Billing code 77085: DXA bone densityMedicare rate & RVUs in Texas
Reports axial DXA of the hips, pelvis, or spine with vertebral fracture assessment when bone density and vertebral fracture evaluation are performed together.
Medicare pays $50.44–$56.83 for 77085 in the office in Texas, from Beaumont to Austin. 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 77085 covers
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.
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 77085 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$50.44 to $56.83
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $56.83 | Unavailable |
| Beaumont | $50.44 | Unavailable |
| Brazoria | $53.84 | Unavailable |
| Dallas | $54.17 | Unavailable |
| Fort Worth | $53.75 | Unavailable |
| Galveston | $53.99 | Unavailable |
| Houston | $54.72 | Unavailable |
| Rest Of Texas | $52.10 | Unavailable |
How the 77085 rate is calculated
Each of 77085’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 · 77085
RVUs × geographic indexes × conversion factor
Work0.29
0.29 RVUs× 1.000 GPCI
Practice expense1.30
1.30 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.6300
Conversion factor
$33.4009
Medicare rate
$54.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77085
The CMS indicators that decide how 77085 is paid alongside other services.
CMS payment indicators · 77085
DXA bone density
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
77085 without 26 · national office
$54.44
DXA bone density
77085-26 · Professional component
$14.36
Pays only the interpretation and report.
77085 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77080DXA bone density scan
- Both describe axial DXA, but 77085 includes vertebral fracture assessment. Choose 77080 when that assessment is not part of the study.
- 77086Vertebral fracture assessment
- 77086 represents vertebral fracture assessment via DXA, while 77085 combines that assessment with axial bone-density measurement.
- 77081Bone density
- 77081 is for appendicular DXA, such as a forearm site; 77085 is for axial sites such as the hips, pelvis, or spine.
- 77078CT bone density
- 77078 uses CT to assess bone density. 77085 is the DXA service that includes axial bone-density measurement and vertebral fracture assessment.
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 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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