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US · guidance

CMS Pub. 100-04, ch. 18, § 20.3.1.1

Outpatient Hospital Mammography Payment Table

activein force · 2026-08-25 – presentas-observed

Payment for screening mammography in the Hospital Outpatient Setting (Revenue code 403) is the

lesser of charge, or TC of MPFS for code 77067* (G0202*). Neither deductible nor a coinsurance

applies.

Payment for diagnostic mammography, bilateral in the Hospital Outpatient Setting (Revenue code

401) is the lesser of charge, or TC of MPFS for code 77066* (G0204*).

Payment for diagnostic mammography, unilateral in the Hospital Outpatient Setting (Revenue

code 401) is the lesser of charge, or TC of MPFS for code 77065* (G0206*). Deductible and

coinsurance apply.

Beginning January 1, 2005, Medicare Prescription Drug, Improvement, and Modernization Act

(MMA) of 2003, §644, Public Law 108-173 has changed the way Medicare pays for diagnostic

mammography. Medicare payment will be based on the MPFS. Payment will no longer be made

under the OPPS.

History

(Rev. 3844, Issued: 08-18-17, Effective: 01-01-18, Implementation: 01-02-18)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c691ab255875782562ce75e28e072babcaafad90c4036cd1ad8219a24bee7ffb
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