CPT 0637T: Bilateral CT of Breasts with Contrast

CPT code 0637T represents a bilateral computed tomography (CT) examination of the breasts using intravenous contrast, a diagnostic breast imaging modality that can provide cross-sectional and optionally rendered 3D views. As advanced breast imaging grows, this code matters nationally for payers, imaging providers, and health systems because it defines billing for an evolving technology that complements mammography and breast MRI in select clinical scenarios. Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise policy and reimbursement-focused briefing that explains the clinical context for CT breast imaging with contrast, common sites of service, and typical use cases. The publication summarizes payer coverage patterns and benchmarks where available, highlights recent policy developments affecting advanced breast imaging reimbursement, and outlines operational considerations for imaging departments and radiology practices. The content provides a national-level view intended to inform coding, billing, and administrative decision-making for facilities and clinicians who offer bilateral contrast-enhanced breast CT.

Billing Code Overview

CPT code 0637T describes a computed tomography (CT) examination of both breasts performed with intravenous contrast material. The code covers bilateral breast CT imaging and includes, but does not require, three-dimensional (3D) rendering as part of the study.

Service type: Diagnostic imaging — breast CT with contrast

Typical site of service: Outpatient radiology department or dedicated imaging center, and may also be performed in hospital outpatient imaging suites when CT breast imaging is available.

Clinical Context

A typical patient is a 52-year-old woman with a new palpable breast mass and inconclusive mammography and ultrasound findings. The ordering breast surgeon requests a contrast-enhanced computed tomography (CT) bilateral breast study to further evaluate extent of disease and to assess for multifocal or multicentric lesions prior to surgical planning. The patient arrives at an outpatient radiology center or hospital outpatient imaging department. After informed consent and screening for intravenous contrast allergy and renal function, an IV catheter is placed. The CT technologist positions the patient prone or supine per facility protocol and performs a bilateral breast CT with iodinated intravenous contrast, acquiring multiplanar images; optional 3D rendering may be performed as part of the exam. The radiologist reviews axial, coronal, and sagittal reformats, documents lesion size, location (clock-face and depth), enhancement characteristics, and relationship to chest wall and skin. A diagnostic report is issued to the ordering provider with recommendations for biopsy, additional imaging (MRI, targeted ultrasound), or surgical consultation as appropriate. The typical site of service is an outpatient imaging center or hospital outpatient radiology department. The service type is diagnostic radiology — contrast-enhanced CT of both breasts (diagnostic imaging with IV contrast).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional component (interpretation) separate from technical component.

Taxonomy Code	Specialty	Notes
`2085P0201X`	Diagnostic Radiology	Radiologists commonly interpret contrast-enhanced breast CT.
`207K00000X`	General Surgery	Breast surgeons order and act on CT findings for operative planning.
`261QM0800X`	Radiology Technician	Technologists perform the acquisition and IV contrast administration.
`323Z00000X`	Breast Imaging Fellowship (Radiology)	Subspecialists with expertise in breast imaging perform advanced interpretation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Used when CT is performed to stage or evaluate known right breast cancer.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Used when CT is performed to stage or evaluate known left breast cancer.
`N63`	Unspecified lump in breast	Common indication for diagnostic breast CT when mammography/ultrasound are inconclusive.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Indicates need for additional imaging such as contrast-enhanced breast CT.
`Z90.11`	Acquired absence of right breast and nipple	Used when imaging is needed for reconstruction planning or surveillance of the contralateral breast.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77063`	Screening digital breast tomosynthesis, bilateral; performed as an adjunct to screening mammography	May be performed as initial screening prior to diagnostic CT in the breast imaging workup.
`76085`	Computer-aided detection (CAD) for interpretation of breast imaging	May be used adjunctively for lesion detection on breast CT reconstructions.
`77046`	Magnetic resonance imaging, breast, unilateral or bilateral, with contrast material(s)	Alternative cross-sectional contrast study used when additional soft-tissue characterization is needed after CT.
`19083`	Image-guided needle biopsy, breast, percutaneous, with placement of localization device when performed (first lesion)	Performed after CT demonstrates a target lesion for biopsy and when CT or other imaging guides the procedure.
`77012`	CT guidance for needle placement (guidance for biopsy)	Used when CT guidance is required for percutaneous breast biopsy following CT findings.

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Summary & Overview