Billing code 77090: TBS processingMedicare rate & RVUs in Georgia

Reports preparation and transfer of DXA data for trabecular bone score analysis, before the technical calculation and fracture-risk interpretation are performed.

CMS RVU26DEffective Oct 1, 20262 payment localities582 Medicare services in 2024

Medicare pays $2.78–$3.12 for 77090 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.

$2.78–$3.12Office (non-facility)
—Hospital or facility

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

We’ll open 77090 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Georgia
  2. What 77090 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 77090 covers

Trabecular bone score (TBS) is a software-based analysis of lumbar-spine DXA data that provides information about bone microarchitecture for fracture-risk assessment. Code 77090 covers the technical workflow of preparing the DXA data and transmitting it for analysis; it does not describe the resulting TBS calculation or a clinician’s interpretation. Imaging technologists or other bone-density staff typically handle this step in an outpatient densitometry workflow.

Select 77090 when the documented service is data preparation and transfer for TBS analysis, rather than calculation alone (77091) or interpretation and reporting (77092). Documentation should identify the source DXA data and show that the preparation and transmission were performed. CMS classifies 77090 as technical-component-only, with interpretation covered by a separate code. CMS assigns no physician-work RVUs to this service.

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 77090 pays more and less in Georgia

77090 office and facility rates by payment locality
Payment localityOfficeFacility
Atlanta$3.12Unavailable
Rest Of Georgia$2.78Unavailable

How the 77090 rate is calculated

Each of 77090’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 · 77090

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 0.08Malpractice 0.01

0.0900 adjusted RVUs×$33.4009 conversion factor=$3.01

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

Payment rules and modifiers for 77090

The CMS indicators that decide how 77090 is paid alongside other services.

CMS payment indicators · 77090

TBS processing

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
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/technical3Technical component only.

77090 compared with similar codes

Compare codes

77090 vs 77091 vs 77092 vs 77089: national Medicare rates

Swap in your local Medicare rate.

  • 77090
    TBS processing · 0 wRVU
    $3.01
  • 77091
    Trabecular bone score · 0 wRVU
    $26.72+$23.71
  • 77092
    TBS interpretation · 0.2 wRVU
    $10.02+$7.01
  • 77089
    Trabecular bone score · 0.2 wRVU
    $39.75+$36.74

How to choose

77091Trabecular bone score
Choose 77090 for preparing and transferring DXA data for analysis; choose 77091 for the TBS technical calculation.
77092TBS interpretation
77090 covers data preparation and transmission. 77092 covers the clinician’s TBS interpretation and fracture-risk report.
77089Trabecular bone score
77089 covers TBS technical calculation with interpretation and reporting; 77090 is limited to data preparation and transmission.

77090 billing questions

How is 77090 different from 77091?

77090 covers preparing and transmitting data for TBS analysis. 77091 describes the technical calculation itself.

Does 77090 include the fracture-risk interpretation?

No. CMS identifies 77090 as technical-component-only; interpretation and reporting are covered by a separate code, 77092.

When would 77089 be considered instead?

77089 represents a TBS service that includes technical calculation with interpretation and reporting. 77090 describes the data-preparation and transmission step.

What documentation supports 77090?

Document the DXA data used and the technical work to prepare and transmit those data for TBS analysis.

Can 77090 be reported for the DXA scan itself?

No. 77090 describes preparing and transmitting data for TBS analysis, not acquiring the DXA images.

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 77090PPRRVU2026_Oct_nonQPP.csv, line 9,023 (RVU26D)

Open CMS sourceHow we calculate rates

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