How much does Medicare pay for CPT 77065?

Medicare allowed an average of $64.22 per service and paid $45.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $242.69, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77065?

Diagnostic mammography of 1 breast. It was billed 665,754 times to 619,309 Medicare beneficiaries by 8,920 providers in 2024.

Does 77065 pay differently in an office than a hospital?

Yes. The allowed amount averaged $95.68 in an office setting and $37.56 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 77065 most?

Diagnostic Radiology, with 636,588 services from 8,419 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, General Surgery.

CPT 77065

Diagnostic mammography of 1 breast

$64.22Medicare-allowed amount per service, averaged across 665,754 services

Providers submitted

$242.69

Asking price, not received

Medicare allowed

$64.22

The fee schedule figure

Medicare paid

$45.81

Balance is patient coinsurance

Providers submitted an average of $242.69 for this code and Medicare allowed $64.22 — 3.8× 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 $45.81 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $95.68
Hospital / facility: $37.56

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. 305,303 services were billed in an office setting and 360,451 in a facility.

Services: 665,754
Beneficiaries: 619,309
Providers billing it: 8,920
Total allowed: $42,754,722

What Medicare pays for CPT 77065

Across 665,754 services billed by 8,920 providers to 619,309 beneficiaries, Medicare allowed an average of $64.22 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 77065

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	636,588	593,173	$62.93	8,419
Independent Diagnostic Testing Facility (IDTF)	12,775	11,298	$105.78	158
Interventional Radiology	5,056	4,807	$64.82	93
General Surgery	2,440	2,228	$98.49	36
Obstetrics & Gynecology	2,085	1,775	$89.69	73
Family Practice	1,458	1,172	$87.12	45
Internal Medicine	1,197	1,094	$83.52	34
Radiation Oncology	697	637	$70.21	7
Mammography Center	680	570	$107.58	3
Rheumatology	476	379	$77.17	1
Emergency Medicine	439	414	$69.87	9
Nuclear Medicine	414	407	$74.51	8
Hematology-Oncology	244	235	$121.03	9
Nurse Practitioner	190	186	$92.75	5
Surgical Oncology	190	180	$127.11	2

77065 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	61,713	$78.95	$50.17	767
New York	47,914	$84.34	$55.28	593
Florida	47,743	$78.89	$57.88	561
Texas	36,220	$58.36	$42.48	513
Pennsylvania	31,683	$48.05	$33.98	407
Illinois	31,356	$50.16	$34.69	408
Massachusetts	25,310	$51.14	$34.15	295
North Carolina	25,008	$67.23	$49.00	345
New Jersey	24,884	$90.98	$59.40	304
Virginia	22,636	$61.59	$43.66	245
Ohio	21,494	$41.55	$29.67	298
Maryland	18,449	$102.54	$69.07	162
Georgia	18,225	$49.83	$35.94	277
Michigan	16,736	$44.61	$31.30	243
Tennessee	15,062	$55.03	$41.30	247
Washington	15,011	$72.71	$48.64	167
Missouri	14,855	$43.85	$31.69	210
Indiana	13,882	$45.19	$33.05	154
Arizona	12,744	$92.00	$66.48	128
Minnesota	11,603	$63.86	$44.65	213
South Carolina	11,571	$46.11	$34.21	131
Wisconsin	9,994	$51.68	$36.95	223
Colorado	9,569	$72.70	$48.09	134
Kentucky	8,339	$45.36	$33.42	108
Oklahoma	7,865	$40.81	$30.75	85
Connecticut	7,806	$66.02	$44.56	144
Arkansas	7,316	$62.09	$48.58	78
Iowa	7,240	$60.61	$45.15	108
Oregon	7,060	$53.52	$38.63	114
Louisiana	6,668	$42.86	$32.25	124
Alabama	6,298	$48.66	$37.30	137
Kansas	6,008	$54.02	$40.76	93
Nebraska	5,959	$55.24	$41.74	81
Mississippi	5,689	$50.86	$39.96	99
District of Columbia	5,092	$79.70	$52.80	45
Rhode Island	4,207	$68.59	$46.38	39
Delaware	3,653	$71.44	$51.36	34
New Hampshire	3,380	$52.37	$36.27	60
Nevada	3,301	$88.50	$62.90	64
New Mexico	3,178	$82.92	$61.58	42
Maine	2,588	$38.92	$26.35	53
Utah	2,524	$46.34	$34.26	56
West Virginia	2,486	$39.42	$27.52	62
Idaho	2,376	$43.02	$31.48	40
Hawaii	2,201	$74.56	$50.33	32
South Dakota	1,982	$56.09	$38.66	37
North Dakota	1,951	$44.63	$31.40	36
Montana	1,723	$50.22	$35.17	36
Vermont	1,514	$36.77	$26.14	23
Alaska	1,508	$75.55	$46.46	21
Wyoming	1,371	$81.63	$59.20	24
Guam	254	$105.92	$68.35	4
Puerto Rico	230	$91.85	$68.72	11
AP	229	$81.07	$54.71	2
U.S. Virgin Islands	70	$104.97	$68.94	2
AA	26	$35.95	$30.00	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
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
77049Mri scan of both breasts$196.04
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.