The business of biopsy: How imaging centers are monetizing diagnostic add-ons

How Biopsies Became a Profit Center for Imaging Facilities in the AI-Driven Mammography Boom

As diagnostic imaging volumes rise across the United States in 2025, one segment is emerging as a clear revenue driver: breast biopsies. Once viewed primarily as a necessary clinical follow-up to mammograms, biopsies are now being reimagined by imaging centers as strategic service lines—equipped with advanced technology, backed by AI, and tightly integrated into broader diagnostic pathways.

This shift is not only enabling faster, more accurate diagnosis of breast abnormalities but also creating new monetization opportunities for outpatient centers and hospital-based radiology groups. From image-guided biopsy systems to reimbursement-optimized scheduling models, facilities are increasingly viewing biopsy services as central to revenue growth, patient retention, and competitive differentiation.

Why Breast Biopsy Volumes Are Increasing in 2025

The surge in breast biopsy procedures is closely tied to rising diagnostic mammography volumes. According to IMV Medical Information Division’s 2025 survey, over 60% of mammograms in U.S. facilities are now diagnostic, driven by factors such as increased screening compliance, better awareness of breast density, and improvements in lesion detection through AI.

This has resulted in more patients being referred for biopsy evaluations—either stereotactic, ultrasound-guided, or MRI-guided—depending on the complexity and visibility of the lesion. Radiology directors indicate that biopsy conversion rates from diagnostic reads are climbing, especially as image quality and detection thresholds improve.

Additionally, patient expectations are shifting. With faster results and clearer procedural explanations enabled by AI-driven visualization tools, more patients are opting in to same-day or next-day biopsies at the point of diagnosis—further accelerating volume growth.

How Imaging Centers Are Structuring Biopsy Services for Profitability

To monetize this trend effectively, imaging centers are optimizing biopsy workflows across staffing, technology, and reimbursement parameters. Facilities that used to refer biopsies to external surgical clinics are now bringing those services in-house, enabled by compact, office-based systems with minimal infrastructure overhead.

Vendors like Hologic, GE Healthcare, and Siemens Healthineers have responded with modular, scalable biopsy units that integrate seamlessly with existing mammography platforms. Hologic’s Affirm Prone and Eviva biopsy systems, for instance, allow stereotactic biopsies to be performed on the same equipment used for screening, eliminating unnecessary patient movement and improving throughput.

From a billing perspective, many facilities are segmenting their diagnostic offerings to ensure that biopsies, image guidance, pathology prep, and physician interpretation are correctly coded and reimbursed. Centers offering bundled biopsy packages are also negotiating favorable rates with private insurers to retain patient loyalty and reduce claim denials.

What Are the Leading Technologies in Image-Guided Breast Biopsy Today?

Technological innovation in biopsy equipment has been critical to making these procedures more viable—and profitable—in outpatient imaging settings.

Stereotactic biopsy systems are now designed to operate with 3D tomosynthesis guidance, allowing radiologists to precisely localize calcifications and architectural distortions that may not appear on conventional 2D images. This capability is especially vital for facilities serving high-risk populations and dense breast demographics.

Ultrasound-guided biopsy tools remain the most commonly used due to their real-time targeting and lower cost. They are also increasingly supported by AI-assisted lesion tracking and tissue sampling analytics, improving confidence and efficiency in community practices.

MRI-guided biopsies, while more niche due to equipment and staffing needs, are gaining traction at tertiary care centers where patients with complex or multifocal presentations require advanced imaging evaluation. These procedures often command higher reimbursement and are used selectively to manage institutional case mix.

AI’s Expanding Role in Biopsy Planning and Execution

Artificial intelligence is not just changing how lesions are detected—it’s also beginning to inform how, when, and where biopsies are conducted. Some AI platforms now recommend biopsy modality (e.g., ultrasound vs. stereotactic) based on lesion characteristics, tissue composition, and anatomical factors pulled from multimodal imaging datasets.

Vendors like iCAD and QView Medical are exploring tools that simulate biopsy trajectories and identify ideal sampling sites, reducing sampling errors and the need for repeat procedures. This can directly reduce costs for both payers and providers while also improving diagnostic confidence.

Radiology departments are also using AI to predict histopathologic outcomes based on lesion morphology, BI-RADS categorization, and patient history, creating a new layer of pre-biopsy triage. While these predictions are not yet diagnostic, they are influencing how physicians counsel patients and determine urgency levels.

How Hospitals and PE-Backed Chains Are Scaling Biopsy Capacity

Institutional investors and healthcare operators are taking note of biopsy’s strategic importance in radiology’s service mix. Private equity-backed imaging networks are aggressively expanding their biopsy capacity as part of broader consolidation plays, offering full-spectrum breast imaging—from screening to diagnosis—in-house.

Hospitals are similarly investing in biopsy upgrades, particularly in regions where reimbursement parity favors outpatient procedural growth. By internalizing biopsy workflows, hospitals can reduce referral leakage, speed up treatment initiation, and improve performance on cancer care quality metrics tracked by CMS and commercial payers.

In some markets, outpatient diagnostic centers are partnering directly with oncology groups to create joint biopsy-review clinics, where pathology and imaging interpretations are cross-validated within 48 hours—a model gaining traction in value-based care environments.

How Reimbursement Models Are Shaping Biopsy Monetization Strategies

The financial success of biopsy services depends not only on volume but also on reimbursement mechanics. Medicare and commercial insurers reimburse differently based on guidance type, facility setting, and pathology processing. In 2025, imaging centers that optimize coding for add-on services—such as clip placement, post-biopsy imaging, and sedation—are seeing significantly improved margins.

Facilities with bundled payment models are also creating “biopsy pathways” that include imaging, tissue sampling, pathology, and surgical referral as a single care episode. This improves care continuity while stabilizing per-patient revenue in high-volume practices.

Radiology consultants are advising facilities to avoid common pitfalls like undercoding core samples or failing to bill separately for multiple lesions biopsied during a single visit. Revenue cycle management vendors are also offering specialty biopsy billing services to help centers maximize compliant earnings.

Future Outlook: Will Breast Biopsy Services Continue to Expand as a Business Line?

The outlook for breast biopsy services remains strong, especially as imaging facilities evolve from pure diagnostics to full-cycle breast care hubs.

As AI improves risk stratification and detection sensitivity, biopsy indications will likely become more targeted—focusing on earlier-stage lesions with higher likelihood of malignancy. This will make procedural efficiency, comfort, and turnaround speed even more important to both patients and referring clinicians.

Meanwhile, biopsy hardware manufacturers are expected to introduce next-generation systems with robotic targeting, integrated specimen verification, and real-time radiologic-pathologic correlation. These features could further reduce errors, speed workflows, and expand procedural access in smaller centers.

On the policy side, any federal efforts to expand preventive care coverage or mandate dense breast notification (as already seen in several U.S. states) could push more patients into advanced diagnostics, reinforcing biopsy’s role as the revenue-bearing final step in the diagnostic journey.

Why Mastering Biopsy Services Is Crucial for Imaging Centers in 2025

Breast biopsy is no longer an afterthought in the imaging value chain. It has become a strategic service that balances clinical necessity with economic opportunity. For imaging centers navigating the 2025 diagnostic landscape, mastering the business of biopsy is increasingly essential—not just to improve patient care, but to remain competitive and financially resilient in an evolving healthcare economy.