CPT 77054
Global XXX ActiveX-ray of mammary ducts
CPT 77054 Billing & Documentation Guide
CPT code 77054 (X-ray of mammary ducts) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.44, a non-facility practice expense RVU of 1.57, and a malpractice RVU of 0.04, a total non-facility RVU of 2.05 and facility RVU of 2.05. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $70.87, though rates vary from $60.43 to $92.65 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 77054, 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 77054 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 77054 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 77054
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.44 | 0.44 |
| Practice Expense RVU | 1.57 | 1.57 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.05 | 2.05 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 77054
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 | $78 | $78 | $73.14 - $92.65 | 29 |
| Florida | $69.91 | $69.91 | $66.84 - $72.66 | 3 |
| Georgia | $66.34 | $66.34 | $63.06 - $69.62 | 2 |
| Illinois | $67.97 | $67.97 | $64.66 - $71.02 | 4 |
| Michigan | $65.82 | $65.82 | $64.08 - $67.55 | 2 |
| North Carolina | $64.48 | $64.48 | $64.48 - $64.48 | 1 |
| New York | $75.71 | $75.71 | $65.45 - $80.47 | 5 |
| Ohio | $63.92 | $63.92 | $63.92 - $63.92 | 1 |
| Pennsylvania | $67.62 | $67.62 | $64.1 - $71.14 | 2 |
| Texas | $67.64 | $67.64 | $63.66 - $71.39 | 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 77054
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 77054 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 |
| 77053 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 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 |
Frequently Asked Questions, CPT 77054
What does CPT code 77054 mean? +
CPT code 77054 represents: X-ray of mammary ducts. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 77054? +
The 2026 Medicare national average non-facility payment for CPT 77054 is $70.87. Rates range from $60.43 to $92.65 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 77054? +
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 77054? +
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 June 1, 2026.
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