Diagnostic Mammogram price: Medicare anchor and facility lever
Anchor for Diagnostic Mammogram - CPT 77066
$154.56
Professional (26) $47.39 plus technical (TC) $107.17.
A diagnostic mammogram is ordered to look at a specific concern or to follow up a screening result, and Medicare treats its cost very differently from screening. CPT 77066 is the bilateral study and 77065 the one-breast study. The patient's share and the add-on lines are what change a diagnostic quote.
CPT code
77066
Diagnostic mammography, including computer-aided detection when performed; bilateral
CPT 77066 is bilateral diagnostic mammography. Unilateral is 77065, and screening is 77067. Tomosynthesis add-on code 77063 can be billed with diagnostic mammography in some settings and changes the total.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 77066 (this page) | $154.56 | $154.56 | not a surgical global | not paid by APC | n/a |
| 77065 | $121.95 | $121.95 | not a surgical global | not paid by APC | n/a |
| 77063 | $50.73 | $50.73 | add-on code | not paid by APC | n/a |
Medicare.gov states that for a diagnostic mammogram, after the Part B deductible, you pay 20 percent of the Medicare-approved amount, while a screening mammogram once every 12 months costs nothing with a provider who accepts assignment. The visit's code therefore matters to the patient's share, not only to the price.
The CY2026 Michigan Locality 01 global anchors are $154.56 for the bilateral diagnostic study and $121.95 for one breast.
The professional component of the bilateral diagnostic study is $47.39 of the $154.56 global anchor, and for one breast it is $38.55 of $121.95. When a diagnostic mammogram is followed the same day by another imaging study, each study is its own code and its own anchor, so a complete written quote should list every study the facility expects to perform.
Inside and outside the 77066 anchor
Covered by the anchor
- Diagnostic imaging of both breasts
- Radiologist diagnostic interpretation and report
- Computer-aided detection when performed as part of 77066
Billed outside it
- Tomosynthesis when billed as a separate add-on line
- Additional diagnostic views or ultrasound ordered after the first study
- The ordering visit and follow-up visit
Why prices vary for CPT 77066
Diagnostic mammography is paid under the Physician Fee Schedule in most settings, including hospital outpatient departments, rather than under OPPS. Cash prices still vary by site, by whether tomosynthesis is added, and by how the facility bundles the professional and technical components.
Ask whether tomosynthesis is included in the quote, and whether the quote is the global price or only the facility portion with the radiologist billing separately.
Questions specific to Diagnostic mammogram
- Is the order for one breast (77065) or both (77066)?
- Will tomosynthesis be added, and is it inside the quoted price?
- For Medicare patients: has the Part B deductible already been met this year?
- If a breast ultrasound is added the same day, what is its code and price?
Diagnostic Mammogram: billing questions
Why did I owe money for this mammogram when my last one was free?
Medicare covers a screening mammogram at no cost with assignment, but a diagnostic mammogram is subject to the Part B deductible and 20 percent coinsurance, according to Medicare.gov. Many commercial plans draw the same line between screening and diagnostic.
What is the difference between 77065 and 77066?
77065 is a diagnostic study of one breast and 77066 covers both. Each has its own anchor. Check that the code on the bill matches what was ordered.
Does a diagnostic mammogram in a hospital get an OPPS facility amount?
No. In the CY2026 OPPS Addendum B, diagnostic mammography carries a status for services paid under a fee schedule, so the anchor on this page applies across settings.
Is tomosynthesis part of the diagnostic mammogram anchor?
No. Tomosynthesis is billed with an add-on code, 77063, which has its own CY2026 global anchor of $50.73. Whether a facility adds it to a diagnostic study, and whether its cash price includes it, are questions to ask before the appointment.