Summary & Overview
CPT 0634T: CT Breast With Contrast, Single Breast
CPT code 0634T represents a CT examination of a single breast performed using intravenous or intra-breast contrast material and may include 3D rendering. The code captures an advanced diagnostic breast imaging procedure used to evaluate focal findings, characterize lesions, or support surgical planning. As a distinct procedural code, 0634T matters nationally because it defines a standardized way to report contrast-enhanced breast CT imaging, supports billing and utilization tracking, and informs coverage and benefit design for advanced breast imaging services.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for contrast-enhanced breast CT, typical sites of service (outpatient imaging centers and hospital radiology departments), and common billing considerations. The publication summarizes available benchmarks and policy-relevant points where payers may differ in coverage or prior authorization requirements. It also outlines how the procedure is documented in claims and what stakeholders — including radiology practices, hospital billing departments, and payers — need to consider when coding and submitting services.
The content is intended to inform billing staff and policy analysts about the code’s clinical use, reporting expectations, and the payer landscape nationally. Data not available in the input will be identified as such in relevant sections.
Billing Code Overview
CPT code 0634T describes a computed tomography (CT) examination of a single breast performed with contrast material. The service includes advanced image processing and may include 3D rendering, though 3D rendering is not required for reporting the code.
Service type: Diagnostic imaging — CT breast with contrast
Typical site of service: Outpatient imaging center or hospital radiology department
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman referred for evaluation of a suspicious focal breast abnormality after screening mammography or diagnostic mammogram and targeted ultrasound demonstrate an indeterminate mass or architectural distortion. The ordering physician (breast surgeon, breast imaging radiologist, or oncologist) requests a contrast-enhanced dedicated breast CT of a single breast to better delineate lesion extent, vascularity, and multifocality prior to biopsy or surgical planning. The clinical workflow includes patient history and consent, screening for contraindications to iodinated contrast (renal function review, allergy assessment), IV access placement, contrast administration, acquisition of multiplanar CT images of the affected breast, optional 3D rendering, radiologist interpretation (professional component), and technologist/room resources (technical component). Results are communicated to the referring provider and used to guide image-directed biopsy planning, preoperative mapping, or further staging. Typical site of service is an outpatient imaging center or hospital radiology department equipped for dedicated breast CT and contrast administration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the radiologist interpretation separate from technical component. |
TC | Technical component | Use when billing only the equipment, technologist, and supplies portion of the service. |
52 | Reduced services | Use when the examination is partially completed or limited in scope compared with full protocol. |
53 | Discontinued procedure | Use when the exam is started but stopped for patient safety or intolerance (e.g., contrast reaction). |
76 | Data not available in the input. | Data not available in the input. |
80 | Assistant surgeon | Use when a qualified assistant surgeon participates in a related surgical procedure documented separately. |
82 | Assistant surgeon when qualified resident not available | Use when a qualified assistant surgeon provides assistance because a resident is not available. |
62 | Two surgeons | Use when two surgeons of different specialties jointly perform a related breast operation. |
52 | Data not available in the input. | Data not available in the input. |
AS | Accredited in Surgical setting | Use when service is performed in an ambulatory surgical center setting with appropriate billing. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RR0500X | Diagnostic Radiology | Performs and interprets dedicated breast CT and contrast studies. |
| 207RC0000X | Radiology - Diagnostic | Alternative taxonomy for radiologists performing cross-sectional breast imaging. |
| 207XS0117X | Breast Imaging | Subspecialty radiologist focused on breast imaging and image-guided procedures. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N63 | Unspecified lump in breast | Common indication for targeted breast imaging including contrast-enhanced dedicated breast CT to characterize a palpable or imaging-detected mass. |
R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | Used when prior imaging is inconclusive and additional cross-sectional imaging is needed. |
C50.911 | Malignant neoplasm of unspecified site of right female breast | Used when staging or extent-of-disease assessment of a known breast cancer is required for surgical planning. |
C50.912 | Malignant neoplasm of unspecified site of left female breast | As above, for the left breast. |
N61 | Inflammatory disorders of breast | When inflammatory or infectious processes require imaging to evaluate abscess or complex fluid collections. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
77063 | Magnetic resonance imaging (MRI) of the breast (contrast-enhanced), unilateral | Alternative cross-sectional contrast-enhanced modality for problem solving or preoperative staging; may be ordered before or instead of dedicated breast CT. |
77061 | MRI of the breast, bilateral, without and with contrast | Bilateral MRI when more extensive assessment is needed; complements unilateral breast CT when multifocal disease is suspected. |
19083 | Image-guided biopsy, breast, with placement of breast localization device, when performed | Often performed after lesion characterization on breast CT to obtain tissue diagnosis and localize for surgery. |
77067 | Screening mammography, two-view study of each breast | Screening test that frequently triggers additional diagnostic imaging such as dedicated breast CT for equivocal findings. |
77055 | Diagnostic mammography; single view, unilateral | Prior diagnostic imaging that may precede dedicated breast CT for targeted evaluation of a single breast. |