Summary & Overview

CPT 77047: Bilateral Breast MRI, Non-Contrast

CPT code 77047 represents a bilateral, non-contrast breast magnetic resonance imaging (MRI) exam that produces three-dimensional images using magnetic fields and radiofrequency waves. This diagnostic imaging code is nationally relevant for breast cancer screening, diagnostic workups, and surveillance when contrast is not administered or is contraindicated. Breast MRI is an important tool in high-risk screening, problem-solving imaging, and preoperative planning, and proper coding affects clinical documentation, payer coverage determinations, and facility planning.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how 77047 is used across settings, typical billing considerations, and where policy updates could affect coverage and coding practice.

Readers will learn the clinical context for use of CPT code 77047, the typical sites where the service is delivered, and the implications for billing and reimbursement workflows. The report includes benchmarking and payment context, common modifiers and billing considerations (where provided), and notes on documentation elements that support the use of a non-contrast bilateral breast MRI. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare77047CPTbreast MRIdiagnostic imagingnon-contrast MRIradiologybreast cancer screeningmedical billing

Billing Code Overview

CPT code 77047 describes a non-contrast magnetic resonance imaging procedure that acquires three-dimensional images of both breasts using an external magnetic field and radiofrequency waves. The service is a diagnostic breast MRI performed without intravenous contrast medium.

Service type: Diagnostic imaging — Breast MRI, non-contrast, bilateral

Typical site of service: Hospital outpatient imaging center or freestanding radiology/imaging facility

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 48-year-old woman with dense breast tissue and a prior history of suspicious findings on screening mammography is referred for a diagnostic breast MRI without contrast to further evaluate complex parenchymal asymmetries and to localize architectural distortion identified on prior imaging. The patient arrives at an outpatient radiology center and is registered, screened for MRI contraindications (eg, pacemaker, metallic implants, pregnancy, renal failure is not relevant for non-contrast), and provided ear protection. The MRI technologist positions the patient prone with the breasts placed in a dedicated bilateral breast coil. The protocol includes multiplanar, high-resolution, non-contrast sequences such as T1-weighted, T2-weighted, STIR/fat-suppressed, and diffusion-weighted imaging to characterize lesions. The interpreting radiologist reviews images, documents BI-RADS assessment, and provides an impression indicating whether further evaluation with contrast-enhanced MRI, ultrasound, or biopsy is recommended. Image post-processing generates three-dimensional reconstructions. Final images and report are transmitted to the referring clinician for management decisions.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation separate from technical component.
`TC`	Technical component	Use when billing only facility/technical portion (scanner, technologist).
`76`	Data not in provided list — Data not available in the input.	Data not available in the input.
`50`	Bilateral procedure (note: included in this code)	Use if payer requires bilateral modifier despite `77047` describing both breasts; verify payer policy.
`59`	Data not in provided list — Data not available in the input.	Data not available in the input.
`26`	Professional component	Use when physician billing separate professional interpretation.
`52`	Reduced services	Use when the MRI study was partially reduced in scope (eg, terminated early).
`53`	Discontinued procedure	Use when the exam was started but discontinued for patient intolerance or safety concerns.
`77`	Repeat procedure by another physician	Use when a different provider repeats the technical component for quality reasons.
`99`	Other unlisted modifier	Use for unusual circumstances not captured by standard modifiers; include documentation.
`QK`	Medical direction of two or more qualified health care professionals	Use when applicable for anesthesia-related billing (if anesthesia required).
`QX`	Service provided under a physician's supervision by a nurse practitioner	Use when advanced practitioner performed portion under physician's supervision, per payer rules.
`QY`	Medical direction of one qualified health care professional by a physician	Use when physician medically directs the procedure.

Taxonomy Code	Specialty	Notes
2085R0200X	Diagnostic Radiology	Radiologists interpret breast MRI studies and provide BI-RADS assessments.
207RH0000X	Radiology — Diagnostic	Imaging specialists performing and supervising MRI studies.
363L00000X	Nurse Practitioner	NPs may coordinate care and in some settings perform interpretation under supervision, per payer rules.
207K00000X	Anesthesiology	Anesthesiologists provide sedation for claustrophobic or noncompliant patients when required.
207EP0003X	Breast Surgery	Breast surgeons frequently order and act on MRI results for surgical planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N60.19`	Fibrosclerosis of breast, unspecified breast	Evaluates fibrocystic changes or areas of scarring that may mimic malignancy on mammography.
`N63`	Unspecified lump in breast	Non-specific palpable mass evaluation when mammography is inconclusive.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Follow-up imaging to clarify indeterminate findings on mammography or ultrasound.
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Staging, extent assessment, or treatment planning in known breast cancer.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Staging, extent assessment, or treatment planning in known breast cancer.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77047`	Magnetic resonance (eg, breast), bilateral, without contrast medium, including computer-aided detection (CAD) when performed	Primary code describing the non-contrast bilateral breast MRI procedure.
`76000`	Fluoroscopic guidance for needle placement (eg, biopsy)	May be performed subsequently if MRI identifies a target requiring image-guided biopsy.
`19083`	Biopsy, breast, with placement of localization device when performed, percutaneous, including imaging guidance, when performed; with placement of localization device(s) (eg, clip)	Performed after MRI-directed biopsy planning or lesion localization.
`77046`	Magnetic resonance (eg, breast), unilateral, without contrast medium	Used when only one breast is imaged without contrast as opposed to bilateral `77047`.
`77048`	Magnetic resonance (eg, breast), with contrast material(s) and without contrast material, including non-contrast images, followed by contrast and further sequences	Performed when contrast-enhanced imaging is needed after the initial non-contrast study to characterize lesions.