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CPT 77067 Medicare payment status

Screening Mammogram

Unable to determine from available CMS sources

77067 · PFS Q4 2017 · Historical

No national PFS rate in Q4 2017

Status I is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU17DOctober 1 – December 31, 2017

PFS status evidence

Physician relative value file (Q4 2017) · rvu17d.zip (PPRRVU17_OCT.csv row 12,659)
Inspect PFS status evidence
Code
77067
Release
Q4 2017, revision 1
Result
Unable to determine from available CMS sources

Citations

  • Shows this code’s PFS status (I). Result: Unable to determine from available CMS sources.

    Physician relative value file (PPRRVU)CMS RVU17DOctober 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.

    PPRRVU17_OCT.csv row 12,659 in rvu17d.zip

    In the CMS file

    Loading rows 12,657–12,661 of PPRRVU17_OCT.csv…

    Download rvu17d.zip from CMS File fingerprint 4ec25bedea18799c66d10002a3731757548ccfd70e37379c856bb8a1fafe8da4

Plain-text summaryReport a problem

CPT 77067 has no published national rate. It carries status I (not valid) in the Q4 2017 release. Medicare uses a different code to report and pay for this service. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 77067?

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.

About this code

Also known as Mammogram

X-ray images of both breasts in someone with no breast symptoms, taken to catch changes before they can be felt. Medicare reported 6.1 million services under this code in CY2024.

Plain-language context only—not the official CPT descriptor and not coding guidance

What do commercial payers pay? Copy link

Which billing rules and modifiers apply? Copy link

Payment rules for 77067 Copy link

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 would a Medicare claim for 77067 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
  • 77067 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.

Global period: what 77067's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

These billing-policy indicators explain how 77067 is treated. They apply whether the code is nationally priced or carrier-priced: 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

Check a pair of codes 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 for the pair.

See every current NCCI pair for 77067 →

Why a 77067 line may not pay separately Copy link

CMS publishes no separately payable amount for 77067 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 check

  • 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.

Compare against 77066, 77071 and 77065: their amounts are in Related codes.

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).

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 77067 across quarterly releases. -10.1% decrease since Q1 2018 · peak $140.40 in Q1 2018

Q1 2018 · $140.40 Q2 2018 · $140.40 (0.0%) Q3 2018 · $140.40 (0.0%) Q4 2018 · $140.40 (0.0%) Q1 2019 · $138.39 (-1.4%) Q2 2019 · $138.39 (0.0%) Q3 2019 · $138.39 (0.0%) Q4 2019 · $138.39 (0.0%) Q1 2020 · $139.31 (+0.7%) Q2 2020 · $139.31 (0.0%) Q3 2020 · $139.31 (0.0%) Q4 2020 · $139.31 (0.0%) Q1 2021 · $134.34 (-3.6%) Q2 2021 · $134.34 (0.0%) Q3 2021 · $134.34 (0.0%) Q4 2021 · $134.34 (0.0%) Q1 2022 · $132.54 (-1.3%) Q2 2022 · $132.54 (0.0%) Q3 2022 · $132.54 (0.0%) Q4 2022 · $132.54 (0.0%) Q1 2023 · $130.47 (-1.6%) Q2 2023 · $130.47 (0.0%) Q3 2023 · $130.47 (0.0%) Q4 2023 · $130.47 (0.0%) Q1 2024 · $125.74 (-3.6%) Q1 2024 · $127.82 (+1.7%) Q2 2024 · $127.82 (0.0%) Q3 2024 · $127.82 (0.0%) Q4 2024 · $127.82 (0.0%) Q1 2025 · $124.53 (-2.6%) Q2 2025 · $124.53 (0.0%) Q3 2025 · $124.53 (0.0%) Q4 2025 · $124.53 (0.0%) Q1 2026 · $126.26 (+1.4%) Q2 2026 · $126.26 (0.0%) Q3 2026 · $126.26 (0.0%) Q4 2026 · $126.26 (0.0%)
Office (non-facility) Facility
Release Status Office Facility
Q4 2026 Oct 1, 2026 – present A $126.26 (0.0% no change) $126.26 (0.0% no change)
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 77067 rate last moved in Q1 2026. See its rate history.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Usage and related codes Copy link

How often 77067 is billed Copy link

Across Original Medicare in CY2024, 77067 ranked #28 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
5.7M
Office + facility beneficiaries combined
Services
6.1M
Times it was billed
Allowed
$394.5M
Total Medicare allowed dollars
Compare: ↑ #27 more popular · 93306 ↓ #29 less popular · 90837

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.

Who bills 77067 to Medicare

Observed CY2024 Medicare fee-for-service billing, by the rendering clinician's CMS specialty. Each share is that specialty's slice of all observed services for this code that year.

Radiology
95%
Obstetrics & Gynecology
2%
Family Medicine
1%
Internal Medicine
1%
NP/PA
0%

Setting split that year: 51% Office (non-facility) · 49% facility. CMS publishes only this facility vs non-facility split, never the exact place of service. The Office (non-facility) figure does not identify urgent care or any other specific setting.

CY2024 Medicare fee-for-service only, from the CMS Physician & Other Practitioners dataset, which suppresses rows under 11 beneficiaries. We omit specialty groups with fewer than 30 observed clinicians, so the shares can fall short of 100%. Specialty and practice-type pages linked elsewhere on this page are curated code lists, not utilization claims.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q4 2017 release (effective October 2017). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q4 2017) · rvu17d.zip (PPRRVU17_OCT.csv row 12,659)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 77067 National PFS baseline: No national PFS rate (Q4 2017; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU17D, PPRRVU17_OCT.csv row 12,659. Localis. https://localishealth.com/cpt/77067/2017/D