Summary & Overview

CPT 0635T: CT Examination of Single Breast Without and With Contrast

CPT code 0635T denotes a CT examination of a single breast performed initially without contrast and subsequently with contrast, optionally including 3D rendering. This imaging procedure is part of advanced breast diagnostic and assessment workflows and matters nationally as facilities expand breast-specific imaging modalities to complement mammography and MRI. Payers commonly covering or adjudicating this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what the code represents clinically, typical sites of service, and how it fits into breast imaging care pathways. The publication presents benchmarks and coverage context where available, highlights relevant billing and documentation considerations, and summarizes the clinical context for when dual-phase breast CT may be used. Data not available in the input is noted when applicable. This summary is written for a national audience and is focused on clarifying the procedure, its service setting, and the payers assessed in the accompanying analysis.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0635TCPTbreast CTdiagnostic imagingradiologycontrast imaging3D renderingoutpatient imagingbreast diagnostics

Billing Code Overview

CPT code 0635T describes a computed tomography (CT) examination of a single breast performed first without contrast and then with contrast material. The service may include, but does not require, 3D rendering of the image data.

Service type: Breast CT imaging with and without contrast

Typical site of service: Outpatient radiology or imaging center, including hospital outpatient departments and freestanding CT suites.

Clinical & Coding Specifications

Clinical Context

A 52-year-old woman with a recent abnormal screening mammogram and persistent focal breast density is referred for further evaluation with breast CT (dedicated breast computed tomography). The imaging workflow includes pre-procedure patient consent and explanation, patient positioning prone on the dedicated breast CT scanner with the targeted single breast placed in the field of view, acquisition of a non-contrast CT series of the single breast, followed by intravenous administration of iodinated contrast and repeat CT acquisition of the same breast. Image post-processing may include multiplanar reformats and optional 3D rendering for lesion conspicuity. The examination is interpreted by a board-certified radiologist with breast imaging expertise; a radiology report documents technical parameters, comparison to prior studies, lesion characterization, and recommendations for further management (ultrasound, MRI, biopsy) as indicated. Typical site of service is an outpatient imaging center or hospital radiology department equipped with dedicated breast CT capability.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician interpretation separate from technical component
`TC`

Taxonomy Code	Specialty	Notes
`261QM0800X`	Diagnostic Radiology	Interpreting physician for breast CT studies
`261QR0400X`	Radiology—Diagnostic Radiology	Alternate radiology taxonomy for hospital-based radiologists
`207RC0000X`	Radiology Technician	Practitioners performing the technical component and acquisition
`363A00000X`	Nurse Practitioner	May perform patient assessment and contrast screening
`2084P0800X`	Radiation Oncologist	Consults when findings prompt multidisciplinary care

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Common indication for problem-solving breast CT after abnormal mammography
`N60.31`	Solitary cystic mastopathy of right breast	Benign breast findings that may be characterized on breast CT
`N63`	Unspecified lump in breast	Palpable mass prompting targeted breast CT evaluation
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Staging or lesion characterization in known breast cancer may involve dedicated breast CT
`N64.89`	Other specified disorders of breast	Miscellaneous breast symptoms or findings evaluated with breast CT

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77063`	Screening digital breast tomosynthesis, unilateral or bilateral; single view per breast	Alternative advanced breast imaging modality used for problem solving prior to breast CT
`77061`	Diagnostic mammography, including CAD when performed; unilateral	Often performed before or after breast CT for correlative evaluation
`76641`	Ultrasound breast, unilateral, real time with image documentation	Frequently performed as an adjunct to evaluate lesions detected on breast CT and guide biopsy
`19083`	Biopsy, breast, percutaneous, with imaging guidance (e.g., stereotactic, ultrasound, MRI), first lesion	Performed if breast CT identifies a suspicious lesion requiring tissue diagnosis
`75563`	Magnetic resonance angiography, chest, for breast MRI protocols	Breast MRI may be performed as a complementary cross-sectional study when CT findings are indeterminate