CPT code 77261: Radiation planning, simple complexity2026 Medicare rate & RVUs in Puerto Rico

Reports the radiation oncologist’s professional planning work for a simple radiation treatment approach after review of the patient’s clinical and tumor information.

CMS RVU26DEffective Oct 1, 2026One payment locality13.6K Medicare services in 2024

In Puerto Rico, Medicare pays $70.05 for 77261 in the office and $70.05 when it’s performed in a hospital or facility.

$70.05Office (non-facility)
$70.05Hospital or facility
+0.3%vs the national office rate ($69.81)

Check a contract rate as a % of Medicare · 77261 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 77261 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 77261 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 77261 covers

A radiation oncologist uses this service to develop a simple external-beam radiation treatment approach after reviewing relevant clinical information, such as the cancer diagnosis, disease extent, imaging, and prior treatment. Planning may include defining the treatment approach and determining the intended dose and beam arrangement. It is performed in radiation oncology practices and hospital-based cancer centers as part of preparing a patient’s course of treatment.

Select the simple level based on the documented complexity of the physician’s planning work; do not infer the level from a field count alone. The record should support the clinical information reviewed and the treatment decisions made. CMS identifies 77261 as a professional-component-only service: it represents the physician’s interpretation and report, while a separate code accounts for the technical portion. Field simulation and dosimetry calculations are distinct services when performed and documented; this planning code does not itself describe those services.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 77261

Across 109 of 109 payment localities, the office rate for 77261 runs from $65.14 in Arkansas to $91.60 in Alaska. Puerto Rico pays $70.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

77261 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$70.05
  2. Los Angeles, CA · California$75.35+$5.30
  3. Washington, DC area · District of Columbia$76.82+$6.77
  4. Miami, FL · Florida$74.41+$4.36
  5. Chicago, IL · Illinois$73.26+$3.21
  6. Manhattan, NY · New York$77.95+$7.90
  7. Alaska · Alaska$91.60+$21.55

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

77261 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$65.66$65.66
ArkansasArkansas$65.14$65.14
ArizonaArizona$68.69$68.69
Bakersfield, CACalifornia$72.10$72.10
Chico, CACalifornia$71.85$71.85
El Centro, CACalifornia$71.86$71.86
Fresno, CACalifornia$71.85$71.85
Hanford, CACalifornia$71.85$71.85

77261 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$65.14

$91.60

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
77261 office rate range by state
State / territoryOffice rate rangeLocalities
AK$91.601
AL$65.661
AR$65.141
AZ$68.691
CA$71.85–$84.4629
CO$71.411
CT$73.081
DC$76.821
DE$69.481
FL$69.88–$74.413
GA$67.55–$70.812
GU$72.261
HI$72.261
IA$66.271
ID$66.571
IL$68.94–$73.264
IN$66.781
KS$66.241
KY$66.831
LA$66.83–$68.652
MA$71.34–$76.152
MD$70.34–$76.823
ME$66.92–$68.722
MI$67.93–$70.542
MN$68.891
MO$66.29–$68.613
MS$65.721
MT$69.801
NC$67.291
ND$68.421
NE$66.421
NH$70.541
NJ$74.04–$76.652
NM$68.201
NV$69.441
NY$67.86–$79.265
OH$67.651
OK$66.611
OR$69.01–$72.672
PA$67.63–$72.052
PR$70.051
RI$71.191
SC$67.551
SD$68.261
TN$66.451
TX$67.39–$71.088
UT$68.071
VA$68.69–$76.822
VI$70.051
VT$68.401
WA$71.13–$77.192
WI$67.141
WV$67.531
WY$69.201

See 77261 in every payment locality

How the 77261 rate is calculated

Each of 77261’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 77261

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.27

1.27 RVUs× 1.000 GPCI

Practice expense0.75

0.75 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

2.0900

Conversion factor

$33.4009

Medicare rate

$69.81

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,026

Code
77261
Physician work
1.27
Practice expense
0.75
Malpractice
0.07

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 77261 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0001.2700
Practice expense0.75× 1.0110.7582
Malpractice0.07× 0.9850.0690
Total RVUs2.0972
Conversion factor× 33.4009

Office rate, Puerto Rico$70.05

Office: (1.27 × 1 + 0.75 × 1.011 + 0.07 × 0.985) × $33.4009 = $70.05

Facility: (1.27 × 1 + 0.75 × 1.011 + 0.07 × 0.985) × $33.4009 = $70.05

Open 77261 in the RVU calculator

Payment rules and modifiers for 77261

The CMS indicators that decide how 77261 is paid alongside other services.

CMS payment indicators · 77261

Radiation planning, simple complexity

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical2Professional component only.

