Billing code 77086: Vertebral fracture assessmentMedicare rate & RVUs in Utah
Reports DXA-based vertebral imaging used to identify vertebral fractures, typically during osteoporosis evaluation when fracture status will guide care.
Medicare pays $32.97 for 77086 in the office in Utah (Utah). 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 77086 covers
This service uses a DXA scanner to obtain images of the vertebral spine for assessment of vertebral fractures. It is distinct from measuring bone density: the clinician evaluates the vertebrae for fracture findings, often in patients being assessed for osteoporosis or suspected to have an unrecognized vertebral fracture. A technologist typically acquires the images in a bone-density center or imaging department, and a qualified practitioner interprets them and prepares a report.
Report 77086 for the vertebral fracture assessment itself, supported by documentation of the DXA imaging and interpretation. When axial bone-density measurement and vertebral fracture assessment are both performed, distinguish this service from 77085, which combines axial DXA with vertebral fracture assessment. CMS recognizes professional and technical components: modifier 26 identifies interpretation and report, modifier TC identifies equipment and staff, and no modifier represents the global 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.
77086 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $32.97 | Unavailable |
How the 77086 rate is calculated
Each of 77086’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 · 77086
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.17Practice expense 0.85Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77086
The CMS indicators that decide how 77086 is paid alongside other services.
CMS payment indicators · 77086
Vertebral fracture assessment
| 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
77086 without 26 · national office
$34.74
Vertebral fracture assessment
77086-26 · Professional component
$8.02
Pays only the interpretation and report.
77086 compared with similar codes
Compare codes
77086 vs 77085 vs 77080 vs 77081: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77085DXA bone density
- Choose 77086 for the DXA-based vertebral fracture assessment alone. Choose 77085 when axial bone-density measurement and vertebral fracture assessment are performed as the combined service.
- 77080DXA bone density scan
- 77080 measures axial bone density; it does not represent the vertebral fracture assessment described by 77086.
- 77081Bone density
- 77081 measures bone density at appendicular sites, such as the forearm; 77086 assesses vertebral fractures using DXA imaging.
77086 billing questions
How is 77086 different from 77085?
77086 represents DXA-based vertebral fracture assessment. Code 77085 represents axial DXA bone-density measurement together with vertebral fracture assessment, so do not report 77086 separately for the same assessment included in 77085.
Can 77086 be reported with 77080?
77080 represents axial DXA bone-density measurement, while 77086 represents vertebral fracture assessment. The record should identify each service actually performed and interpreted.
Which modifier identifies the interpretation?
Append modifier 26 for the professional component, which is the interpretation and report. Modifier TC identifies the technical component, including equipment and staff.
What does billing 77086 without a modifier represent?
An unmodified claim represents the global service, including both the professional interpretation and the technical component.
What documentation supports 77086?
Document the DXA-based vertebral imaging, the clinical reason for assessing vertebral fracture status, and the interpreting practitioner's findings and report.
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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