Billing code 77053: Mammary duct X-rayMedicare rate & RVUs in Virginia
Reports contrast imaging of one breast duct, typically during evaluation of unilateral nipple discharge when the ductal system needs focused assessment.
Medicare pays $52.13–$61.05 for 77053 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 77053 covers
A ductogram images the milk ducts of one breast after a radiologist or other qualified imaging professional cannulates a duct opening at the nipple and introduces contrast. Mammographic images then show the opacified ductal pathway and may help assess an abnormality associated with nipple discharge, such as a suspected intraductal lesion. This is a focused duct study, not a routine screening mammogram or a standard diagnostic mammogram of the breast.
Select this unilateral service when only one breast is examined; use 77054 for a bilateral ductogram. Documentation should identify the side, clinical reason for the study, duct cannulation and contrast administration, imaging performed, and interpretation. The service has professional and technical components: report modifier 26 for interpretation only, modifier TC for equipment and staff only, or no component modifier when billing 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.
Where 77053 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $61.05 | Unavailable |
| Virginia | $52.13 | Unavailable |
How the 77053 rate is calculated
Each of 77053’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 · 77053
RVUs × geographic indexes × conversion factor
Work0.35
0.35 RVUs× 1.000 GPCI
Practice expense1.21
1.21 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.5900
Conversion factor
$33.4009
Medicare rate
$53.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77053
The CMS indicators that decide how 77053 is paid alongside other services.
CMS payment indicators · 77053
Mammary duct X-ray
| 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) | 9 | The concept doesn’t apply. |
| 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
77053 without 26 · national office
$53.11
Mammary duct X-ray
77053-26 · Professional component
$16.70
Pays only the interpretation and report.
77053 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77054Ductography
- 77053 describes duct imaging of one breast; 77054 is for bilateral duct imaging.
- 77065Diagnostic mammogram
- 77065 is unilateral diagnostic mammography. Use 77053 for a focused contrast study of one breast duct.
- 77066Diagnostic mammogram
- 77066 is bilateral diagnostic mammography, while 77053 images a duct in one breast after contrast administration.
77053 billing questions
When should 77053 be selected instead of 77054?
Use 77053 for a ductogram of one breast. Use 77054 when the ductogram is bilateral.
Is this the same as a diagnostic mammogram?
No. A ductogram opacifies and images a breast duct after contrast is introduced through the nipple. Diagnostic mammography images breast tissue without that duct cannulation and contrast study.
How should the professional and technical portions be reported?
Use modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither when billing the global service.
What documentation supports reporting 77053?
Record the unilateral side, the indication for duct imaging, the duct cannulated, contrast administration, images obtained, and the interpretation.
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
Fee sheets
Put 77053 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →