Which mammography code applies?

Mammography is billed under several codes depending on whether it's a screening (preventive, no symptoms) or diagnostic (following up on a finding or symptom), and whether one breast or both are imaged.

  • Preventive — no breast symptoms, no prior abnormal finding being followed up. Most insurance plans cover this at no cost under ACA preventive-service rules.

  • G0202 Digital screening mammography (Medicare) (this page)

    Medicare-specific code for a preventive screening done on digital equipment. Used in place of 77067 for Medicare patients.

  • Following up on a symptom (lump, pain, discharge) or a finding from a prior screening, with both breasts imaged. Cost-sharing applies — this is not covered as preventive.

  • Following up on a symptom or finding limited to one breast. Cost-sharing applies — this is not covered as preventive.

Important: If a screening mammogram (77067 / G0202) finds something requiring follow-up imaging in the same visit, the radiologist may add a diagnostic code on top of the screening code. Patients sometimes see two charges where they expected only the preventive one. Ask the imaging center what code will be billed before you leave.

Observations about coding conventions, sourced to CMS and AMA code definitions. Not medical advice. Not legal advice.

Screening test prices vary because most insurance plans are required to cover preventive screenings at no cost to you — but only when they're coded as preventive. If your doctor codes the same test as diagnostic (for example, following up on a concerning symptom), you may owe the full negotiated rate. Hospitals also price screenings differently based on whether they're done at the hospital itself, an outpatient clinic, or a mobile screening unit. Before you schedule, ask your doctor how the test will be coded, confirm with your insurance that it will be covered as preventive, and ask the facility whether they offer a cash price if you'd prefer to avoid an insurance claim entirely.

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Data compiled by HospitalCost from 17 federal sources including CMS Hospital Price Transparency files, Hospital Compare, HCAHPS, and Medicare Cost Reports. Updated August 2026.