Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)
Medicare pricing data for 16,567 providers across 52 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) (HCPCS code G0279) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.28, but hospitals typically charge $148.21 — a 4.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.28, your out-of-pocket cost would be approximately $7.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $26.83 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $48 | $145 | 267 | 29,552 | +32.6% |
| New Jersey | $45 | $193 | 521 | 33,393 | +25.3% |
| Nevada | $44 | $160 | 159 | 5,808 | +22.0% |
| Puerto Rico | $44 | $56 | 21 | 232 | +20.0% |
| Arizona | $42 | $189 | 223 | 21,140 | +16.2% |
| New York | $42 | $168 | 953 | 62,390 | +15.8% |
| District of Columbia | $42 | $178 | 75 | 9,093 | +15.5% |
| Florida | $42 | $160 | 1,005 | 88,253 | +15.5% |
| California | $41 | $169 | 1,152 | 85,508 | +13.2% |
| Wyoming | $41 | $150 | 36 | 1,405 | +11.8% |
| New Mexico | $40 | $151 | 92 | 6,238 | +11.4% |
| Colorado | $39 | $217 | 230 | 13,685 | +8.3% |
| Alaska | $39 | $178 | 32 | 2,446 | +6.9% |
| Hawaii | $38 | $183 | 56 | 2,817 | +5.5% |
| Rhode Island | $38 | $190 | 66 | 5,868 | +4.9% |
| Washington | $38 | $152 | 449 | 22,845 | +4.3% |
| Connecticut | $37 | $156 | 257 | 11,062 | +3.0% |
| North Carolina | $37 | $139 | 778 | 40,476 | +0.7% |
| Minnesota | $36 | $133 | 386 | 14,782 | -0.3% |
| Delaware | $36 | $104 | 45 | 4,412 | -0.6% |
| Virginia | $35 | $138 | 407 | 34,152 | -3.9% |
| Texas | $35 | $173 | 970 | 56,685 | -4.3% |
| New Hampshire | $34 | $108 | 122 | 4,614 | -6.1% |
| Tennessee | $34 | $137 | 518 | 25,536 | -7.7% |
| Kansas | $33 | $81 | 303 | 10,268 | -7.9% |
| Arkansas | $33 | $197 | 119 | 13,164 | -8.3% |
| Massachusetts | $33 | $166 | 495 | 32,544 | -9.8% |
| Georgia | $33 | $163 | 564 | 27,854 | -10.2% |
| Illinois | $33 | $149 | 648 | 47,427 | -10.3% |
| Montana | $32 | $91 | 62 | 2,742 | -11.1% |
| Alabama | $32 | $97 | 308 | 10,183 | -11.3% |
| Iowa | $32 | $146 | 240 | 10,470 | -11.4% |
| Wisconsin | $32 | $163 | 569 | 15,942 | -12.2% |
| Nebraska | $32 | $142 | 190 | 5,790 | -13.2% |
| Pennsylvania | $31 | $113 | 751 | 51,789 | -13.5% |
| Utah | $31 | $109 | 150 | 3,862 | -13.8% |
| Michigan | $31 | $117 | 449 | 21,661 | -14.2% |
| South Dakota | $31 | $104 | 94 | 3,146 | -14.2% |
| South Carolina | $31 | $134 | 183 | 15,835 | -15.7% |
| Louisiana | $30 | $123 | 262 | 11,526 | -16.4% |
| Missouri | $30 | $118 | 355 | 22,658 | -16.5% |
| North Dakota | $30 | $86 | 88 | 2,721 | -16.5% |
| Oregon | $30 | $99 | 200 | 10,243 | -17.3% |
| Kentucky | $30 | $104 | 231 | 11,696 | -17.5% |
| Oklahoma | $30 | $123 | 144 | 11,422 | -18.0% |
| Indiana | $30 | $101 | 319 | 21,604 | -18.0% |
| Ohio | $30 | $115 | 472 | 30,514 | -18.3% |
| Mississippi | $29 | $114 | 145 | 8,108 | -19.4% |
| Idaho | $29 | $104 | 80 | 3,057 | -20.3% |
| Vermont | $29 | $106 | 30 | 1,826 | -21.3% |
| Maine | $28 | $108 | 164 | 3,677 | -21.8% |
| West Virginia | $28 | $99 | 125 | 3,546 | -22.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber