Find policies, billing codes, payers, states, and providers

CPT 77049: Bilateral Breast MRI with and without Contrast

CPT code 77049 represents a bilateral breast magnetic resonance imaging (MRI) study performed with and without intravenous contrast, often producing three-dimensional images and optionally using real-time computer-aided detection. This advanced diagnostic imaging code is central to breast cancer detection, preoperative planning, and evaluation of complex breast conditions, making it clinically and financially significant across care settings nationwide. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of the clinical context for bilateral contrast-enhanced breast MRI, benchmarks related to utilization and payment (where available), and relevant policy updates affecting coverage and reimbursement. The publication explains typical service locations such as outpatient imaging centers and hospital outpatient departments, outlines common billing considerations, and highlights coverage patterns among major national payers. Data not provided in the input will be noted as unavailable where applicable.

Customize your policy alerts

Sign up for cpt 77049 policy alerts

Get alerted when payer policies referencing 77049 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 77049 describes a bilateral breast magnetic resonance imaging (MRI) procedure performed with and without contrast, producing three-dimensional images. The provider applies an external magnetic field and radiofrequency waves to generate cross-sectional and volumetric breast images; the service may include real-time computer-aided detection (CAD) during image acquisition.

Service type: Diagnostic advanced imaging (breast MRI with and without contrast, bilateral)
Typical site of service: Outpatient imaging centers, hospital outpatient departments, or specialized breast imaging clinics

Data not available in the input.

Find policies, billing codes, payers, states, and providers

CPT 77049: Bilateral Breast MRI with and without Contrast

Customize your policy alerts

Sign up for cpt 77049 policy alerts

Get alerted when payer policies referencing 77049 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Diagnostic advanced imaging (breast MRI with and without contrast, bilateral)
Typical site of service: Outpatient imaging centers, hospital outpatient departments, or specialized breast imaging clinics

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a woman aged 40–75 referred for a contrast-enhanced breast MRI (77049) after abnormal findings on screening mammography or diagnostic ultrasound, or for high-risk surveillance (personal or strong family history, BRCA mutation). The workflow begins with an order from the referring physician documenting the indication (eg, suspicious mammographic mass, extent-of-disease staging, or high-risk screening). The patient completes MRI safety screening (implant, pacemaker, renal function), IV access is obtained, and gadolinium-based contrast is administered unless contraindicated. The MRI technologist positions the patient prone with a dedicated breast coil and acquires multiplanar, high-resolution 3D sequences before and after contrast. A radiologist interprets the images, may use real-time computer-aided detection (CAD) during review, and issues a diagnostic report with BI-RADS assessment. Results are communicated to the referring provider for management decisions such as biopsy, short-interval follow-up, or surgical planning. Typical site of service is an outpatient radiology center or hospital outpatient imaging department. The service type is diagnostic breast MRI with and without contrast, including potential real-time CAD.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician interpretation/report is billed separate from technical imaging.
`TC`	Technical component	Use when only the facility/equipment/technologist portion is billed.
`59`	Distinct procedural service	Use when another separate, identifiable service is performed on the same day and needs claim separation.
`76`	Repeat procedure by same physician	Use if the same breast MRI is repeated later the same day by the same provider.
`77`	Repeat procedure by another physician	Use if repeat imaging is performed by a different provider the same day.
`52`	Reduced services	Use when the MRI was partially reduced or limited compared with full protocol.
`53`	Discontinued procedure	Use when the MRI was started but terminated due to patient intolerance or safety concerns.
`22`	Increased procedural services	Use when documentation supports unusually high complexity or time beyond the typical service.
`25`	Significant, separately identifiable evaluation and management service	Use when a separately identifiable E/M visit is provided on the same day as MRI and reported by the physician.
`59`	Distinct procedural service	Use when another procedure on the same day is separate and not normally billed together.
`RT`	Right side	Use for laterality reporting when billing component-level or modifier-based laterality is required.
`LT`	Left side	Use for laterality reporting when billing component-level or modifier-based laterality is required.
`50`	Bilateral procedure	Use when billing indicates a bilateral breast MRI when payer accepts bilateral modifier instead of dual units.
`GY`	Not in provided list — Data not available in the input.	Data not available in the input.

