How much does Medicare pay for CPT 77049?

Medicare allowed an average of $196.04 per service and paid $147.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1173.60, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77049?

Mri scan of both breasts. It was billed 121,124 times to 116,205 Medicare beneficiaries by 3,317 providers in 2024.

Does 77049 pay differently in an office than a hospital?

Yes. The allowed amount averaged $272.11 in an office setting and $107.12 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 77049 most?

Diagnostic Radiology, with 114,497 services from 3,182 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Hematology-Oncology.

CPT 77049

Mri scan of both breasts

$196.04Medicare-allowed amount per service, averaged across 121,124 services

Providers submitted

$1173.60

Asking price, not received

Medicare allowed

$196.04

The fee schedule figure

Medicare paid

$147.66

Balance is patient coinsurance

Providers submitted an average of $1173.60 for this code and Medicare allowed $196.04 — 6.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $147.66 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $272.11
Hospital / facility: $107.12

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 65,283 services were billed in an office setting and 55,841 in a facility.

Services: 121,124
Beneficiaries: 116,205
Providers billing it: 3,317
Total allowed: $23,745,149

What Medicare pays for CPT 77049

Across 121,124 services billed by 3,317 providers to 116,205 beneficiaries, Medicare allowed an average of $196.04 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 77049

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	114,497	109,865	$191.72	3,182
Independent Diagnostic Testing Facility (IDTF)	5,008	4,776	$286.25	86
Interventional Radiology	846	817	$186.42	21
Hematology-Oncology	172	162	$360.29	6
Family Practice	112	108	$235.49	3
General Surgery	99	95	$163.57	2
Surgical Oncology	63	59	$410.80	2
Dermatology	46	46	$121.64	1
Internal Medicine	45	44	$178.92	3
Physician Assistant	44	44	$228.64	1
Pediatric Medicine	43	41	$263.15	2
Radiation Oncology	41	40	$358.16	2
Nuclear Medicine	34	34	$103.28	2
Nurse Practitioner	29	29	$234.53	1
Anesthesiology	18	18	$113.77	1

77049 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	17,365	$234.02	$152.70	374
Florida	11,101	$227.92	$173.29	217
New York	10,882	$247.60	$165.73	265
Pennsylvania	6,537	$142.94	$101.40	166
Texas	5,705	$168.93	$127.46	180
Massachusetts	4,863	$162.02	$108.98	126
New Jersey	4,505	$236.19	$158.95	100
Virginia	4,401	$173.38	$125.34	110
Illinois	3,972	$157.40	$112.89	136
Washington	3,233	$210.11	$145.92	101
Arizona	3,007	$252.90	$192.52	67
Ohio	2,665	$129.51	$94.77	92
Maryland	2,518	$291.21	$206.57	62
North Carolina	2,489	$176.55	$134.76	98
Missouri	2,371	$120.19	$88.93	84
Indiana	2,244	$126.21	$94.24	70
Georgia	2,216	$152.92	$112.03	82
Iowa	2,041	$152.86	$118.13	51
Tennessee	1,989	$194.97	$150.70	66
South Carolina	1,979	$122.15	$92.53	60
Michigan	1,917	$130.05	$93.76	84
Colorado	1,796	$257.13	$179.49	53
Minnesota	1,769	$211.22	$156.45	67
Oklahoma	1,699	$106.27	$77.64	43
Oregon	1,332	$173.43	$129.29	36
District of Columbia	1,301	$260.40	$173.68	22
New Mexico	1,288	$266.93	$204.04	22
Alabama	1,197	$130.44	$102.11	35
Arkansas	1,096	$222.28	$183.15	29
Nebraska	1,040	$190.53	$149.25	24
Connecticut	1,030	$190.61	$132.18	40
Kentucky	1,024	$119.01	$88.60	33
Wisconsin	981	$128.11	$94.80	52
Louisiana	799	$122.46	$94.59	34
Nevada	671	$287.60	$216.02	20
Kansas	665	$150.98	$116.07	24
Delaware	656	$197.23	$142.98	13
New Hampshire	598	$134.40	$98.94	18
Rhode Island	527	$174.05	$124.06	18
Mississippi	463	$130.05	$104.54	21
North Dakota	457	$118.03	$83.47	12
South Dakota	439	$210.68	$153.55	15
Montana	376	$182.19	$131.27	15
Idaho	355	$115.09	$87.84	11
Utah	343	$164.07	$123.75	17
Hawaii	342	$221.19	$154.93	11
Maine	340	$118.56	$85.04	16
Wyoming	122	$269.04	$205.83	6
Vermont	122	$104.69	$70.24	6
Alaska	118	$241.04	$159.13	4
West Virginia	96	$103.51	$75.81	5
AP	38	$378.92	$258.51	2
Puerto Rico	33	$347.08	$258.05	1
AA	11	$98.29	$73.83	1

Related codes

77067Screening mammography$65.10
77063Screening 3d breast mammography$34.08
77080Dxa bone density measurement of hip$21.30
77014Ct guidance for insertion of radiation therapy fields$70.52
77065Diagnostic mammography of 1 breast$64.22
77066Diagnostic mammography of both breasts$84.05
77002Fluoroscopic guidance for needle placement$90.55
77001Fluoroscopic guidance for insertion or removal of central vein access$21.63
77081Dxa bone density measurement of forearm$19.89
77012Review by radiologist of ct guidance for needle placement$69.78
77085Dxa bone density measurement of hip$38.47
77092Interpretation of trabecular bone score (tbs) and report on fracture r$9.60

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.