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2020 Office Fee <br />Code Fee Allowed <br />Clinical breast examination N/A Yes <br />77063 53.35$ No <br />77063TC 23.49$ <br />77063-26 29.86$ <br />77067 131.10$ No <br />77067TC 92.91$ <br />77067-26 38.19$ <br />Radiological examination, surgical specimen 76098 41.21$ No <br />76098TC 25.45$ <br />76098-26 15.76$ <br />Diagnostic mammography, unilateral, includes CAD 77065 128.54$ No <br />77065TC 87.87$ <br />77065-26 40.67$ <br />Diagnostic mammography, bilateral, includes CAD 77066 161.91$ No <br />77066TC 112.04$ <br />77066-26 49.87$ <br />G0279 53.35$ No <br />G0279TC 23.49$ <br />G0279-26 29.86$ <br />Ultrasound, complete examination of breast including axilla,76641 102.96$ No <br /> unilateral (4)76641TC 66.73$ <br />76641-26 36.23$ <br />Ultrasound, limited examination of breast including axilla, 76642 84.37$ No <br /> unilateral (4)76642TC 50.62$ <br />76642-26 33.75$ <br />Surgical evaluation/Consultation N/A (10)Yes <br />Fine needle aspiration biopsy without imaging guidance, first lesion 10021 95.77$ Yes <br /> Each additional lesion 10004 51.01$ Yes <br />Fine needle aspiration biopsy including ultrasound guidance, first lesion 10005 126.05$ Yes <br /> Each additional lesion 10006 59.02$ Yes <br />Puncture aspiration of cyst of breast 19000 105.82$ Yes <br />Puncture aspiration of cyst of breast, each additional cyst, used with 19000 19001 26.93$ Yes <br />Breast biopsy, with placement of localization device and imaging of 19081 588.30$ Yes <br /> biopsy specimen, percutaneous; stereotactic guidance; first lesion (5) <br /> Each additional lesion (5) 19082 472.38$ Yes <br />Breast biopsy, with placement of localization device and imaging of 19083 581.78$ Yes <br /> biopsy specimen, percutaneous; ultrasound guidance; first lesion (5) <br /> Each additional lesion (5)19084 459.57$ Yes <br />Breast biopsy, percutaneous, needle core, not using imaging guidance 19100 149.01$ Yes <br />Breast biopsy, open, incisional 19101 326.42$ Yes <br />North Carolina Breast and Cervical Cancer Control Program <br />Breast Cancer Screening and Diagnostic Procedures <br />2020 Services Fee Schedule (1) <br />For the Period 01/01/2020 through 12/31/2020 <br />Follow-Up <br />Created: 1/14/2020 <br />Screening mammography, bilateral, includes CAD <br />Screening <br />Screening digital breast tomosynthesis, bilateral (2) <br />Diagnostic digital breast tomosynthesis, unilateral or bilateral (3) <br />DocuSign Envelope ID: FB8633A7-7427-4234-85C2-8B1508ED7177