CPT 77067
Global XXX ActiveScr mammo bi incl cad
CPT 77067 Billing & Documentation Guide
CPT code 77067 (Scr mammo bi incl cad) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.74, a non-facility practice expense RVU of 2.99, and a malpractice RVU of 0.05, a total non-facility RVU of 3.78 and facility RVU of 3.78. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $130.88, though rates vary from $111.36 to $172.34 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 77067, 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 77067 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Coding Tips for 77067
Real-world specialist guidance from the PayerReady Medical Coding Team, not generic boilerplate.
Screening mammography, bilateral (77067). Medicare covers annually for women 40+ with no co-pay under ACA preventive benefit. Commercial preventive coverage follows USPSTF Grade B recommendation.
Diagnostic mammography uses 77065 (unilateral) or 77066 (bilateral). Screening that identifies a finding requiring workup should be billed as diagnostic on the same-day follow-up, not as dual billing on the same date of service.
3D mammography (tomosynthesis) add-on G0279 for screening; 77063 add-on for diagnostic. Not all commercial payers cover tomosynthesis add-ons; verify coverage before billing.
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 1 units of 77067 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 77067
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.74 | 0.74 |
| Practice Expense RVU | 2.99 | 2.99 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 3.78 | 3.78 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 77067
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 | $144.68 | $144.68 | $135.49 - $172.34 | 29 |
| Florida | $128.17 | $128.17 | $122.7 - $132.9 | 3 |
| Georgia | $122.03 | $122.03 | $115.79 - $128.26 | 2 |
| Illinois | $124.49 | $124.49 | $118.51 - $130.41 | 4 |
| Michigan | $120.85 | $120.85 | $117.78 - $123.91 | 2 |
| North Carolina | $118.96 | $118.96 | $118.96 - $118.96 | 1 |
| New York | $139.57 | $139.57 | $120.77 - $148.14 | 5 |
| Ohio | $117.58 | $117.58 | $117.58 - $117.58 | 1 |
| Pennsylvania | $124.55 | $124.55 | $117.97 - $131.12 | 2 |
| Texas | $124.73 | $124.73 | $117.15 - $131.91 | 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 77067
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 77067 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 |
| 77061 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 77062 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 19281 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 19282 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 77065 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 77066 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| G0202 | Column 2 (secondary), bundled into primary | No | More extensive procedure |
Frequently Asked Questions, CPT 77067
What does CPT code 77067 mean? +
CPT code 77067 represents: Scr mammo bi incl cad. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 77067? +
The 2026 Medicare national average non-facility payment for CPT 77067 is $130.88. Rates range from $111.36 to $172.34 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 77067? +
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 77067? +
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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