CPT 77091 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 • 49 - Independent Clinic |
| Common Modifiers | • None • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 77091 by major payers:
$33.65
$33.08
$32.28
$52.60
| 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 77091 | ||||||
United | 77091 | $35.47 | 1780655795 - RALPH PICKARD | 363637465 - (IL) HOOPESTON COMMUNITY MEMORIAL HOSPITAL | CO | Pediatric Radiology Physician (2085P0229X) |
United | 77091 | $72.69 | 1396727491 - GAMALIEL RODRIGUEZ-HERRERA | 341932969 | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 77091 | $122.94 | 1821380932 - SVETLANA YABLOK | 223970667 - (NY) NORTH SHORE-LIJ RADIOLOGY SERVICES P C | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 77091 | $67.73 | 1144274226 - NAVARRO HOSPITAL LP, NAVARRO REGIONAL HOSPITAL | 621762428 | TX | General Acute Care Hospital (282N00000X) |
United | 77091 | $132.10 | 1700032729 - APARNA DALAL | 680334324 | CA | Anesthesiology Physician (207L00000X) |
United | 77091 | $29.21 | 1821595091 - KELSEY GRACE | 381917674 - (MI) CHELSEA COMMUNITY HOSPITAL | MI | Emergency Medicine Physician (207P00000X) |
United | 77091 | $82.61 | 1821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER | 934555562 | SC | General Acute Care Hospital (282N00000X) |
United | 77091 | $77.80 | 1548720097 - SEMA YILDIZ | 800886397 | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 77091 | $30.07 | 1962821991 - BERTHINA COLEMAN | 381459362 - WILLIAM BEAUMONT HOSPITAL | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 77091 | $228.77 | 1811942444 - WILLIAM HASELOW | 270196924 | WI | Emergency Medicine Physician (207P00000X) |
United | 77091 | $82.61 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 77091 | $82.61 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 77091 | $33.84 | 1205183415 - GRETHE MORTENSON | 391745745 - (WI) NEONATAL RESOURCES OF WISCONSIN, INC. | OR | Nurse Practitioner (363L00000X) |
United | 77091 | $132.17 | 1801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL | 720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISH | LA | General Acute Care Hospital (282N00000X) |
United | 77091 | $32.38 | 1821595091 - KELSEY GRACE | 381917674 - (MI) CHELSEA COMMUNITY HOSPITAL | MI | Emergency Medicine Physician (207P00000X) |
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 77091 vs. Other Bone/Joint Studies Codes
The CPT 77091 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 77091 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 | Computed Tomography Bone Mineral Density Study 1 Or More Sites Axial Skeleton |
| 77085-CPT | Low | Dual-Energy X-Ray Absorptiometry (Dxa), Bone Density Study, 1 Or More Sites; Axial Skeleton (Eg, Hips, Pelvis, Spine), Including Vertebral Fracture Assessment |
| 77089-CPT | Low | Trabecular Bone Score (Tbs), Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram, Calculation, With Interpretation And Report On Fracture-Risk |
| 77091-CPT | Low | Trabecular Bone Score (Tbs), Structural Condition Of The Bone Microarchitecture; Technical Calculation Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77091 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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