CPT 77086 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 Bone/Joint Studies |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 77086 |
National average reimbursement for CPT 77086 by major payers:
$42.28
$39.47
$38.95
$58.46
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 77086 | $15.01 | 1790836252 - RANGADHAM NAGARAKANTI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NJ | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 77086 | $22.55 | 1407050693 - KIANNE HARDEE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 77086 | $22.55 | 1023542677 - ABIOLA FEMI-ABODUNDE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 77086 | $22.55 | 1467985986 - MOHAMMAD IBRAHIM | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 77086 | $39.04 | 1013534106 - NATALIA CASTRO | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Family Nurse Practitioner (363LF0000X) |
United | 77086 | $11.00 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 77086 | $5.82 | 1598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO | 832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC | FL | Home Health Agency (251E00000X) |
United | 77086 | $45.00 | 1568459717 - JOHN SCHOR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X) |
United | 77086 | $15.01 | 1487041935 - TOMASZ KROLIKOWSKI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 77086 | $30.84 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 77086 | $9.92 | 1245778992 - SARAH BERNSTEIN | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Occupational Therapist (225X00000X) |
United | 77086 | $15.01 | 1780998237 - NEEJA DAVE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 77086 | $90.22 | 1780335901 - ELIZABETH SUAREZ | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 77086 | $10.57 | 1649569096 - AARON CARTER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 77086 | $41.58 | 1306391610 - CAMILLA GRANT | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
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 77086 vs. Other Bone/Joint Studies Codes
The CPT 77086 code is part of the Radiology Procedures services used for Bone/Joint Studies. 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 77086 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 |
|---|---|---|
| 77078-CPT | Low | Ct Scan For Bone Density, A Ct (Computed Tomography) Scan Is Used For A Bone Mineral Density Study. The Images Help To Evaluate The Calcium And Mineral Content In One Or More Segments Of Bone. The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. |
| 77080-CPT | Low | Bone Density Study, A Bone Density Study Measures The Amounts Of Calcium And Other Minerals With Dual-Energy X-Ray Absorptiometry (Dexa). The Result Is An Assessment Of Bone Health. |
| 77084-CPT | Moderate | Mri Of Bone Marrow, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of Blood Vessels And Bone Marrow. A Contrast Agent May Be Introduced To Highlight An Area. Multiple Images May Be Taken. |
| 77086-CPT | Low | Vertebra Fract Assess Via Dual-Enrgy X-Ray Absorptiom (Dx, Vertebral Fracture Assessment Via Dual-Energy X-Ray Absorptiometry (Dx |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77086 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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