$356.49
Both describe breast MRI before and after contrast with CAD; 77049 is bilateral, while 77048 is unilateral.
On this page
CMS RVU26D · Effective 2026-10-01
77049 Breast MRI Medicare reimbursement rates in Connecticut
Bilateral breast MRI performed before and after contrast, with computer-aided detection, for high-risk screening or diagnostic assessment of breast disease. Compare 77049 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 77049 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$362.29
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast imaging
About 77049: Bilateral breast MRI with contrast and CAD
Bilateral breast MRI performed before and after contrast, with computer-aided detection, for high-risk screening or diagnostic assessment of breast disease.
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.
CMS billing rules for 77049
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU2.24 · 22%
- Practice expense (office) RVU7.77 · 76%
- Malpractice RVU0.16 · 2%
138.8K
Medicare services in 2024 · #467 by national volume
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.
77049 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$230.58
This code is for bilateral MRI without contrast. Choose 77049 when the bilateral examination includes imaging before and after contrast with CAD.
$167.56
77066 is bilateral diagnostic mammography, not MRI. The modality and examination protocol determine which code describes the service performed.
$134.79
77067 is bilateral screening mammography. Use 77049 for the bilateral breast MRI service with contrast and CAD, not for mammography.
Compare 77049 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$362.29
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 77049 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,958
- Code
- 77049
- Physician work
- 2.24
- Practice expense
- 7.77
- Malpractice
- 0.16
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.24 | × 1.020 | 2.2848 |
| Practice expense | 7.77 | × 1.077 | 8.3683 |
| Malpractice | 0.16 | × 1.210 | 0.1936 |
| Total RVUs | 10.8467 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$362.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.24 | 1.02 |
| Practice expense | 7.77 | 1.077 |
| Malpractice | 0.16 | 1.21 |
(2.24 × 1.02 + 7.77 × 1.077 + 0.16 × 1.21) × $33.4009 = $362.29
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
77049 billing questions
When should 77049 be selected instead of 77048?
Use 77049 for a bilateral breast MRI performed before and after contrast with CAD. Code 77048 describes the corresponding unilateral examination.
Is CAD reported separately with 77049?
No. CAD is included in this code’s service; do not report a separate CAD code for the same breast MRI.
Can the radiologist and imaging facility report separate components?
Yes. The interpreting professional may report modifier 26, and the entity providing the equipment and staff may report modifier TC. Without either modifier, the claim represents the global service.
Should modifier 50 be appended for the two breasts?
The code already represents bilateral imaging. CMS pricing does not increase when modifier 50 is appended.
How does the multiple-procedure reduction affect this code?
When the CMS diagnostic imaging multiple-procedure reduction applies, it affects both the professional and technical components of 77049.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,95577048,,Mri breast c-+ w/cad uni,A,,2.05,7.80,,7.80,NA,0.15,10.00,10.00,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,95677048,26,Mri breast c-+ w/cad uni,A,,2.05,0.73,,0.73,,0.12,2.90,2.90,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,95777048,TC,Mri breast c-+ w/cad uni,A,,0.00,7.07,,7.07,NA,0.03,7.10,7.10,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,0.00,0.00,0.00
8,95877049,,Mri breast c-+ w/cad bi,A,,2.24,7.77,,7.77,NA,0.16,10.17,10.17,1,XXX,0.00,0.00,0.00,4,2,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,95977049,26,Mri breast c-+ w/cad bi,A,,2.24,0.80,,0.80,,0.13,3.17,3.17,1,XXX,0.00,0.00,0.00,4,2,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,96077049,TC,Mri breast c-+ w/cad bi,A,,0.00,6.97,,6.97,NA,0.03,7.00,7.00,1,XXX,0.00,0.00,0.00,4,2,0,0,0,9,,33.4009,02,0,88,0.00,0.00,0.00
8,96177053,,X-ray of mammary duct,A,,0.35,1.21,,1.21,NA,0.03,1.59,1.59,1,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,7.36,7.36,0.09
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808