Billing code 77049: Breast MRIMedicare rate & RVUs

Medicare pays $339.69 for 77049 nationally in the office. Local office rates run $300.50–$460.15.

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

What 77049 covers

This service images both breasts using MRI before and after contrast, with computer-aided detection included in the reported service. Radiologists interpret the images in hospital imaging departments and outpatient imaging centers. Common clinical situations include screening patients at elevated breast cancer risk and assessing known breast cancer, such as its extent or response to treatment.

Select this code when the study covers both breasts and includes imaging before and after contrast; the record should support the indication, bilateral examination, contrast protocol, and interpretation. CAD is included rather than reported as a separate service under this code. The code represents bilateral imaging, so modifier 50 does not increase payment. A radiologist may report the professional component with modifier 26, the facility may report the technical component with modifier TC, or one entity may bill the global service without either modifier. When multiple diagnostic imaging procedures are furnished, the CMS 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 77049 pays more and less

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

109 of 109 payment localities

77049 rates by state

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

How the 77049 rate is calculated

Each of 77049’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.

Payment rules and modifiers for 77049

The CMS indicators that decide how 77049 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

77049 compared with similar codes

How to choose

77048Breast MRI

Both describe breast MRI before and after contrast with CAD; 77049 is bilateral, while 77048 is unilateral.

77047Breast MRI

This code is for bilateral MRI without contrast. Choose 77049 when the bilateral examination includes imaging before and after contrast with CAD.

77066Diagnostic mammogram

77066 is bilateral diagnostic mammography, not MRI. The modality and examination protocol determine which code describes the service performed.

77067Screening mammogram

77067 is bilateral screening mammography. Use 77049 for the bilateral breast MRI service with contrast and CAD, not for mammography.

Codes related to 77049

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

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

Open CMS sourceHow we calculate rates