CPT77067

Screening Mammogram Cost in South Dakota

Scr mammo bi incl cad

$125.15South Dakota physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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South Dakota Medicare physician rate (2026)

-0.9% vs national

Single statewide locality.

South Dakota (Hospital)
$125.15
Facility physician fee
Private plan est.
$163–$250
~130–200% of Medicare
Cash / self-pay est.
$100–$188
~80–150% of Medicare

Your ZIP in South Dakota

Try a ZIP lookup for your area, whether Sioux Falls, Rapid City and the Black Hills, Aberdeen, Pierre, or the reservation and ranch country in between.

What screening mammogram costs at hospitals near you

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

Locked

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 South Dakota

National office$126.26
National hospital (physician)$126.26
South Dakota vs nationalwithin 2% of the national office rate of $126.26

Where South Dakota ranks for this CPT

Rank (lowest physician fee first)#31 of 51
Lowest stateArkansas ($111.36)
Highest stateDistrict of Columbia ($145.56)

Screening Mammogram and how South Dakota is priced

All of South Dakota falls under a single payment locality with indices near the bottom of the national scale, cushioned by the work index floor for low-cost states. Sioux Falls and a West River ranch community share one published fee schedule. The state's east-west split, with most people and providers east of the Missouri River, has no counterpart in the pricing structure. That leaves South Dakota with some of the simplest and lowest Medicare pricing in the country.

Sioux Falls has become a genuine regional medical hub, headquarters to large systems whose reach extends across the Dakotas and into neighboring states, while Rapid City anchors care for the West River side and the Black Hills. Vast stretches between them rely on critical access hospitals and tribal facilities, some of the most isolated care settings in America. Referrals to Sioux Falls, Rapid City, or out of state are a routine part of rural 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 South Dakota: questions

South Dakota is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 77067 is $125.15 in an office and $125.15 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. South Dakota uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $25 for the office physician line or $25 for the hospital physician line in South Dakota. Medigap may cover that 20%. This is not the hospital facility fee.

No. $125.15 is the Medicare physician allowed amount for CPT 77067. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. South Dakota ranks #31 of 51 states on this physician line (within 2% of 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.