How do I dispute CPT 77065?

Request a fully itemized bill with CPT codes and your EOB. For 77065 specifically, the most common issues are technical professional split, duplicate. Write a short dispute letter to the provider's billing office listing the specific line items you're contesting and the reason; federal and state law require them to investigate and pause collections while the dispute is open. Or upload the bill to patientbill.org and we'll do the dispute letter for you — we only get paid if we lower your bill.

Why is CPT 77065 on my bill?

Diagnostic mammography, unilateral. It appears on bills when a service was performed in a hospital or imaging center setting and the provider documented enough work to support this specific code. If the description doesn't match what you remember happening at your visit, ask for the chart note that supports the code.

CPT code

77065 — Diagnostic mammography, unilateral

Q: What's a fair price for CPT 77065?

Most patients should expect to pay no more than 2–3× the Medicare allowable for the same service. There's no straightforward Medicare allowable for this code (it's not on the standard physician fee schedule). A reasonable target when negotiating cash-pay or self-pay is somewhere between the Medicare rate and the in-network allowed amount your insurer would pay.

Plain-English reference for CPT 77065. What it covers, what it typically costs, and the billing errors patientbill.org looks for on this code.

Typical setting: Hospital or imaging center
Medicare allowable: —

The Medicare allowable is the national non-facility rate from the CMS Physician Fee Schedule and is the most defensible "fair price" anchor. Commercial charges typically run 2–5× this number; hospital list prices can be much higher still.

What this code actually is

CPT 77065 is a radiology / imaging study — diagnostic mammography, unilateral. Imaging bills routinely split into a 'technical component' (facility/equipment, modifier TC) and a 'professional component' (the radiologist's read, modifier 26). If you receive two bills for the same study, make sure one carries TC and the other 26 — being charged the global rate twice is a common error. Hospital outpatient pricing is also typically 2–5× a freestanding imaging center for the same study.

Audit issues we look for on 77065

Technical & professional double-bill — both global and component charges appear
Duplicate billing — the same service charged more than once

Think your bill has the wrong 77065 charge?

Upload the bill and we'll check for upcoding, unbundling, duplicates, and prices above what's reasonable. If we recover money for you, we keep a small contingency fee. If we don't, you owe nothing.

Common questions about CPT 77065

Charges vary widely between providers and payers. There's no straightforward Medicare allowable for this code (it's not on the standard physician fee schedule). If your bill for this code is significantly above the high end of that range, ask for an itemized statement and compare against your Explanation of Benefits (EOB) — the insurance "allowed amount" is the most defensible reference point.

Related codes in Imaging (X-ray, CT, MRI, ultrasound)

Patientbill.org is not affiliated with any provider, insurer, or the AMA. Code descriptions are CMS-published short descriptors plus our own plain-English explanations; pricing references are from the CMS Medicare Physician Fee Schedule and public charge benchmarks and may be outdated. Verify your specific charges against your EOB.