CPT 77067: Screening Mammography, Digital Bilateral with CAD
Medicare pays $88 and commercial payers pay $146 on average nationally for this procedure.
CPT code 77067 describes a bilateral screening mammography with digital image acquisition and computer‑aided detection (CAD) analysis; the service is a screening breast X‑ray procedure typically provided in an outpatient imaging center or hospital radiology department and involves obtaining two standard views of each breast with digital processing to assist image interpretation.
For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.
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National Reimbursement Benchmarks
Across national payers, Medicare’s mean rate of $87.7 sits well below BUCA’s average commercial mean of $145.6, indicating a sizeable gap between public and this pooled commercial benchmark. The median for Medicare is $93, close to its mean, while BUCA’s median of $135.8 is noticeably higher, reflecting that commercial reimbursements commonly exceed Medicare for CPT 77067.
Dispersion measured as P75 minus P25 highlights variability differences: Blue Cross Blue Shield has a range of $75.7 (P75 $191.1 minus P25 $115.4), UnitedHealth Group shows a tighter range of $88.2 (P75 $166.0 minus P25 $74.8) while Cigna’s range is $115. - calculated as P75 $182.1 minus P25 $67.2, and Aetna’s range is $78.0 (P75 $137.5 minus P25 $59.9). BUCA’s interquartile spread is $89.8 (P75 $178.6 minus P25 $94.8). Cigna displays the widest IQR, and Aetna the tightest among those with full quartile data.