| Services and Payment for Screening-Based Services |
CPT Code |
Rate |
| Screening Mammography Bilateral, includes CAD |
77067 |
$120.09 ($85.70 and $34.39) |
| Diagnostic mammography, unilateral, includes CAD |
77065 |
$117.98 ($80.99 and $36.99) |
| Diagnostic mammography, bilateral, includes CAD |
77066 |
$149.42 ($103.90 and $45.52) |
| Screening digital breast tomosynthesis, unilateral and bilateral (in addition to 77067) |
77063 |
$49.18 ($21.98 and $27.20) |
Diagnostic digital breast tomosynthesis, unilateral and bilateral (in addition to 77065 or 77066) |
G0279 |
$39.13 ($11.93 and $27.20) |
| *Radiological examination surgical specimen |
76098 |
$41.06 ($26.67 and $14.39) |
| Complete Ultrasound, Unilateral |
76641 |
$95.54 ($62.47 and $33.08) |
| Limited Ultrasound, Unilateral |
76642 |
$79.74 ($48.97 and $30.78) |
| *Ultrasonic guidance for needle placement, imaging supervision interp |
76942 |
$61.53 ($30.75 and $30.77) |
| *Aspiration of Cyst of Breast |
19000 |
$91.91/$35.71 |
| *Aspiration of Cyst of Breast, additional |
19001 |
$25.56/$17.71 |
| *Biopsy of breast, needle core (surgical procedure only) |
19100 |
$155.59/$60.15 |
| *Incisional Biopsy of breast |
19101 |
$334.56/$208.66 |
*Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion, open; 1 or more lesions |
19120 |
$548.30 |
| Excisional Biopsy, Facility only (Agreement between B&C & Provider-Flat rate) |
19120 |
$1,250.00 |
| Excision of Breast lesion identified by preoperative placement of radiological marker, open; single lesion |
19125 |
$607.56 |
| Excisional Biopsy, Facility only (Agreement between B&C & Provider-Flat rate) |
19125 |
$1,250.00 |
| Excision of breast lesion identified by preoperative placement of radiological marker, open; each addt’l lesion separately identified by a preoperative radiological marker) |
19126 |
$140.03 |
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; stereotactic guidance; first lesion |
19081 |
$455.54 ($319.62 and $135.92) |
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; stereotactic guidance; each additional lesion |
19082 |
$$344.59 ($276.30 and $68.29)/td>
|
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; ultrasound guidance; first lesion |
19083 |
$452.67 ($324.33 and $128.34) |
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; ultrasound guidance; each additional lesion |
19084 |
$338.75 ($274.72 and $64.03) |
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; magnetic resonance guidance; first lesion |
19085 |
$682.28 ($533.43 and $148.85) |
| Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous; magnetic resonance guidance; each additional lesion |
19086 |
$523.24 ($448.97 and $74.27) |
| Placement of breast localization device, percutaneous; mammographic guidance; first lesion |
19281 |
$224.36 ($142.54 and $81.82) |
| Placement of breast localization device, percutaneous; mammographic guidance; each additional lesion |
19282 |
$156.64 ($115.86 and $40.78) |
| Placement of breast localization device, percutaneous; stereotactic guidance; first lesion |
19283 |
$238.78 ($156.05 and $82.73) |
| Placement of breast localization device, percutaneous; stereotactic guidance; each additional lesion |
19284 |
$172.61 ($130.93 and $41.68) |
| Cytopathology, evaluation of FNA; immediate cytohostologic study to determine adequacy of specimen(s), first evaluation episode |
88172 |
$52.50 |
| Cytopathology, evaluation of FNA; immediate cytohostologic study to determine adequacy of specimen(s), each additional evaluation episode |
88177 |
$27.77 |
| Cytopathology, evaluation of FNA; interpretation and report |
88173 |
$158.13 |
| Surgical pathology, gross & microscopic examination |
88305 |
$66.51 |
| Surgical pathology, gross & microscopic examination; requiring microscopic evaluation of surgical margins |
88307 |
$262.98 |