$36.75–$40.98
Both describe axial DXA, but 77085 includes vertebral fracture assessment. Choose 77080 when that assessment is not part of the study.
On this page
CMS RVU26D · Effective 2026-10-01
77085 DXA bone density Medicare reimbursement rates in Pennsylvania
Reports axial DXA of the hips, pelvis, or spine with vertebral fracture assessment when bone density and vertebral fracture evaluation are performed together. Compare 77085 office and facility rates across CMS payment localities in Pennsylvania.
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 77085 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$50.81–$56.66
2 of 2 localities have a supported rate.
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 imaging
About 77085: Axial DXA with vertebral fracture assessment
Reports axial DXA of the hips, pelvis, or spine with vertebral fracture assessment when bone density and vertebral fracture evaluation are performed together.
This service combines DXA bone density measurement of the axial skeleton, such as the hips, pelvis, or spine, with evaluation for vertebral fractures. It is commonly performed in outpatient imaging centers and hospitals for patients being evaluated for osteoporosis or vertebral fracture risk. Imaging staff acquire the study, and a qualified interpreting professional reviews the bone density and fracture-assessment findings and prepares a report.
Report 77085 when the axial DXA study includes vertebral fracture assessment; the documentation should identify the sites examined and support both the bone-density study and its interpretation. The code may be billed globally, or the interpretation may be reported with modifier 26 and the equipment-and-staff portion with modifier TC. The record should make clear which portion the billing entity furnished when a component modifier is used.
CMS billing rules for 77085
- 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 RVU0.29 · 18%
- Practice expense (office) RVU1.30 · 80%
- Malpractice RVU0.04 · 2%
110.6K
Medicare services in 2024 · #529 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.
77085 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$32.37–$36.13
77086 represents vertebral fracture assessment via DXA, while 77085 combines that assessment with axial bone-density measurement.
$29.69–$32.98
77081 is for appendicular DXA, such as a forearm site; 77085 is for axial sites such as the hips, pelvis, or spine.
$91.43–$102.84
77078 uses CT to assess bone density. 77085 is the DXA service that includes axial bone-density measurement and vertebral fracture assessment.
Compare 77085 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$56.66
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$50.81
Facility
Unavailable
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77085 billing questions
When should 77085 be used instead of 77080?
Use 77085 when axial DXA is performed with vertebral fracture assessment. Use 77080 for axial DXA without that assessment.
Can 77086 also be reported for the same vertebral fracture assessment?
77085 includes vertebral fracture assessment with the axial DXA. Do not report 77086 again for that same included assessment.
How do modifiers 26 and TC apply?
Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical portion involving equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 77085?
Document the axial sites examined, the DXA findings, the vertebral fracture assessment, and the interpreting professional’s report.
Is a DXA of the forearm reported with 77085?
No. 77085 describes axial sites such as the hips, pelvis, or spine; appendicular DXA, such as a forearm study, is reported with 77081.
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.
9,01377084,,Mri bone marrow blood supply,A,,1.56,7.72,,7.72,NA,0.11,9.39,9.39,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,7.83,7.83,0.11
9,01477084,26,Mri bone marrow blood supply,A,,1.56,0.56,,0.56,,0.08,2.20,2.20,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,01577084,TC,Mri bone marrow blood supply,A,,0.00,7.16,,7.16,NA,0.03,7.19,7.19,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,7.27,7.27,0.03
9,01677085,,Dxa bone density axl vrt fx,A,,0.29,1.30,,1.30,NA,0.04,1.63,1.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.26,3.26,0.07
9,01777085,26,Dxa bone density axl vrt fx,A,,0.29,0.12,,0.12,,0.02,0.43,0.43,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,01877085,TC,Dxa bone density axl vrt fx,A,,0.00,1.18,,1.18,NA,0.02,1.20,1.20,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.14,3.14,0.05
9,01977086,,Vrt fracture assmt via dxa,A,,0.17,0.85,,0.85,NA,0.02,1.04,1.04,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,2.69,2.69,0.04