CPT 2026 · Radiology

CPT 77053

Global XXX Active

X-ray of mammary duct

Effective 2026-04-01 Conv. factor $33.4009
$54.97
National Avg (Non-Fac)
1.59
Total RVU
10
NCCI Partners
109
MPFS Localities

CPT 77053 Billing & Documentation Guide

CPT code 77053 (X-ray of mammary duct) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.35, a non-facility practice expense RVU of 1.21, and a malpractice RVU of 0.03, a total non-facility RVU of 1.59 and facility RVU of 1.59. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $54.97, though rates vary from $46.92 to $71.79 based on MAC locality and Geographic Practice Cost Indices (GPCIs).

When billing 77053, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 77053 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator
A

Active code (paid under MPFS)

Global Period
XXX

No global period (E/M and other non-procedural services)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service
2
Rationale: Code Descriptor / CPT Instruction
Adjudication: Date of Service (Policy)
Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 2 units of 77053 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

RVU Breakdown, CPT 77053

Component Non-Facility Facility
Work RVU0.350.35
Practice Expense RVU1.211.21
Malpractice RVU0.030.03
Total RVU1.591.59
Conversion Factor$33.4009

2026 Medicare Reimbursement by State, CPT 77053

State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.

State Non-Facility Facility Range (Non-Fac) Localities
California $60.47 $60.47 $56.72 - $71.79 29
Florida $54.19 $54.19 $51.83 - $56.3 3
Georgia $51.46 $51.46 $48.93 - $53.99 2
Illinois $52.7 $52.7 $50.16 - $55.05 4
Michigan $51.05 $51.05 $49.72 - $52.38 2
North Carolina $50.04 $50.04 $50.04 - $50.04 1
New York $58.69 $58.69 $50.79 - $62.35 5
Ohio $49.6 $49.6 $49.6 - $49.6 1
Pennsylvania $52.46 $52.46 $49.74 - $55.17 2
Texas $52.48 $52.48 $49.4 - $55.36 8

Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.

NCCI Bundling Edits, CPT 77053

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 77053 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code Relationship Modifier Allowed Rationale
36591 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
36592 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
96523 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
99446 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
99447 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
99448 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
99449 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
99451 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
99452 Column 1 (primary), can be billed with modifier Yes CPT Manual or CMS manual coding instruction
77054 Column 2 (secondary), bundled into primary Yes HCPCS/CPT procedure code definition

Frequently Asked Questions, CPT 77053

What does CPT code 77053 mean? +

CPT code 77053 represents: X-ray of mammary duct. It's in the Radiology category with a global period of XXX.

What is the Medicare reimbursement for CPT 77053? +

The 2026 Medicare national average non-facility payment for CPT 77053 is $54.97. Rates range from $46.92 to $71.79 across 53 states depending on MAC locality and GPCIs.

What modifiers can I use with CPT 77053? +

Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.

What bundling edits apply to CPT 77053? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on April 17, 2026.

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