What is CPT Code 77063?

CPT 77063 is a medical billing code for Screening Digital Breast Tomosynthesis, Bilateral. It's part of Radiology Procedures and Breast, Mammography services, representing a moderate-complexity encounter.

What factors affect CPT 77063 fee schedules?

Factors affecting fee schedules include Medicare & Medicaid rates (government-set), private insurance rates (negotiated), geographic location (costs may be higher in urban areas), and provider type (hospital vs. private practice).

Where can I view Medicare rates for CPT 77063?

You can view Medicare rates for CPT 77063 for 2025 on the PayerPrice website via their Medicare fee schedule lookup tool, which provides detailed physician fee schedule data.

How can I find the cost of a medical procedure?

To find the cost of a specific medical procedure, it's highly recommended to use a tool that provides detailed fee schedules based on CPT codes and your specific location. You can utilize Payerprice's fee schedule lookup tool for this purpose, as it allows you to search with CPT codes and specific geographical areas.

CPT stands for Current Procedural Terminology. CPT codes are a set of standardized five-digit codes published by the American Medical Association (AMA) that describe medical, surgical, and diagnostic services and procedures performed by physicians and other healthcare providers. They are crucial for consistent billing and reporting of medical services.

How does insurance affect the cost of medical care?

Insurance plays a significant role in determining your out-of-pocket medical costs. Your insurance plan will typically cover a portion of the total cost after you meet your deductible, and you may still be responsible for co-payments or co-insurance. The exact amount depends on your specific plan's benefits, whether the provider is in-network, and the type of service. Always check with your insurance provider for specific coverage details related to your plan.

Why do medical costs vary so much for the same procedure?

Medical costs can vary significantly due to multiple factors, including the specific healthcare provider or facility, geographic location, negotiated rates with different insurance companies, the complexity of the procedure, and whether the service is performed in an outpatient clinic versus a hospital. Different healthcare systems and regions have diverse pricing structures.

Where can I find a fee schedule for medical services based on CPT codes and location?

To find fee schedules for medical services, especially based on specific CPT codes and your particular location, you should use specialized lookup tools. Payerprice offers a fee schedule lookup tool that enables users to search for pricing information using CPT codes and specific geographical locations, providing relevant cost data for your needs.

CPT 77063 Fee Schedule

Q: How does CPT 77063 compare to other breast mammography codes?

CPT 77063 involves more provider time and moderate medical decision-making compared to lower-level codes. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation.

Last Verified: September 2026

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.

Screening Digital Breast Tomos, Screening Digital Breast Tomosynthesis Bilateral (List Separately In Addition To Code For Primary Procedure)

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 TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 77063
Medicaid Fee Schedule	View Medicaid rates for 77063

National average reimbursement for CPT 77063 by major payers:

$63.49

$66.15

$66.93

$86.18

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 77063.

CPT 77063

5 of 25 sample ratesHigher to lower in this preview

Valerie Flaherman
CAPediatrics PhysicianNPI 1467497008Tax ID 94-3281660
$288.70Published rate
Erica Pollack
University Physicians Incorporated
CODiagnostic Radiology PhysicianNPI 1497994255Tax ID 74-2161737
$96.69Published rate
Trever Bivona
NYMedical Oncology PhysicianNPI 1093861346Tax ID 94-3281660
$67.25Published rate
Kimberlee Hashiba
Queens University Medical Group
MADiagnostic Radiology PhysicianNPI 1932556008Tax ID 88-0820406
$41.04Published rate
Eduardo Pascual Van Sant
New York City Health And Hospitals Corporation
NYDiagnostic Radiology PhysicianNPI 1225525165Tax ID 13-2655001
$20.80Published rate

Get a free rate benchmark for your specialty.

Choose your state and specialty to build a report from payer-published rates.

Build my free benchmark

Use market rates to prepare your payer proposal.

Rate Benchmarking

Compare your rates with similar providers.

Select a published rate, define comparable providers, and see where that rate falls in your market.

See a sample rate comparison

Payer Contract Negotiation

Draft a fee schedule renegotiation letter.

Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.

See a sample payer proposal

Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

Check published rates for your payer and codes.

Explore state-level rates by specialty

CPT 77063 vs. Other Breast, Mammography Codes

The CPT 77063 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 77063 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.

Code	Complexity	Description
77054-CPT	Low	Mammary Ductogram Or Galactogrm Multi Ducts Radiologi Superv, Mammary Ductogram Or Galactogram Multiple Ducts Radiological Supervi
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 77063. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 77063 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 77063) and we'll show you how you compare in 15 minutes or less.

Schedule a Demo

CPT 77063 Fee Schedule

Compare published rates across providers.

Valerie Flaherman

Erica Pollack

Trever Bivona

Kimberlee Hashiba

Eduardo Pascual Van Sant