CPT 77063
Global ZZZ ActiveBreast tomosynthesis bi
CPT 77063 Billing & Documentation Guide
CPT code 77063 (Breast tomosynthesis bi) is classified under Radiology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.59, a non-facility practice expense RVU of 0.91, and a malpractice RVU of 0.03, a total non-facility RVU of 1.53 and facility RVU of 1.53. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $52.69, though rates vary from $46.33 to $66.24 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 77063, 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 77063 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 77063 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 77063
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.59 | 0.59 |
| Practice Expense RVU | 0.91 | 0.91 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 1.53 | 1.53 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 77063
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 | $56.92 | $56.92 | $53.89 - $66.24 | 29 |
| Florida | $52.15 | $52.15 | $50.27 - $53.88 | 3 |
| Georgia | $49.93 | $49.93 | $48.01 - $51.85 | 2 |
| Illinois | $51.06 | $51.06 | $49.02 - $52.84 | 4 |
| Michigan | $49.66 | $49.66 | $48.59 - $50.73 | 2 |
| North Carolina | $48.71 | $48.71 | $48.71 - $48.71 | 1 |
| New York | $55.91 | $55.91 | $49.29 - $58.97 | 5 |
| Ohio | $48.47 | $48.47 | $48.47 - $48.47 | 1 |
| Pennsylvania | $50.73 | $50.73 | $48.56 - $52.9 | 2 |
| Texas | $50.67 | $50.67 | $48.3 - $52.79 | 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 77063
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 77063 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 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 |
| 76376 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 76377 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 77052 | Column 1 (primary), can be billed with modifier | 9 | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 77055 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
| 77056 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
| 77057 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 77063
What does CPT code 77063 mean? +
CPT code 77063 represents: Breast tomosynthesis bi. It's in the Radiology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 77063? +
The 2026 Medicare national average non-facility payment for CPT 77063 is $52.69. Rates range from $46.33 to $66.24 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 77063? +
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 77063? +
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 May 31, 2026.
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