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See a sample rate comparisonCPT 77061 Fee Schedule
CPT 77061 is classified under Radiology Procedures, in the Breast, Mammography subgroup.
A 3d Mammogram, 3d Mammograms Use Low Dose X-Rays To Create A Three Dimensional Image Of One Or Both Breasts.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Breast, Mammography |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 77061 |
| Medicaid Fee Schedule | $42.955 median of the 8 states in the free preview · View Medicaid rates for 77061 |
National average reimbursement for CPT 77061 by major payers:
$192.13
BCBS / Anthem
$171.11
UnitedHealthcare
$144.88
Aetna
$180.81
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 77061.
CPT 77061
5 of 25 sample ratesHigher to lower in this preview
Jared Narvid
$942.60Published rateRavi Giyanani
Guthrie Medical Group PC
$205.28Published rateMichelle Ginsberg
$132.19Published rateNicholas Ferguson
Usc Care Medical Group Inc
$98.83Published rateBrett Travis
Richland Parish Hospital
$39.70Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 77061 vs. Other Breast, Mammography Codes
The table lists codes related to 77061. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 77053-CPT | Low | Mammary Ductogram Or Galactogrm Sngle Duct Rdiological Superv, Mammary Ductogram Or Galactogram Single Duct Radiological Supervisio |
| 77061-CPT | Low | A 3d Mammogram, 3d Mammograms Use Low Dose X-Rays To Create A Three Dimensional Image Of One Or Both Breasts. |
| 77062-CPT | Moderate | A 3d Mammogram, 3d Mammograms Use Low Dose X-Rays To Create A Three Dimensional Image Of One Or Both Breasts. |
| 77063-CPT | Low | Screening Digital Breast Tomos, Screening Digital Breast Tomosynthesis Bilateral (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77061. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77061 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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Frequently Asked Questions
The cost of a medical procedure or service can vary significantly based on the provider, your location, and your specific insurance plan. For the most accurate estimate tailored to your situation, you can use Payerprice's fee schedule lookup tool. This tool allows you to search with a CPT code and your specific location to get detailed pricing information.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services they provide. They are crucial for consistent communication between providers, patients, and insurance companies, ensuring accurate billing and processing of claims.
To determine if a specific medical service is covered by your insurance plan, the best course of action is to contact your insurance provider directly. You can typically find a member services phone number on the back of your insurance card. Be prepared to provide the CPT code for the service, if you have it, as this will help them identify the exact service and your coverage details.
These are common terms related to your health insurance costs: * **Deductible:** The amount you must pay out-of-pocket for covered healthcare services before your insurance plan starts to pay. * **Copay (Copayment):** A fixed amount you pay for a covered healthcare service after you've met your deductible. For example, you might pay $20 for a doctor's visit. * **Coinsurance:** Your share of the cost for a covered healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service after you've met your deductible.
Medical service prices can vary widely due to several factors, including the specific healthcare provider (e.g., hospital vs. independent clinic), geographic location, negotiated rates with different insurance companies, facility fees, and the complexity of the service. Tools like Payerprice aim to increase transparency by allowing users to compare prices for specific CPT codes and locations.