CPT 77065
Unilateral Diagnostic Mammography
Unable to determine from available CMS sources
77065 · PFS Q4 2017 · Historical
No national PFS rate in Q4 2017
Status I is not separately payable under the PFS.
Not at a published national rate. CPT 77065 carries status I (not valid) in the Q4 2017 release. Medicare uses a different code to report and pay for this service. Treat the blank amount as unpriced, not as $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 77065
- Release
- Q4 2017, revision 1
- Result
- Unable to determine from available CMS sources
Citations
-
Establishes the PFS status (I) and the resulting pathway for this code: unable to determine from available cms sources.
Physician relative value file (PPRRVU)Q4 2017 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2017
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU17_OCT.csv in rvu17d.zip (row 12,653)- hcpcs (col 1)
- 77065
- modifier (col 2)
- blank
- status_code (col 4)
- I
SHA-256: 4ec25bedea18799c66d10002a3731757548ccfd70e37379c856bb8a1fafe8da4
Why is there no national PFS amount for 77065?
Its status indicator is I (not valid). Medicare uses a different code to report and pay for this service. Status I is not separately payable under the PFS.
Payment considerations Copy link
Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.
Other payment indicators (9)
Facility/non-facility: Not determined, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why a 77065 line may not pay separately Copy link
CMS publishes no separately payable amount for 77065 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.
What to reconcile
- Confirm the status that governed the date of service before working this line as a short payment—CMS publishes no separately payable fee-schedule amount for it in this release.
- Confirm which component the line carried before comparing anything: the same code prices three ways—globally, as a professional component with modifier 26, and as a technical component with modifier TC.
- Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.
Nearby payment lines
National Q4 2017 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04).
Global period: what 77065's fee already covers Copy link
The global surgery concept does not apply to this code.
Billing policy Copy link
What 77065's billing-policy indicators mean. These show for every code, priced or not: a restriction like "bilateral not allowed" still matters on a carrier-priced code.
| Policy | Value | What it means |
|---|---|---|
| Professional/technical split | 1 | Splits into professional and technical. This procedure splits into a professional component (modifier 26) and a technical component (modifier TC), each separately payable. |
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and 77065.
Common payment questions Copy link
Why would a Medicare claim for 77065 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is I (not valid)—Medicare uses a different code to report and pay for this service. See status indicators
- 77065 splits into a professional component (modifier 26) and a technical component (modifier TC)—a claim for only one part needs that modifier to price correctly. See billing policy
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
Rate history by release Copy link
National non-facility amount for 77065 across quarterly releases. -10.1% decrease since Q1 2018 · high $137.88 in Q1 2018
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | A | $123.92 (0.0% no change ) | $123.92 (0.0% no change ) |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | A | $123.92 (0.0% no change ) | $123.92 (0.0% no change ) |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | A | $123.92 (0.0% no change ) | $123.92 (0.0% no change ) |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | A | $123.92 (+1.6% increase ) | $123.92 (+1.6% increase ) |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | A | $121.95 (0.0% no change ) | $121.95 (0.0% no change ) |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | A | $121.95 (0.0% no change ) | $121.95 (0.0% no change ) |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | A | $121.95 (0.0% no change ) | $121.95 (0.0% no change ) |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | A | $121.95 (-2.6% decrease ) | $121.95 (-2.6% decrease ) |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | A | $125.16 (0.0% no change ) | $125.16 (0.0% no change ) |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | A | $125.16 (0.0% no change ) | $125.16 (0.0% no change ) |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | A | $125.16 (0.0% no change ) | $125.16 (0.0% no change ) |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | A | $125.16 (+1.7% increase ) | $125.16 (+1.7% increase ) |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | A | $123.12 (-3.4% decrease ) | $123.12 (-3.4% decrease ) |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | A | $127.42 (0.0% no change ) | $127.42 (0.0% no change ) |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | A | $127.42 (0.0% no change ) | $127.42 (0.0% no change ) |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | A | $127.42 (0.0% no change ) | $127.42 (0.0% no change ) |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | A | $127.42 (-2.1% decrease ) | $127.42 (-2.1% decrease ) |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | A | $130.12 (0.0% no change ) | $130.12 (0.0% no change ) |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | A | $130.12 (0.0% no change ) | $130.12 (0.0% no change ) |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | A | $130.12 (0.0% no change ) | $130.12 (0.0% no change ) |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | A | $130.12 (-0.8% decrease ) | $130.12 (-0.8% decrease ) |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | A | $131.20 (0.0% no change ) | $131.20 (0.0% no change ) |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | A | $131.20 (0.0% no change ) | $131.20 (0.0% no change ) |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | A | $131.20 (0.0% no change ) | $131.20 (0.0% no change ) |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | A | $131.20 (-3.8% decrease ) | $131.20 (-3.8% decrease ) |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | A | $136.42 (0.0% no change ) | $136.42 (0.0% no change ) |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | A | $136.42 (0.0% no change ) | $136.42 (0.0% no change ) |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | A | $136.42 (0.0% no change ) | $136.42 (0.0% no change ) |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | A | $136.42 (+0.4% increase ) | $136.42 (+0.4% increase ) |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | A | $135.87 (0.0% no change ) | $135.87 (0.0% no change ) |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | A | $135.87 (0.0% no change ) | $135.87 (0.0% no change ) |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | A | $135.87 (0.0% no change ) | $135.87 (0.0% no change ) |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | A | $135.87 (-1.5% decrease ) | $135.87 (-1.5% decrease ) |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | A | $137.88 (0.0% no change ) | $137.88 (0.0% no change ) |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | A | $137.88 (0.0% no change ) | $137.88 (0.0% no change ) |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | A | $137.88 (0.0% no change ) | $137.88 (0.0% no change ) |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | A | $137.88 | $137.88 |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | I | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | I | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | I | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | I | — | — |
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
The 77065 rate last moved in Q1 2026. See its rate history.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
How often 77065 is billed Copy link
Across Original Medicare in CY2024, 77065 ranked #283 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2017 fee schedule above.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q4 2017 release (effective October 2017). National baselines use GPCI 1.000 and exclude sequestration. Status and payment instructions determine whether a national amount is established; blank RVUs stay blank. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This citation identifies the source release, so its evidence remains reproducible after a newer release lands.
CPT 77065 National PFS baseline: No national PFS rate (Q4 2017; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/77065/2017/D