77067
Screening mammography, bilateral
Screening mammography, bilateral. CMS 2026 global wRVU 0.70, total RVU approximately 3.53, Medicare global allowable approximately $118. The annual breast-cancer screening study. Covered with no patient cost share under ACA preventive benefits and Medicare screening rules.
When to use it
Use 77067 for routine bilateral screening mammography in an asymptomatic patient meeting eligibility criteria (typically age 40+ for commercial, age 40+ for Medicare). Cannot be used when the patient is symptomatic, has a palpable abnormality, or is being recalled from a prior screening — those are diagnostic mammography (77065 unilateral or 77066 bilateral).
Full guidance
Often paired with 77063 (3D tomosynthesis screening add-on) when DBT is performed alongside the 2D screening views.
Documentation checklist
- ✓Order: "screening mammography" with asymptomatic indication, or routine annual screening.
- ✓Patient is asymptomatic, no palpable abnormality, no targeted callback indication.
- ✓Standard four-view mammography (CC and MLO of each breast) performed.
- ✓Interpretation report with BI-RADS category assigned.
- ✓Setting modifier; signed report.
Common pitfalls
- !Billing 77067 for a patient who actually had a palpable lump or focal symptom. That's diagnostic mammography (77065 or 77066) — not screening.
- !Billing 77067 with a 12-month frequency violation. Medicare covers annually (every 11 months actually allowed by CMS); commercial frequency varies but is usually annual.
- !Missing the DBT add-on 77063 when tomosynthesis was performed alongside 2D screening views. 77063 is an add-on code that must be reported with the screening 77067.
- !Confusing 77067 with G0202 (Medicare digital screening). G0202 was the older Medicare-specific HCPCS code; 77067 replaced it for Medicare in recent rule changes — verify your payer's preferred code.
- !Failing to assign a BI-RADS category. The category drives downstream workflow (additional imaging, biopsy referral) and is the structural deliverable of the screen.
Payer notes
Medicare and ACA-compliant commercial plans cover 77067 with no patient cost share when billed as screening (Z12.31 diagnosis). Add 77063 for DBT screening add-on; many payers cover 77063 without separate cost share. Frequency: annual (Medicare every 11 months, commercial typically every 12). If a screening is called back for diagnostic imaging, modifier GG can be used to indicate the screening became diagnostic, preserving the screening cost-share status for Medicare; commercial uses modifier 33 for the equivalent.