CPT 77066 Diagnostic Bilateral Mammography Reimbursement | OpenPayer

Summary & Overview

CPT 77066: Diagnostic Bilateral Mammography with Computer‑Aided Detection

CPT code 77066 represents bilateral diagnostic mammography for patients with a breast lump or suspected cancer and may include computer‑aided detection (CAD) that converts signals into digital data and assists image analysis. This code is widely used in breast imaging workflows and is important for timely cancer diagnosis, triage of palpable findings, and coordination between radiology and breast specialty services. Nationally, diagnostic mammography is a common, high‑value imaging service with implications for quality measures and screening follow‑up.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for utilization and reimbursement patterns, a summary of coding and clinical context for diagnostic mammography with CAD, and notes on payer coverage trends and common modifiers that affect billing. The publication outlines how CPT code 77066 fits into mammography service lines, expected sites of service, and the clinical scenarios that trigger its use. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare77066CPTmammographydiagnostic-imagingbreast-cancercomputer-aided-detectionradiologyoutpatient-imaging

Billing Code Overview

CPT code 77066 describes bilateral X‑ray imaging of the breasts performed for a patient presenting with a palpable lump or suspected breast cancer. The service includes acquisition of mammographic images of both breasts and may include the use of specialized computer software that converts signals into digital data and assists in image analysis to identify potential abnormalities.

Service type: Diagnostic mammography with computer‑aided detection/analysis
Typical site of service: Outpatient radiology suite or hospital imaging department

Clinical & Coding Specifications

Clinical Context

A 52-year-old female presents to the breast imaging center with a palpable right breast mass noted on self-exam. The referring breast surgeon orders diagnostic mammography with computer-aided detection to evaluate the mass. The imaging appointment is scheduled at an outpatient radiology facility. On arrival, the patient registration confirms clinical history of a new lump and prior inconclusive screening mammogram. A mammography technologist obtains bilateral diagnostic craniocaudal and mediolateral oblique views, including magnification and spot-compression as indicated. The interpreting radiologist reviews the images, applies the facility’s FDA-cleared computer-aided detection/diagnostic software that converts analog/digital signals to enhance lesion conspicuity, documents findings, and issues a diagnostic mammography report. If additional tissue characterization is required, the radiologist may recommend targeted breast ultrasound or image-guided biopsy. Typical documentation includes clinical indication (palpable mass), procedure performed as bilateral diagnostic mammography with CAD, images obtained, any additional views, and the final impression with BI-RADS assessment. Typical site of service: outpatient radiology department or dedicated breast imaging center. Service type: diagnostic bilateral mammography with computer-aided detection/analysis.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation of the mammogram separate from the technical component.

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

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

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

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

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

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

CPT 77061: Digital Tomosynthesis of One Breast, Diagnostic

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

CPT 77054: Ductogram (Galactogram) Radiological Supervision and Interpretation

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

CPT 77047: Bilateral Breast MRI, Non-Contrast

77067-SCREENING-MAMMOGRAPHY-BILATERAL-2VIEW-STUDY-OF-EACH-BREAST

CPT 77067: Screening Mammography, Bilateral with CAD

CPT-77049-BREAST-MRI-WITH-AND-WITHOUT-CONTRAST-BILATERAL

CPT 77049: Bilateral Breast MRI with and without Contrast

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

CPT 77063: Digital Breast Tomosynthesis (3D Mammography)

CPT-77046-BREAST-MRI-NON-CONTRAST-SINGLE-BREAST-3D

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

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Taxonomy Code	Specialty	Notes
207P00000X	Radiology	Diagnostic radiologists interpret mammography and CAD-assisted breast imaging.
2085R0200X	Diagnostic Radiology	Physicians with diagnostic radiology focus commonly provide interpretation in breast imaging centers.
363L00000X	Radiology—Breast Imaging	Breast imaging specialists and fellowship-trained radiologists perform diagnostic mammography and image-guided procedures.
207L00000X	Internal Medicine	Primary care physicians commonly refer and may document clinical indication; not primary performers of the service.
207V00000X	Surgery	Breast surgeons commonly refer and manage subsequent procedures based on mammography findings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Commonly used when imaging identifies abnormal or inconclusive findings requiring further evaluation.
`R92.0`	Mammographic microcalcification found on diagnostic imaging of breast	Relevant when calcifications are identified on mammography prompting diagnostic assessment.
`N63`	Unspecified lump in breast	Typical presenting complaint (palpable mass) that prompts diagnostic mammography `77066`.
`C50.912`	Malignant neoplasm of unspecified site of right female breast	Used when imaging is performed for suspected or known breast cancer on the right side.
`C50.911`	Malignant neoplasm of unspecified site of left female breast	Used when imaging is performed for suspected or known breast cancer on the left side.
`N64.4`	Mastodynia (breast pain)	Breast pain may prompt diagnostic rather than screening mammography when associated with focal concern.
`R92.1`	Other abnormal mammographic findings	General code for abnormal mammogram results leading to diagnostic imaging and workup.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77067`	Screening mammography, bilateral (2-view study of each breast)	Performed as routine screening; may precede diagnostic `77066` when an abnormality is identified on screening.
`76641`	Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete	Often performed following diagnostic mammography `77066` to further evaluate a palpable mass or mammographic finding.
`19083`	Biopsy, breast, with placement of localization device when performed, and imaging guidance (e.g., stereotactic), first lesion	Stereotactic or image-guided biopsy may follow diagnostic mammography findings requiring tissue sampling.
`77063`	Computer-aided detection (CAD) for screening mammography, processing only (list separately in addition to screening mammography)	Related CAD services may be reported depending on payer rules; supports lesion detection in digital studies.
`76000`	Fluoroscopy (separate procedure), up to 1 hour physician time, including fluoroscopic guidance and fluoroscopic supervision and interpretation	May be used as part of localization or interventional procedures following diagnostic mammography findings.

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