$39.29
77089 covers TBS calculation with interpretation and a fracture-risk report. 77091 is for the technical calculation only, with interpretation covered separately.
On this page
CMS RVU26D · Effective 2026-10-01
77091 Trabecular bone score Medicare reimbursement rates in Delaware
Reports the technical computation of a trabecular bone score from DXA data when the calculation is performed separately from data preparation and interpretation. Compare 77091 office and facility rates across CMS payment localities in Delaware.
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 77091 in Delaware?
Delaware 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
$26.37
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Bone density analysis
About 77091: Trabecular bone score technical calculation
Reports the technical computation of a trabecular bone score from DXA data when the calculation is performed separately from data preparation and interpretation.
This service calculates a trabecular bone score from DXA image data, generally from a lumbar spine bone-density study. The score analyzes image texture as an indicator of trabecular bone microarchitecture and can contribute to fracture-risk assessment. DXA technologists or other technical staff typically perform the software-based calculation in a bone-density or radiology setting; the calculation does not itself provide a clinician’s interpretation.
Report 77091 for the technical calculation when that work is separately performed. CMS classifies it as a technical-component-only service, with interpretation covered by a separate code; 77092 is used for the interpretation and report. Documentation should identify the DXA data processed and support completion of the calculation. Distinguish this service from 77090, which covers preparation and transmission of data, and from 77089, which describes a TBS service that includes calculation with interpretation and a fracture-risk report.
CMS billing rules for 77091
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.79 · 99%
- Malpractice RVU0.01 · 1%
6.4K
Medicare services in 2024 · #1715 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.
77091 compared with similar codes
Office rates for Delaware, from the same CMS release.
$2.94
77090 covers preparation and transmission of DXA data for analysis elsewhere; 77091 covers the technical TBS calculation.
$9.98
77092 reports the interpretation and report for TBS. 77091 covers the technical calculation.
$38.99
77080 reports axial DXA bone-density measurement. 77091 reports a TBS calculation using DXA data, not the density measurement itself.
Compare 77091 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
Delaware →
Office / nonfacility
$26.37
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 77091 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
9,024
- Code
- 77091
- Physician work
- 0.00
- Practice expense
- 0.79
- Malpractice
- 0.01
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.005 | 0.0000 |
| Practice expense | 0.79 | × 0.988 | 0.7805 |
| Malpractice | 0.01 | × 0.899 | 0.0090 |
| Total RVUs | 0.7895 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$26.37
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.005 |
| Practice expense | 0.79 | 0.988 |
| Malpractice | 0.01 | 0.899 |
(0 × 1.005 + 0.79 × 0.988 + 0.01 × 0.899) × $33.4009 = $26.37
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.
77091 billing questions
Does 77091 include the clinician’s interpretation?
No. It covers the technical calculation only; the interpretation and report are covered by a separate code, 77092.
How does 77091 differ from 77090?
77091 represents the technical TBS calculation. 77090 represents preparation and transmission of DXA data for analysis elsewhere.
When would 77089 be considered instead?
77089 describes a TBS service that includes calculation with interpretation and a fracture-risk report. Use the code that reflects the service actually performed and reported.
What documentation supports 77091?
Document the DXA data used and completion of the technical TBS calculation. The interpretation and report belong to the separate interpretation service.
Is this the code for the DXA scan itself?
No. 77091 reports the TBS technical calculation from DXA data, not the bone-density measurement; 77080 is an axial DXA bone-density code.
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.
9,02177086,TC,Vrt fracture assmt via dxa,A,,0.00,0.79,,0.79,NA,0.01,0.80,0.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,2.63,2.63,0.03
9,02277089,,Tbs dxa cal w/i&r fx risk,A,,0.20,0.96,,0.96,NA,0.03,1.19,1.19,4,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02377090,,Tbs techl prep&transmis data,A,,0.00,0.08,,0.08,NA,0.01,0.09,0.09,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,2.36,2.36,0.30
9,02477091,,Tbs techl calculation only,A,,0.00,0.79,,0.79,NA,0.01,0.80,0.80,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,2.63,2.63,0.03
9,02577092,,Tbs i&r fx rsk qhp,A,,0.20,0.09,,0.09,,0.01,0.30,0.30,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02677261,,Ther radiology tx plng smpl,A,,1.27,0.75,,0.75,,0.07,2.09,2.09,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02777262,,Ther radiology tx plng intrm,A,,1.95,1.14,,1.14,,0.12,3.21,3.21,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503