CPT Code 77067
Screening Mammography (2D, Bilateral)
Simple English Explanation
Routine bilateral breast cancer screening examination, including computer-aided detection (CAD).
Why doctors use this: Annual preventive breast cancer screening for women, recommended starting at age 40.
🔗 Frequently Billed With CPT 77063
Patients routinely see CPT 77067 and CPT 77063 (Screening 3D Breast Tomosynthesis) listed together on the same bill or EOB.
CPT 77067 is the standard 2D mammogram base code, which is routinely billed alongside CPT 77063 for 3D tomosynthesis.
Clinical & Billing Details
CPT 77067 covers standard 2D digital screening mammography of both breasts, including computer-aided detection (CAD). In modern radiology centers, CPT 77067 is almost universally paired with add-on code CPT 77063 (3D tomosynthesis). Under federal Affordable Care Act (ACA) rules, CPT 77067 is a designated essential preventive service and must be 100% covered by in-network insurers with zero patient deductible, copayment, or coinsurance.
Typical US Price Range
$150 – $400*Estimated cash price before insurance adjustments.
Why prices vary: The cost can change drastically depending on whether you are at a hospital ER (most expensive), a hospital outpatient department, or a private doctor's office. Your location and specific insurance plan also play a huge role.
Insurance Coverage & Mandates
In-network screening mammograms under CPT 77067 are mandated to be 100% covered with $0 out-of-pocket costs for women aged 40 and older by the Affordable Care Act and Medicare. If you received a bill for CPT 77067, common reasons include: (1) it was mistakenly coded as a diagnostic mammogram (CPT 77065/77066), (2) it was performed out-of-network, or (3) you had two screenings within the same 12-month calendar window.
⚠️ Often Misunderstood
This code is frequently confusing for patients. Sometimes it appears as a separate line item from the main procedure, or it might be a "facility fee" component. Always ask for an itemized bill to see exactly what this charge covers.
Questions to Ask Billing
- "Can you confirm that CPT 77067 was billed with preventive screening diagnosis code Z12.31?"
- "Why am I being billed a deductible or copay when ACA law mandates 100% coverage for routine screening mammograms?"
- "Was this billed as a routine screening (77067) or did the provider code it as a diagnostic exam (77065/77066)?"
Frequently Asked Questions
Why do CPT 77067 and 77063 appear together on my bill?
CPT 77067 is the base code for standard 2D screening mammography, while CPT 77063 is the add-on code for 3D breast tomosynthesis. Seeing both on your bill means you had a 3D mammogram screening. Billing rules require submitting both codes together.
Is CPT 77067 100% free under the Affordable Care Act?
Yes. Federal ACA law requires all compliant in-network health plans to cover annual screening mammography (CPT 77067) at 100% with no copay, coinsurance, or deductible. If you received a bill, ask billing if they erroneously submitted it with a diagnostic code instead of preventive code Z12.31.
What is the difference between screening (77067) and diagnostic mammograms?
CPT 77067 is strictly for routine preventive screening when you have no symptoms or lumps. If a lump was felt, or you were called back after an abnormal screening for a follow-up, it becomes a diagnostic mammogram (CPT 77065 or 77066), which is subject to standard deductibles and coinsurance.
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Disclaimer: This website provides educational information only and does not provide medical, legal, or insurance advice. CPT® is a registered trademark of the American Medical Association. Prices are estimates based on national averages.