$167.56
77066 covers diagnostic mammography of both breasts in one session; 77065 covers one breast, identified with RT or LT.
On this page
CMS RVU26D · Effective 2026-10-01
77065 Diagnostic mammogram Medicare reimbursement rates in Connecticut
Diagnostic mammography of a single breast, including computer-aided detection when used, reported for a symptom, a callback from screening, or follow-up of a known finding. Compare 77065 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 77065 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
$132.22
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.
Radiology
About 77065: Unilateral diagnostic mammography with CAD
Diagnostic mammography of a single breast, including computer-aided detection when used, reported for a symptom, a callback from screening, or follow-up of a known finding.
This service is a problem-focused mammographic exam of one breast. It is ordered for a palpable lump, focal pain, nipple discharge, or skin change; a callback for an area of concern on screening; or short-interval follow-up of a probably benign finding. A technologist obtains views tailored to the question, such as spot compression or magnification views when indicated. A radiologist interprets the images and issues a report with a BI-RADS assessment and recommendations. A targeted breast ultrasound may also be performed to evaluate the area of concern.
Report 77065 when one breast is imaged diagnostically; use 77066 when both breasts receive diagnostic mammography. Identify the examined breast with RT or LT. Computer-aided detection, when performed, is included rather than separately billed. The order and report should document the reason for the diagnostic exam and the side examined. For component billing, modifier 26 identifies the radiologist's interpretation, while modifier TC identifies equipment and technologist work. An entity furnishing both components reports the global service without either component modifier.
CMS billing rules for 77065
- 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.
Where the value comes from
- Work RVU0.79 · 21%
- Practice expense (office) RVU2.86 · 77%
- Malpractice RVU0.06 · 2%
691.9K
Medicare services in 2024 · #186 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.
77065 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$134.79
77067 is a bilateral screening study; 77065 is a unilateral diagnostic exam for a symptom, screening callback, or follow-up finding.
77061
No office rateBreast tomosynthesis uni
77061 is a unilateral diagnostic tomosynthesis add-on for payers recognizing that CPT code, not a substitute for 77065. Medicare reports G0279 with 77065 when diagnostic tomosynthesis is performed.
Compare 77065 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
$132.22
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 77065 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,976
- Code
- 77065
- Physician work
- 0.79
- Practice expense
- 2.86
- Malpractice
- 0.06
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.79 | × 1.020 | 0.8058 |
| Practice expense | 2.86 | × 1.077 | 3.0802 |
| Malpractice | 0.06 | × 1.210 | 0.0726 |
| Total RVUs | 3.9586 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$132.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.79 | 1.02 |
| Practice expense | 2.86 | 1.077 |
| Malpractice | 0.06 | 1.21 |
(0.79 × 1.02 + 2.86 × 1.077 + 0.06 × 1.21) × $33.4009 = $132.22
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.
77065 billing questions
When should the bilateral diagnostic code be used instead?
Report 77066 when both breasts are imaged diagnostically at the same session. Use 77065 when only one breast receives a diagnostic exam, even if the other breast had a screening study earlier.
Can CAD be billed separately with this code?
No. Computer-aided detection is included when performed; do not report a separate CAD code.
How is a same-day screening followed by a diagnostic exam reported to Medicare?
When a screening mammogram leads to a diagnostic mammogram on the same day, report the screening and diagnostic codes and append modifier GG to the diagnostic code.
How is diagnostic tomosynthesis reported with this code for Medicare?
Medicare uses add-on code G0279 for diagnostic digital breast tomosynthesis performed with 77065; it does not replace the diagnostic mammography code.
Which modifiers identify the professional and technical components?
A radiologist billing only the interpretation reports 77065-26. A provider billing only image acquisition reports 77065-TC; an entity furnishing both components reports 77065 without either component modifier.
How is the examined breast identified?
Append RT or LT to 77065 to identify the breast examined.
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.
8,97377063,,Breast tomosynthesis bi,A,,0.59,0.91,,0.91,NA,0.03,1.53,1.53,1,ZZZ,0.00,0.00,0.00,0,2,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97477063,26,Breast tomosynthesis bi,A,,0.59,0.21,,0.21,,0.03,0.83,0.83,1,ZZZ,0.00,0.00,0.00,0,2,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97577063,TC,Breast tomosynthesis bi,A,,0.00,0.70,,0.70,NA,0.00,0.70,0.70,1,ZZZ,0.00,0.00,0.00,0,2,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97677065,,Dx mammo incl cad uni,A,,0.79,2.86,,2.86,NA,0.06,3.71,3.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97777065,26,Dx mammo incl cad uni,A,,0.79,0.29,,0.29,,0.05,1.13,1.13,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97877065,TC,Dx mammo incl cad uni,A,,0.00,2.57,,2.57,NA,0.01,2.58,2.58,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,97977066,,Dx mammo incl cad bi,A,,0.98,3.64,,3.64,NA,0.08,4.70,4.70,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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