CPT 77046 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Breast, Mammography |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 77046 by major payers:

$284.19

$519.54

$322.84

$363.82
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 77046 | ||||||
United | 77046 | $230.13 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 77046 | $524.34 | 1265445506 - WILLIAMSON COUNTY HOSPITAL DISTRICT, WILLIAMSON MEDICAL CENTER | 621501534 | TN | General Acute Care Hospital (282N00000X) |
United | 77046 | $211.66 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | 77046 | $89.15 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 77046 | $359.67 | 1437186111 - PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. | 582179986 - (GA) PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 77046 | $209.19 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 77046 | $517.78 | 1811992480 - PASCACK VALLEY HOSPITAL | 264051248 | NJ | General Acute Care Hospital (282N00000X) |
United | 77046 | $391.95 | 1073893020 - PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC, ADVENTHEALTH WESLEY CHAPEL | 208488713 - (FL) PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | 77046 | $528.75 | 1134137466 - OLNEY HAMILTON HOSPITAL DISTRICT | 756001727 | TX | Critical Access Hospital (282NC0060X) |
United | 77046 | $67.76 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | 77046 | $368.89 | 1437135902 - AU MEDICAL CENTER, INC | 582144788 - (GA) AU MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 77046 | $312.92 | 1770583999 - TRINITAS REGIONAL MEDICAL CENTER, TRINITAS HOSPITAL ACUTE CARE | 223601678 - (NJ) RWJ BARNABAS HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 77046 | $345.20 | 1598144362 - PRIME HEALTHCARE SERVICES, SAINT CLARE'S HOSPITAL | 463483967 | NJ | General Acute Care Hospital (282N00000X) |
United | 77046 | $391.95 | 1871977942 - SOUTHEAST VOLUSIA HEALTHCARE CORPORATION, ADVENTHEALTH NEW SMYRNA BEACH | 473793197 - SOUTHEAST VOLUSIA HEALTHCARE CORPORATION | FL | General Acute Care Hospital (282N00000X) |
United | 77046 | $478.60 | 1942265327 - LINCOLN COUNTY HOSPITAL | 480896979 - (KS) LINCOLN COUNTY HOSPITAL | KS | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 77046 vs. Other Breast, Mammography Codes
The CPT 77046 code is part of the Radiology Procedures services used for Breast, Mammography. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 77046 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77046. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77046 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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