Magnetic resonance imaging to evaluate bone marrow blood supply, assessing marrow perfusion and composition across one or more regions.
- Medicare
- $313.63
- Work RVU
- 1.56
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Clinical question focused on marrow perfusion or marrow disease
- Why a standard joint or region MRI is not sufficient
- Prior imaging results that raised the marrow concern
- Regions imaged
- Signed interpretation
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
Bone marrow blood supply MRI is not the code for a routine hip MRI looking for avascular necrosis. That study is a lower extremity joint MRI (73721 to 73723). 77084 is used when the clinical question is the marrow itself: marrow infiltration, perfusion changes, or a diffuse marrow process across multiple bones.
Orthopedic practices rarely order it. When they do, it is usually through an orthopedic oncologist or in coordination with hematology. If your order for an AVN workup comes back billed as 77084, push back to the imaging center, because payers often deny it as the wrong study for the diagnosis.
Most commercial plans require prior authorization through their radiology benefit manager. The authorization has to match the code. An approval for a hip MRI does not cover 77084, and a mismatch between authorized and billed code is a common and avoidable denial.
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 (1.56) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (9.39) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.56 |
| Practice expense RVU | 7.72 |
| Malpractice RVU | 0.11 |
| Total RVU | 9.39 |
| Medicare national rate | $313.63 |
| 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 | $313.63 |
HOPD (APC 5523) Hospital outpatient department | $243.77 |
Common denial reasons
The recurring reasons claims for CPT 77084 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Used for a routine AVN or joint MRI that should be coded 73721-73723
- Prior authorization obtained for a different MRI code
- Diagnosis does not support marrow-specific imaging
- Billed with a same-region MRI for the same session without a distinct reason
- Missing interpretation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Is 77084 the right code for an MRI of the hip for avascular necrosis?
02Does 77084 need prior authorization?
03Who typically orders a bone marrow blood supply MRI?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/physician
Mira Scribe
Mira Scribe records the specific clinical question and prior imaging in the ordering note, which helps the authorization match the study that is actually needed.
See how Mira captures CPT 77084 documentation