| Category | Amount |
|---|---|
| Medicare Allowed Rate What Medicare approves for this service | $41.57 |
| Typical Billed Amount What providers commonly charge | $75 – $350 |
| Potential Markup How much more you might pay vs. Medicare rate | 742% above Medicare |
What CPT 77080 Means and When It's Used
CPT code 77080 represents a DXA (dual-energy X-ray absorptiometry) bone density scan, commonly called a DEXA scan. This test measures the density of bones in your axial skeleton, which includes your spine and hip bones - the areas most likely to fracture due to osteoporosis.
Your doctor may order this test if you're over 65, have gone through menopause, have a family history of osteoporosis, or take medications that can weaken bones. The scan is painless and takes about 10-30 minutes. You'll lie on a table while a scanner passes over your body, measuring how much calcium and other minerals are in your bones.
This code specifically covers the technical component of the scan (the actual imaging) and may be billed separately from the professional component (the doctor's interpretation of the results).
Understanding Your DEXA Scan Bill
When you receive your bill or explanation of benefits, look for CPT code 77080. The typical charge for this scan ranges from $75 to $350, depending on your location and healthcare facility. Medicare reimburses providers $41.57 for this service, though your actual out-of-pocket cost depends on your insurance coverage and whether you've met your deductible.
Many insurance plans, including Medicare, cover DEXA scans for qualifying patients once every two years. If you're a woman over 65 or a man over 70, or if you have risk factors for osteoporosis, your scan is likely covered as a preventive service with no copay.
You might see this code billed alongside other codes if you had additional imaging or if the radiologist's interpretation is billed separately. The facility fee and professional fee are sometimes combined, but they can also appear as separate line items on your bill.
How to Verify Your Billing and Handle Errors
To check if you were billed correctly, first confirm that you actually received a DEXA bone density scan of your spine and hip. If you only had a scan of your forearm or heel, that would be a different code (77080 is specifically for spine and hip scans). Make sure the date of service matches when you had your scan.
If the charge seems unusually high (over $350) or you're being charged for a service you didn't receive, contact the billing department of the facility where you had your scan. Ask for an itemized bill and explanation of charges. Sometimes patients are mistakenly billed for additional services they didn't receive.
If you believe your insurance should have covered the scan but didn't, check with your insurance company about coverage requirements. You may need documentation from your doctor explaining why the scan was medically necessary. If you're still having issues, consider contacting a patient advocate at your healthcare facility or your state's insurance commissioner for help resolving billing disputes.