Taxonomy Code	Specialty	Notes
207RC0000X	Diagnostic Radiology	Radiologists who interpret breast MRI and issue diagnostic reports.
207RR0500X	Radiology — Vascular & Interventional	Interventional radiologists perform MRI-guided breast biopsies closely associated with MRI services.
207P00000X	Pathology	Pathologists analyze biopsy specimens obtained after MRI-guided procedures.
207L00000X	Nuclear Medicine	Nuclear medicine physicians occasionally collaborate for multimodality imaging in complex cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.912`	Malignant neoplasm of unspecified site of right female breast	Used when MRI is performed for staging or extent-of-disease assessment in known breast cancer.
`C50.911`	Malignant neoplasm of unspecified site of left female breast	As above, for left-sided disease assessment and surgical planning.
`N63`	Unspecified lump in breast	MRI is used to further evaluate a palpable mass not well characterized on mammography/ultrasound.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Used when prior imaging is indeterminate and MRI is needed for problem solving.
`Z15.01`	Genetic susceptibility to malignant neoplasm of breast (BRCA1)	High-risk surveillance indication for contrast-enhanced breast MRI screening.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19083`	Biopsy, breast, with MRI guidance, single lesion; first lesion	Often performed following suspicious MRI findings to obtain tissue diagnosis.
`77046`	Magnetic resonance (eg, breast), unilateral or bilateral, without contrast material, followed by contrast material(s) and further sequences	Related breast MRI technical code representing sequences with and without contrast; used in some billing scenarios or payer-specific bundling.
`76942`	Ultrasonic guidance for needle placement (eg, diagnostic or therapeutic injection, aspiration, biopsy)	Ultrasound guidance may be used for targeted biopsies when MRI findings can be correlated and localized with ultrasound.
`73110`	Computed tomography, extremity, other than joints, with contrast — Data not typical for breast MRI but included only when cross-sectional multimodality imaging is required	Performed rarely in complex staging; not routine for breast MRI workup.
`77051`	Screening mammography, bilateral (2-view study of each breast)	Often performed before or after MRI as part of comprehensive breast imaging evaluation.

CPT 77046: Breast MRI, Non-Contrast, Single Breast

CPT-77047-BREAST-MRI-NON-CONTRAST-BILATERAL

CPT 77047: Bilateral Breast MRI, Non-Contrast

CPT-77048-BREAST-MRI-SINGLE-BREAST-CONTRAST-3D

CPT 77048: Breast MRI (single breast), Contrast-Enhanced 3D

CPT-77053-DUCTOGRAM-RADIOLOGICAL-SUPERVISION-INTERPRETATION-SINGLE-DUCT

CPT 77053: Radiological Supervision & Interpretation of Ductogram, Single Duct

CPT-77054-DUCTOGRAM-GALACTOGRAM-MULTIPLE-DUCTS-RADIOLOGICAL-INTERPRETATION

CPT 77054: Ductogram (Galactogram) Radiological Supervision and Interpretation

CPT-77061-DIGITAL-TOMOSYNTHESIS-ONE-BREAST-DIAGNOSTIC

CPT 77061: Digital Tomosynthesis of One Breast, Diagnostic

CPT-77062-DIGITAL-BREAST-TOMOSYNTHESIS-BILATERAL-DIAGNOSTIC

CPT 77062: Digital Breast Tomosynthesis, Bilateral, Diagnostic

CPT-77063-DIGITAL-BREAST-TOMOSYNTHESIS-3D-MAMMOGRAPHY

CPT 77063: Digital Breast Tomosynthesis (3D Mammography)

CPT-77065-DIAGNOSTIC-BREAST-IMAGING-COMPUTER-AIDED-DETECTION

CPT 77065: Diagnostic X-ray Imaging of One Breast with Computer Analysis

CPT-77066-DIAGNOSTIC-BILATERAL-MAMMOGRAPHY-WITH-CAD

CPT 77066: Diagnostic Bilateral Mammography with Computer‑Aided Detection

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician interpretation/report is billed separate from technical imaging.
`TC`	Technical component	Use when only the facility/equipment/technologist portion is billed.
`59`	Distinct procedural service	Use when another separate, identifiable service is performed on the same day and needs claim separation.
`76`	Repeat procedure by same physician	Use if the same breast MRI is repeated later the same day by the same provider.
`77`	Repeat procedure by another physician	Use if repeat imaging is performed by a different provider the same day.
`52`	Reduced services	Use when the MRI was partially reduced or limited compared with full protocol.
`53`	Discontinued procedure	Use when the MRI was started but terminated due to patient intolerance or safety concerns.
`22`	Increased procedural services	Use when documentation supports unusually high complexity or time beyond the typical service.
`25`	Significant, separately identifiable evaluation and management service	Use when a separately identifiable E/M visit is provided on the same day as MRI and reported by the physician.
`59`	Distinct procedural service	Use when another procedure on the same day is separate and not normally billed together.
`RT`	Right side	Use for laterality reporting when billing component-level or modifier-based laterality is required.
`LT`	Left side	Use for laterality reporting when billing component-level or modifier-based laterality is required.
`50`	Bilateral procedure	Use when billing indicates a bilateral breast MRI when payer accepts bilateral modifier instead of dual units.
`GY`	Not in provided list — Data not available in the input.	Data not available in the input.

