Dual-energy X-ray absorptiometry measurement of bone mineral density at axial sites such as the hips, pelvis, or lumbar spine.

3 sources ↓

Medicare: $39.41
Work RVU: 0.2
Global, days
Region: Multi-region

Drawn from CMSMedicare NCD

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 3 cited references ↓

Qualifying indication, such as fragility fracture, estrogen deficiency, glucocorticoid use, or vertebral abnormality on X-ray
Date of last bone density study
Sites scanned, T-scores and Z-scores
Signed interpretation with diagnostic category
Treatment or follow-up plan based on result

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component TC Modifier

What this code covers

Source · Editorial summary grounded in 3 cited references ↓

Orthopedic practices order the hip and spine DXA (77080) after fragility fractures (distal radius, vertebral compression, hip), before elective spine fusion in older patients, and as part of fracture liaison or bone health programs. Practices with their own DXA machine can bill the global service.

Medicare covers it as a bone mass measurement for qualifying patients, no more than once every 23 months. The exceptions are monitoring long-term glucocorticoid therapy and confirming a baseline so later treatment monitoring compares like with like. The denial you will see most is a repeat inside the window. Check the last DXA date before scheduling.

If vertebral fracture assessment is done in the same session, bill 77085, which includes both, rather than 77080 plus 77086. Use the fracture diagnosis or the specific risk factor that qualifies the patient, not a screening code alone when a better one exists.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (0.2) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.18) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	0.2
Practice expense RVU	0.96
Malpractice RVU	0.02
Total RVU	1.18
Medicare national rate	$39.41
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$39.41
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 77080 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Repeat scan within the Medicare frequency limit with no covered exception
77080 and 77086 billed together instead of 77085
Diagnosis does not meet coverage criteria
Missing interpretation report
Global billed by practice that only performed the technical portion

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01How often does Medicare pay for a DXA scan?

No more than once every 23 months for qualifying beneficiaries, with exceptions for glucocorticoid monitoring and for confirming a baseline before treatment monitoring.

02Can 77080 and 77086 be billed together?

No. When both are done the same session, report 77085, which combines axial DXA and vertebral fracture assessment.

03Can an orthopedic practice bill DXA after a wrist fracture?

Yes. A fragility fracture supports bone density testing, and practices with their own DXA can bill the global service.