Billing code 77054: DuctographyMedicare rate & RVUs in Washington

Reports radiographic imaging of mammary ducts after contrast is introduced into a duct, commonly during evaluation of abnormal nipple discharge.

CMS RVU26DEffective Oct 1, 20262 payment localities

Medicare pays $71.12–$80.87 for 77054 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.

$71.12–$80.87Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 77054 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Washington
  2. What 77054 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 77054 covers

This diagnostic breast study uses radiographic imaging to show mammary ducts after contrast is introduced through a nipple duct. It is most often performed by a radiologist in an imaging department when a patient has concerning nipple discharge and duct imaging is part of the evaluation. The images can help locate an abnormality within the ductal system for clinical assessment.

Report the code when the documented service is mammary duct X-ray imaging, rather than routine breast imaging alone. The record should support the clinical indication and the duct imaging performed, including the interpreting physician’s findings. CMS recognizes separately priced professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or no component modifier when billing the global service. The professional and technical services may be billed by different entities when each performs its respective portion.

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 77054 pays more and less in Washington

77054 office and facility rates by payment locality
Payment localityOfficeFacility
Rest Of Washington$71.12Unavailable
Seattle (King Cnty)$80.87Unavailable

How the 77054 rate is calculated

Each of 77054’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 · 77054

RVUs × geographic indexes × conversion factor

Work0.44

0.44 RVUs× 1.000 GPCI

Practice expense1.57

1.57 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.0500

Conversion factor

$33.4009

Medicare rate

$68.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 77054

The CMS indicators that decide how 77054 is paid alongside other services.

CMS payment indicators · 77054

Ductography

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

77054 without 26 · national office

$68.47

Ductography

77054-26 · Professional component

$21.04

Pays only the interpretation and report.

When to use modifier 26

77054 compared with similar codes

Compare codes · National

4 codes, side by side

  • 77054

    Ductography0.44 wRVU

    $68.47

  • 77053

    Mammary duct X-ray0.35 wRVU

    $53.11−$15.36

  • 77065

    Diagnostic mammogram0.79 wRVU

    $123.92+$55.45

  • 77066

    Diagnostic mammogram0.98 wRVU

    $156.98+$88.51

How to choose

77053Mammary duct X-ray
This is the closely related mammary duct imaging code. Compare the full billing code descriptors with the documented duct study before choosing between them.
77065Diagnostic mammogram
77065 reports unilateral diagnostic mammography; 77054 is for mammary duct X-ray imaging after contrast is introduced into a duct.
77066Diagnostic mammogram
77066 reports bilateral diagnostic mammography; it does not describe the contrast-based imaging of mammary ducts reported with 77054.

77054 billing questions

When is ductography reported instead of diagnostic mammography?

Use this code for imaging of mammary ducts after contrast is introduced into a duct. Diagnostic mammography images breast tissue and is not a substitute for duct imaging.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

What documentation supports this service?

Document the clinical reason for duct imaging, the duct study performed, and the radiologist’s interpretation. Abnormal nipple discharge is a common reason for this examination.

Is this code for a routine mammogram?

No. It describes radiographic imaging of mammary ducts, not standard screening or diagnostic mammography.

How should this code be distinguished from 77053?

Both codes concern mammary duct X-ray imaging. Check the full current billing code descriptors and the documented study details to select the applicable code.

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
RVUs for 77054PPRRVU2026_Oct_nonQPP.csv, line 8,964 (RVU26D)

Open CMS sourceHow we calculate rates

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