Billing code 77048: Breast MRIMedicare rate & RVUs in Pennsylvania
Reports MRI of one breast using images before and after contrast, including computer-aided detection when performed, for diagnostic breast evaluation.
Medicare pays $312.37–$346.89 for 77048 in the office in Pennsylvania, from Rest Of Pennsylvania to Metropolitan Philadelphia. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 77048 covers
This service uses magnetic resonance imaging to evaluate one breast with images acquired before and after contrast administration. A radiologic technologist performs the scan, and a radiologist interprets the images. Common diagnostic situations include assessing the extent of a known breast cancer or investigating a concerning finding that needs further evaluation. Computer-aided detection is included when performed. For imaging both breasts with and without contrast, the bilateral code is used instead.
Report 77048 for one breast, not as a unilateral substitute when the documented examination covers both breasts. The order and imaging report should support the clinical reason for the MRI, the side examined, and the use of pre- and post-contrast imaging. The global service is reported without a component modifier; modifier 26 represents the interpretation, while modifier TC represents the equipment and staff. CMS applies the diagnostic imaging multiple-procedure reduction to both the professional and technical components when it applies.
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 77048 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia | $346.89 | Unavailable |
| Rest Of Pennsylvania | $312.37 | Unavailable |
How the 77048 rate is calculated
Each of 77048’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 · 77048
RVUs × geographic indexes × conversion factor
Work2.05
2.05 RVUs× 1.000 GPCI
Practice expense7.80
7.80 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
10.0000
Conversion factor
$33.4009
Medicare rate
$334.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77048
The CMS indicators that decide how 77048 is paid alongside other services.
CMS payment indicators · 77048
Breast MRI
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
77048 without 26 · national office
$334.01
Breast MRI
77048-26 · Professional component
$96.86
Pays only the interpretation and report.
77048 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77049Breast MRI
- 77049 is for MRI of both breasts with and without contrast; 77048 covers one breast.
- 77046Breast MRI
- 77046 covers one breast but uses imaging without contrast. Choose 77048 when the examination includes both pre-contrast and post-contrast imaging.
- 77047Breast MRI
- 77047 is bilateral breast MRI without contrast. It differs from 77048 in both laterality and contrast protocol.
77048 billing questions
When should 77048 be chosen instead of 77049?
Use 77048 when the MRI covers one breast with and without contrast. Use 77049 when the documented examination covers both breasts with and without contrast.
How does 77048 differ from 77046?
Both are unilateral breast MRI codes, but 77048 describes imaging with and without contrast; 77046 is for imaging without contrast.
Is CAD separately reported with 77048?
No. Computer-aided detection is included in 77048 when performed.
How are the professional and technical services billed?
Report modifier 26 for the professional interpretation or modifier TC for the technical service. Without either modifier, the claim represents the global service.
Does a multiple-procedure reduction affect 77048?
CMS applies the diagnostic imaging multiple-procedure reduction to the professional and technical components when the reduction applies.
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
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