Screening Mammogram Cost
Scr mammo bi incl cad
$126.26Medicare physician fee2026 national office rate- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
National Medicare physician rate (2026)
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.
What screening mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
How CMS prices CPT 77067
Work is about 20% of the office total RVU; practice expense is about 79%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $126.26. Hospital (facility) physician rate: $126.26.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $25 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
What Is Screening Mammogram?
A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s.
What Affects the Cost
- –The screening itself is free under ACA preventive rules at in-network facilities, so out-of-pocket cost usually arises only from what follows.
- –3D tomosynthesis screening is an add-on code; most plans and Medicare now cover it as part of screening, but a few still pass its cost to patients.
- –Callbacks for additional views are billed as diagnostic mammography with normal cost sharing, and roughly one in ten screenings generates a callback.
- –Out-of-network facilities are not bound by the zero-cost-share screening rule.
- –Dense-breast supplemental imaging, like ultrasound or MRI, is billed separately and often with cost sharing.
How It Is Billed
CPT 77067 covers the two-view screening study of both breasts with the radiologist's interpretation, and the 3D screening add-on has its own code when performed. If the radiologist sees something and you return for extra views, that second visit bills as diagnostic (77065 or 77066), not screening. Annual claims frequency matters: plans cover screening at defined intervals, and scheduling a few weeks early can cause an automated denial.
Insurance & Coverage Notes
Under the ACA, in-network screening mammograms are covered with zero cost sharing on essentially all commercial plans, and Medicare covers annual screening with no coinsurance. The common billing surprise is the callback: diagnostic imaging after an abnormal screen is not protected by the preventive rule federally, though many states now mandate free diagnostic follow-up on state-regulated plans. Keep screening and any unrelated breast complaints in separate visits, because mentioning a symptom can convert the whole study to diagnostic billing.
Questions to Ask Before Booking
- 1.Is this facility in network so my screening is fully free?
- 2.Is 3D tomosynthesis included at no charge under my plan?
- 3.If I get called back for more views, what will that diagnostic visit cost me?
- 4.Am I inside my plan's allowed screening interval so the claim will not be denied for timing?
- 5.If I have dense breasts, what supplemental imaging might be recommended and does my plan cover it?
Screening Mammogram (CPT 77067): questions
The 2026 national Medicare physician rate for CPT 77067 is $126.26 in an office and $126.26 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.
For CPT 77067 the office and hospital physician rates are essentially the same ($126.26). The hospital will still usually add a separate facility fee that this page does not show.
A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s. CMS bills it as “Scr mammo bi incl cad.”
No. $126.26 is the physician allowed amount. Anesthesia, facility fees, implants, imaging interpretation billed under a different code, and pathology are separate when they apply. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.