CPT 77065 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 77065 by major payers:

$153.37

$159.56

$162.11

$201.37
| 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 77065 | ||||||
United | 77065 | $130.14 | 1881859247 - BHAWANA RATHORE | 550854430 - (CT) NEWTOWN DIAGNOSTIC IMAGING, LLC | PA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $161.67 | 1013177419 - OMAR USMANI | 860810876 - (AZ) GILA RIVER HEALTH CARE CORPORATION | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $101.84 | 1750361127 - ROBERT FRIEDMAN | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NJ | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $54.31 | 1114926417 - ROBERT SCIULLI | 412007905 - VIRTUAL RADIOLOGIC CORPORATION | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $255.78 | 1568447357 - HUMA QURESHI | 850703768 - (IL) CARLE WEST PHYSICIAN GROUP INC | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $78.02 | 1518941624 - JAMES HYUN | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $293.44 | 1366854325 - WILLIAM RUSNAK | 815309615 | PA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $141.52 | 1871555649 - JONATHAN JAKSHA | 426004813 | ND | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $130.44 | 1497924633 - KENNETH CHONG | 250815795 - GUTHRIE MEDICAL GROUP PC | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $247.08 | 1780729400 - MARK MCVEE | 910369070 - (WA) THE POLYCLINIC, PLLC | AK | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $150.64 | 1073558383 - SURENDER KURAPATI | 770078751 - CENTRAL VALLEY COMMUNITY MEDICAL IMAGING | DE | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $346.67 | 1760608178 - CHRISTIAN COX | 470527459 - (NE) RADIOLOGY CONSULTANTS, P.C. | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $199.80 | 1265533665 - MONJARI GILLIAN | 831716704 | MO | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $166.77 | 1679511356 - KAREN CALDEMEYER | 30219309 - UNIVERSITY OF VERMONT MEDICAL CENTER INC | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 77065 | $180.24 | 1083906960 - GEORGE MAYHALL | 720276883 | GA | Diagnostic Radiology Physician (2085R0202X) |
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 77065 vs. Other Breast, Mammography Codes
The CPT 77065 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 77065 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 |
|---|---|---|
| 76940-CPT | Moderate | Ultrasound Guidance For And Monitoring Of Parenchymal Tissue Ablation |
| 76977-CPT | Low | Ultrasound Bone Density Measurement And Interpretation Peripheral Site(S) Any Method |
| 77065-CPT | Low | Diagnostic Mammography, Including Computer-Aided Detection (Cad) When Performed; Unilateral |
| 77066-CPT | Low | Diagnostic Mammography, Including Computer-Aided Detection (Cad) When Performed; Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77065 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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