How much does Medicare pay for CPT 77085?

Medicare allowed an average of $38.47 per service and paid $38.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $173.95, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77085?

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment. It was billed 102,878 times to 100,467 Medicare beneficiaries by 1,287 providers in 2024.

Does 77085 pay differently in an office than a hospital?

Yes. The allowed amount averaged $45.74 in an office setting and $13.47 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 77085 most?

Diagnostic Radiology, with 47,945 services from 629 clinicians. Next are Rheumatology, Endocrinology, Internal Medicine.

CPT 77085

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment

$38.47Medicare-allowed amount per service, averaged across 102,878 services

Providers submitted

$173.95

Asking price, not received

Medicare allowed

$38.47

The fee schedule figure

Medicare paid

$38.31

Balance is patient coinsurance

Providers submitted an average of $173.95 for this code and Medicare allowed $38.47 — 4.5× 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 $38.31 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $45.74
Hospital / facility: $13.47

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. 79,681 services were billed in an office setting and 23,197 in a facility.

Services: 102,878
Beneficiaries: 100,467
Providers billing it: 1,287
Total allowed: $3,957,717

What Medicare pays for CPT 77085

Across 102,878 services billed by 1,287 providers to 100,467 beneficiaries, Medicare allowed an average of $38.47 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 77085

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	47,945	45,659	$30.83	629
Rheumatology	14,776	14,751	$51.14	155
Endocrinology	11,029	11,024	$49.43	70
Internal Medicine	8,316	8,304	$47.18	138
Family Practice	4,861	4,857	$49.25	95
Physician Assistant	3,233	3,232	$22.79	48
Nurse Practitioner	2,331	2,325	$27.45	32
Independent Diagnostic Testing Facility (IDTF)	2,235	2,235	$44.05	25
Nuclear Medicine	1,904	1,904	$22.50	20
Orthopedic Surgery	1,811	1,810	$50.41	15
Geriatric Medicine	1,043	1,042	$20.44	4
Cardiology	574	572	$64.22	2
Obstetrics & Gynecology	559	551	$42.81	16
Interventional Radiology	523	500	$24.05	12
Hematology-Oncology	417	417	$56.36	5

77085 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
New York	12,631	$40.92	$35.64	121
California	9,042	$51.02	$45.93	101
North Carolina	5,714	$41.98	$43.85	105
Massachusetts	5,331	$39.47	$35.11	33
Michigan	5,284	$19.25	$19.74	46
Florida	4,658	$42.11	$42.93	71
Arizona	4,261	$50.73	$50.87	54
Wisconsin	3,950	$21.43	$22.54	41
Maryland	3,813	$53.31	$50.48	47
Texas	3,740	$45.00	$47.10	88
Oregon	3,425	$35.19	$35.69	26
New Jersey	3,176	$53.04	$47.37	42
Minnesota	2,907	$42.32	$42.17	31
Virginia	2,790	$30.44	$30.45	42
Illinois	2,496	$44.16	$45.48	44
Pennsylvania	2,396	$47.08	$48.12	30
Colorado	2,310	$29.70	$29.23	20
Arkansas	2,243	$28.36	$31.74	21
Ohio	2,209	$19.10	$15.28	55
Missouri	1,986	$28.61	$30.94	18
Georgia	1,827	$47.82	$51.38	22
Louisiana	1,802	$39.97	$44.65	13
Kansas	1,733	$47.32	$51.91	7
Delaware	1,571	$18.56	$18.35	8
Kentucky	1,380	$15.99	$13.47	29
South Carolina	1,223	$45.28	$52.10	12
Alabama	907	$27.97	$30.82	18
Oklahoma	902	$35.73	$39.51	23
New Mexico	851	$19.14	$20.31	7
Wyoming	739	$13.42	$13.99	2
Nebraska	726	$41.49	$45.55	9
Maine	677	$15.38	$15.00	4
Connecticut	566	$32.34	$30.47	17
Nevada	523	$47.49	$47.92	12
Mississippi	434	$14.10	$13.99	4
Tennessee	411	$18.61	$20.14	9
Indiana	362	$46.98	$50.90	7
Utah	292	$32.21	$34.39	4
North Dakota	260	$21.13	$21.51	5
Montana	255	$20.96	$21.33	8
New Hampshire	252	$13.96	$14.03	2
District of Columbia	249	$52.92	$50.47	7
Alaska	164	$49.22	$43.41	8
Hawaii	133	$50.11	$52.24	3
South Dakota	99	$13.52	$13.98	4
Washington	63	$59.81	$52.06	2
Iowa	54	$47.34	$51.58	2
Vermont	33	$13.49	$14.01	2
Puerto Rico	28	$52.04	$52.15	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
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
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.