CPT Code 77063: A 2027 Guide to Billing Screening Breast Tomosynthesis

What Is CPT Code 77063?

CPT 77063 reports bilateral screening digital breast tomosynthesis, the 3D component of a screening mammogram, billed as an add-on to the primary screening mammogram code 77067. It cannot be billed alone. When a practice performs a combined 2D and 3D screening mammogram, 77067 captures the 2D study and 77063 captures the tomosynthesis portion, and both are reported on the same claim for the same encounter.

• Add-on rule: 77063 is an add-on code that must be reported with the primary screening mammogram 77067. Billing it without the primary code is a guaranteed denial.
• 77063 vs 77067: 77067 is the full bilateral screening mammogram (2D). 77063 is the 3D tomosynthesis add-on reported alongside it. They describe different components of the same screening study.
• Medicare coverage: Medicare covers screening tomosynthesis as part of a covered screening mammogram, subject to standard frequency rules. The study must be documented as screening on an asymptomatic patient.

What CPT Code 77063 Covers

77063 describes bilateral screening digital breast tomosynthesis, often called 3D mammography. It captures the tomosynthesis portion of a screening study, the layered images that supplement the standard 2D screening mammogram billed under 77067. It is performed for screening, meaning the patient has no signs or symptoms prompting the study.

Because it is the tomosynthesis component of a screening study, 77063 depends on the primary screening mammogram being performed and billed in the same encounter. The AMA CPT codebook classifies 77063 as an add-on code, which means it has no standalone relative value and generates no payment when submitted without the primary service. This is not a payer quirk or a local coverage decision. It is how the code is built.

One question we hear constantly from practice managers at breast imaging centers is whether their add-on capture rate is where it should be. Across the billing companies we vet, underbilling 77063 is more common than overbilling it. The tomosynthesis was performed, the images exist, but the add-on never made it onto the claim because the superbill did not prompt for it or the coder missed the pairing. That is revenue the practice already earned and never collected.

Is 77063 an Add-On Code?

Yes. 77063 is an add-on code that must be reported in addition to the primary screening mammogram, 77067, and cannot stand alone on a claim. Billing 77063 without the primary code is a guaranteed denial, because the add-on has no independent value without the service it supplements.

The two are billed together on the same encounter: 77067 for the screening mammogram and 77063 for the tomosynthesis add-on. That pairing is the core rule of the code, and it is the single most common reason 77063 claims deny. The claim either has both codes or the add-on fails.

This add-on structure is not unique to mammography. Radiology billing uses the same pattern across modalities. CT abdomen and pelvis codes like 74176 follow a similar component logic where the correct code depends on whether contrast was used and whether multiple body regions were studied in the same session. The principle is the same: the code describes a component, not a standalone service.

What Is the Difference Between CPT Code 77063 and 77067?

77067 is the primary bilateral screening mammogram, the 2D study that captures the standard images. 77063 is the screening tomosynthesis add-on, the 3D component that produces layered cross-sectional images of the breast tissue. They describe different parts of the same screening study and are reported together when both are performed.

The diagnostic counterpart to 77063 is different. When tomosynthesis is performed for a diagnostic reason, such as evaluating a palpable mass or an abnormal screening result, the diagnostic tomosynthesis code applies rather than the screening add-on. Matching the screening or diagnostic intent to the correct code is essential, because payers audit the clinical indication against the code category.

For a deeper look at how the primary screening mammogram is billed and documented, see our CPT 77067 billing guide.

Does Medicare Cover CPT 77063?

Yes. Medicare and most commercial payers cover screening breast tomosynthesis as part of a covered screening mammogram, subject to the standard screening frequency rules. For Medicare beneficiaries, screening mammography is covered annually for women age 40 and older, with no copay or deductible under the preventive services benefit. The tomosynthesis add-on is included in that coverage when billed as part of the screening study.

Like other imaging codes, the screening study splits into a professional and a technical component. When the radiologist and the facility are separate entities, modifier 26 (professional component) and modifier TC (technical component) are reported on separate claims. When one entity provides both the interpretation and the equipment, the code is billed globally with no modifier. This component logic applies to both 77067 and 77063. The ACR imaging guidelines provide the clinical framework that supports the screening indication.

Document that the study was screening, performed on an asymptomatic patient, and that both the primary mammogram and the tomosynthesis add-on were done. That documentation supports the add-on and the coverage. Providers often come to us after a string of tomosynthesis denials, and when we look at the claims the documentation issue is almost always the same: the order or the note does not clearly state that the study was screening rather than diagnostic.

Why Does 77063 Get Denied?

The leading denials on 77063 come from a small set of predictable errors. Every one of them is preventable with a clean workflow.

• Billing 77063 without the primary 77067 on the same claim. The add-on has no standalone value and denies automatically.
• Confusing screening tomosynthesis (77063) with diagnostic tomosynthesis. The screening code on a diagnostic study, or the diagnostic code on a screening study, is a category mismatch that payers reject.
• Missing the component modifier when the professional and technical components are billed separately. Without modifier 26 or TC, the claim processes incorrectly or denies.
• Exceeding the screening frequency interval. Most payers, including Medicare, cover screening mammography on a defined schedule. A claim outside that window denies as not medically necessary unless the order supports a diagnostic indication and the codes are changed accordingly.
• Insufficient documentation of screening intent. If the order does not specify screening or the note references a symptom, the payer may reclassify the study as diagnostic and deny the screening codes.

In our experience matching providers with billing partners, radiology practices that use a mammography-specific claim scrub catch these errors before submission. The add-on pairing check alone eliminates the most common denial. A billing partner that builds that scrub into the workflow, rather than catching it on the back end, keeps the claim clean from the start.

Frequently Asked Questions

Next Steps

• Billing the primary screening mammogram? See our CPT 77067 screening mammogram billing guide for documentation and pairing rules.
• Working with other radiology CPT codes? Our CPT 74176 CT abdomen and pelvis guide covers component billing and contrast-based code selection.
• Need to verify imaging appropriateness criteria? See our ACR radiology guidelines overview.
• Ready to stop losing revenue on missed add-ons and pairing errors? Get matched with a radiology billing partner who catches these before submission.