How 77261 has changed in Puerto Rico

77261 · Office / nonfacility

$70.05

Effective 2026-10-01

The base rate is $1.34 higher than on 2025-10-01, moving from $68.71 to $70.05 (2.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $68.71changed to$70.05

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.30 changed to 1.27
    • Practice expense RVU 0.76 changed to 0.75
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $70.36changed to$68.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.73 changed to 0.76
    • Malpractice RVU 0.08 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $69.21changed to$70.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $71.31changed to$69.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.72 changed to 0.73
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $71.16changed to$71.31

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $72.13changed to$71.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.69 changed to 0.72
    • Malpractice RVU 0.09 changed to 0.08
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $72.02changed to$72.13

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.67 changed to 0.69

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $73.77changed to$72.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.65 changed to 0.67
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $73.29changed to$73.77

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.64 changed to 0.65
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $73.21changed to$73.29

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $72.85changed to$73.21

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 1.39 changed to 1.30
    • Practice expense RVU 0.68 changed to 0.64
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $67.37changed to$72.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.66 changed to 0.68
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $67.36changed to$67.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.65 changed to 0.66

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $67.03changed to$67.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $65.89changed to$67.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.61 changed to 0.65
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $62.21changed to$65.89

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $62.21

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$70.05$70.05RVU26D
2026-07-01$70.05$70.05RVU26C
2026-04-01$70.05$70.05RVU26B
2026-01-01$70.05$70.05RVU26A
2025-10-01$68.71$68.71RVU25D
2025-07-01$68.71$68.71RVU25C
2025-04-01$68.71$68.71RVU25B
2025-01-01$68.71$68.71RVU25A
2024-10-01$70.36$70.36RVU24D
2024-07-01$70.36$70.36RVU24C
2024-04-01$70.36$70.36RVU24B
2024-03-09$70.36$70.36RVU24AR
2024-01-01$69.21$69.21RVU24A
2023-10-01$71.31$71.31RVU23D
2023-07-01$71.16$71.16RVU23C
2023-04-01$71.16$71.16RVU23B
2023-01-01$71.16$71.16RVU23A
2022-10-01$72.13$72.13RVU22D
2022-07-01$72.13$72.13RVU22C
2022-04-01$72.13$72.13RVU22B
2022-01-01$72.13$72.13RVU22A
2021-10-01$72.02$72.02RVU21D
2021-07-01$72.02$72.02RVU21C
2021-04-01$72.02$72.02RVU21B
2021-01-01$72.02$72.02RVU21A
2020-10-01$73.77$73.77RVU20D
2020-07-01$73.77$73.77RVU20C
2020-04-01$73.77$73.77RVU20B
2020-01-01$73.77$73.77RVU20A
2019-10-01$73.29$73.29RVU19D
2019-07-01$73.29$73.29RVU19C
2019-04-01$73.29$73.29RVU19B
2019-01-01$73.29$73.29RVU19A
2018-10-01$73.21$73.21RVU18D
2018-07-01$73.21$73.21RVU18C
2018-04-01$73.21$73.21RVU18B
2018-01-01$73.21$73.21RVU18AR1
2017-10-01$72.85$72.85RVU17D
2017-07-01$72.85$72.85RVU17C
2017-04-01$72.85$72.85RVU17B
2017-01-01$72.85$72.85RVU17A
2016-10-01$67.37$67.37RVU16D
2016-07-01$67.37$67.37RVU16C
2016-04-01$67.37$67.37RVU16B
2016-01-01$67.37$67.37RVU16A
2015-10-01$67.36$67.36RVU15D
2015-07-01$67.36$67.36RVU15C
2015-04-01$67.03$67.03RVU15B
2015-01-01$67.03$67.03RVU15A
2014-10-01$65.89$65.89RVU14D
2014-07-01$65.89$65.89RVU14C
2014-04-01$65.89$65.89RVU14B
2014-01-01$65.89$65.89RVU14A
2013-10-01$62.21$62.21RVU13D
2013-07-01$62.21$62.21RVU13C
2013-04-01$62.21$62.21RVU13B
2013-01-01$62.21$62.21RVU13AR

Price 77261 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

77261 billing questions

How does 77261 differ from 77262?

77261 is for simple treatment planning, while 77262 is for intermediate planning. Choose the level supported by the physician’s documented planning complexity rather than relying on a field count alone.

Is treatment simulation included in 77261?

No. Simulation, such as setting up treatment geometry, is a distinct service. Code 77280 describes simple radiation field simulation when that service is performed and documented.

Does 77261 include the technical portion of planning?

No. CMS identifies 77261 as professional-component-only for the physician’s interpretation and report; a separate code covers the technical portion.

What documentation supports the simple planning level?

Document the clinical information reviewed and the physician’s treatment-planning decisions. The record should support why the planning work meets the simple level.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 77261PPRRVU2026_Oct_nonQPP.csv, line 9,026 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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