Taxonomy Code	Specialty	Notes
207RC0000X	Diagnostic Radiology	Radiologists who interpret breast MRI and issue diagnostic reports.
207RR0500X	Radiology — Vascular & Interventional	Interventional radiologists perform MRI-guided breast biopsies closely associated with MRI services.
207P00000X	Pathology	Pathologists analyze biopsy specimens obtained after MRI-guided procedures.
207L00000X	Nuclear Medicine	Nuclear medicine physicians occasionally collaborate for multimodality imaging in complex cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.912`	Malignant neoplasm of unspecified site of right female breast	Used when MRI is performed for staging or extent-of-disease assessment in known breast cancer.
`C50.911`	Malignant neoplasm of unspecified site of left female breast	As above, for left-sided disease assessment and surgical planning.
`N63`	Unspecified lump in breast	MRI is used to further evaluate a palpable mass not well characterized on mammography/ultrasound.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Used when prior imaging is indeterminate and MRI is needed for problem solving.
`Z15.01`	Genetic susceptibility to malignant neoplasm of breast (BRCA1)	High-risk surveillance indication for contrast-enhanced breast MRI screening.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19083`	Biopsy, breast, with MRI guidance, single lesion; first lesion	Often performed following suspicious MRI findings to obtain tissue diagnosis.
`77046`	Magnetic resonance (eg, breast), unilateral or bilateral, without contrast material, followed by contrast material(s) and further sequences	Related breast MRI technical code representing sequences with and without contrast; used in some billing scenarios or payer-specific bundling.
`76942`	Ultrasonic guidance for needle placement (eg, diagnostic or therapeutic injection, aspiration, biopsy)	Ultrasound guidance may be used for targeted biopsies when MRI findings can be correlated and localized with ultrasound.
`73110`	Computed tomography, extremity, other than joints, with contrast — Data not typical for breast MRI but included only when cross-sectional multimodality imaging is required	Performed rarely in complex staging; not routine for breast MRI workup.
`77051`	Screening mammography, bilateral (2-view study of each breast)	Often performed before or after MRI as part of comprehensive breast imaging evaluation.

CPT 77046: Breast MRI, Non-Contrast, Single Breast

CPT-77047-BREAST-MRI-NON-CONTRAST-BILATERAL

CPT 77047: Bilateral Breast MRI, Non-Contrast

CPT-77048-BREAST-MRI-SINGLE-BREAST-CONTRAST-3D

CPT 77048: Breast MRI (single breast), Contrast-Enhanced 3D

CPT-77053-DUCTOGRAM-RADIOLOGICAL-SUPERVISION-INTERPRETATION-SINGLE-DUCT

CPT 77053: Radiological Supervision & Interpretation of Ductogram, Single Duct

CPT-77054-DUCTOGRAM-GALACTOGRAM-MULTIPLE-DUCTS-RADIOLOGICAL-INTERPRETATION

CPT 77054: Ductogram (Galactogram) Radiological Supervision and Interpretation

CPT-77061-DIGITAL-TOMOSYNTHESIS-ONE-BREAST-DIAGNOSTIC

CPT 77061: Digital Tomosynthesis of One Breast, Diagnostic

CPT-77062-DIGITAL-BREAST-TOMOSYNTHESIS-BILATERAL-DIAGNOSTIC

CPT 77062: Digital Breast Tomosynthesis, Bilateral, Diagnostic

CPT-77063-DIGITAL-BREAST-TOMOSYNTHESIS-3D-MAMMOGRAPHY

CPT 77063: Digital Breast Tomosynthesis (3D Mammography)

CPT-77065-DIAGNOSTIC-BREAST-IMAGING-COMPUTER-AIDED-DETECTION

CPT 77065: Diagnostic X-ray Imaging of One Breast with Computer Analysis

CPT-77066-DIAGNOSTIC-BILATERAL-MAMMOGRAPHY-WITH-CAD

CPT 77066: Diagnostic Bilateral Mammography with Computer‑Aided Detection

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 77049: Bilateral Breast MRI with and without Contrast

Sign up for cpt 77049 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 77049: Bilateral Breast MRI with and without Contrast

Sign up for cpt 77049 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 77049: Bilateral Breast MRI with and without Contrast

Sign up for cpt 77049 policy alerts

Billing Code Overview

CPT 77049: Bilateral Breast MRI with and without Contrast

Sign up for cpt 77049 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What procedure does CPT 77049 represent and where is it typically performed?

Which billing modifiers are relevant for CPT 77049 and when are they used?

What related CPT codes should be considered when billing for breast MRI services?

Which ICD-10 diagnoses are commonly associated with CPT 77049?

What is the typical clinical workflow for a bilateral breast MRI performed with CPT 77049?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What procedure does CPT 77049 represent and where is it typically performed?

Which billing modifiers are relevant for CPT 77049 and when are they used?

What related CPT codes should be considered when billing for breast MRI services?

Which ICD-10 diagnoses are commonly associated with CPT 77049?

What is the typical clinical workflow for a bilateral breast MRI performed with CPT 77049?

References