CPT77067

Screening Mammogram Cost in California

Scr mammo bi incl cad

$144.68California physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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California Medicare physician rate (2026)

+14.6% vs national

Average of 29 localities. Office range $135.49–$172.34.

California (Hospital)
$144.68
Facility physician fee
Private plan est.
$188–$289
~130–200% of Medicare
Cash / self-pay est.
$116–$217
~80–150% of Medicare

Your ZIP in California

A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.

What screening mammogram costs at hospitals near you

Everything above is a national average. The hospital you pick in California moves the bill more than anything else you control.

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Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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.

National vs California

National office$126.26
National hospital (physician)$126.26
California vs national15% above the national office rate of $126.26

Where California ranks for this CPT

Rank (lowest physician fee first)#50 of 51
Lowest stateArkansas ($111.36)
Highest stateDistrict of Columbia ($145.56)

CPT 77067 by California locality

LocalityOffice
san jose-sunnyvale-santa clara (san benito cnty)$172.34
san jose-sunnyvale-santa clara (santa clara cnty)$172.11
san francisco-oakland-berkeley (marin cnty)$168.65
san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty)$168.59
napa$158.75
vallejo$158.67
santa rosa-petaluma$148.99
santa cruz-watsonville$147.47
san diego-chula vista-carlsbad$145.81
los angeles-long beach-anaheim (los angeles/orange cnty)$144.98
oxnard-thousand oaks-ventura$144.49
santa maria-santa barbara$142.75
sacramento-roseville-folsom$142.65
salinas$142.13
san luis obispo-paso robles$139.78
riverside-san bernardino-ontario$136.04
bakersfield$135.66
el centro$135.50
chico$135.49
fresno$135.49
hanford-corcoran$135.49
madera$135.49
merced$135.49
modesto$135.49
redding$135.49
stockton$135.49
visalia$135.49
yuba city$135.49
rest of california$135.49

PE GPCI ranges from 1.096 to 1.442 in California. That index is why the same CPT is not one price statewide.

Screening Mammogram and how California is priced

California is the most finely divided state in the Medicare fee schedule, with roughly thirty payment localities drawn around metropolitan statistical areas after CMS reformed the state's locality map. The San Francisco Bay Area carries some of the highest geographic adjustments in the nation, with San Francisco, San Jose, and the East Bay each priced separately, while Los Angeles, Orange County, San Diego, and Sacramento have their own localities at somewhat lower levels. Rural and inland counties fall into lower-cost localities, so the same procedure can carry meaningfully different Medicare-approved amounts within a single day's drive. No other state shows this much in-state variation on the fee schedule itself.

California's markets differ sharply: the Bay Area combines high wages with heavily consolidated hospital systems, Los Angeles offers enormous choice across a sprawling region, and the Central Valley and far north face genuine access shortages. Where you are treated within the state matters more here than almost anywhere else in the country. Academic medical centers in the Bay Area, Los Angeles, San Diego, and Sacramento handle much of the complex referral care.

This procedure: 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 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.

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 in California: questions

The 2026 Medicare physician office rate for CPT 77067 averages $144.68 across 29 California localities, from $135.49 in CHICO to $172.34 in SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY). The hospital physician rate averages $144.68. Enter a ZIP for the exact locality.

Yes. CMS splits California into 29 payment localities. For this CPT the office physician fee spans $36.85 from the lowest to highest locality. A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $29 for the office physician line or $29 for the hospital physician line in California. Medigap may cover that 20%. This is not the hospital facility fee.

No. $144.68 is the Medicare physician allowed amount for CPT 77067. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. California ranks #50 of 51 states on this physician line (15% above the national office rate of $126.26).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.