 77047 when the noncontrast examination covers both breasts.

How does 77046 differ from 77048?

77046 is unilateral and performed without contrast. 77048 is unilateral and uses a without-and-with-contrast protocol, including CAD when performed.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; without either modifier, the claim represents the global service.

Does a multiple imaging reduction affect 77046?

CMS applies the diagnostic imaging multiple procedure reduction to both the professional and technical components.

What documentation supports reporting 77046?

The record should establish the clinical indication, the breast examined, the noncontrast protocol, the imaging performed, and the radiologist’s interpretation.

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 77046PPRRVU2026_Oct_nonQPP.csv, line 8,949 (RVU26D)

Open CMS sourceHow we calculate rates

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