C8904 Mri w/o cont, breast, uni

Magnetic resonance imaging without contrast, breast; unilateral

Payer policies and prior authorization for C8904

Medicaid fee-for-service

  • WY: $0.00 (professional), effective Jan 1, 2019

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.