CPT code 77262: Radiation planning, intermediate complexity2026 Medicare rate & RVUs in Missouri
Reports physician planning of an intermediate-complexity radiation treatment course, based on the documented clinical work needed to select the treatment approach.
Medicare pays $101.86–$105.40 for 77262 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 77262 covers
A radiation oncologist reviews the patient’s clinical information and relevant imaging, defines the treatment target and considers nearby normal structures, then establishes the treatment approach. Planning decisions may address treatment modality, dose, and fractionation. This service is used in radiation oncology for planning an individual course of treatment; the treatment site alone does not determine its complexity level.
Choose the intermediate level when the documented planning work supports that degree of complexity, rather than the simpler or more complex levels. The record should show the clinical information reviewed and the reasoning behind the treatment approach and complexity assigned. CMS identifies this as a professional-component-only code: it represents the physician’s interpretation and report, while a separate code covers the technical portion. Simulation and treatment planning describe distinct work; report a simulation service separately when performed.
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.
Where 77262 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$101.86 to $105.40
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $104.80 | $104.80 |
| Metropolitan St. Louis, MO | $105.40 | $105.40 |
| Rest of Missouri | $101.86 | $101.86 |
How the 77262 rate is calculated
Each of 77262’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 · 77262
RVUs × geographic indexes × conversion factor
Work1.95
1.95 RVUs× 1.000 GPCI
Practice expense1.14
1.14 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
3.2100
Conversion factor
$33.4009
Medicare rate
$107.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77262
The CMS indicators that decide how 77262 is paid alongside other services.
CMS payment indicators · 77262
Radiation planning, intermediate complexity
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 2 | Professional component only. |
77262 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77261Radiation planningSimple complexity
- Use 77261 when the clinical treatment-planning work is simple; 77262 reflects intermediate planning complexity.
- 77263Treatment planningComplex planning
- Use 77263 when the documented clinical planning is complex. 77262 is for an intermediate level of planning work.
- 77285Radiotherapy simulationIntermediate complexity
- 77285 describes intermediate-complexity simulation, not treatment planning. The two codes represent different work even when part of the same radiation treatment course.
- 77295Radiotherapy planThree-dimensional plan
- 77295 describes a three-dimensional radiotherapy plan. It is not the intermediate-complexity level in the 77261–77263 planning series.
77262 billing questions
How is 77262 distinguished from 77261 or 77263?
The levels distinguish the complexity of the clinical treatment planning. Select the intermediate level when the physician’s documented planning work supports it; the treatment site by itself does not establish the level.
Is simulation included in 77262?
No. Treatment planning and simulation are distinct services. Simulation codes, such as 77285 for intermediate-complexity simulation, describe simulation work rather than the physician’s treatment-planning decisions.
Does 77262 represent the professional or technical service?
It represents the professional component: the physician’s interpretation and report. CMS identifies a separate code for the technical portion.
Should modifier 26 be appended?
No. This is already a professional-component-only code; it does not represent a global service that needs modifier 26 to identify the professional portion.
What documentation supports the intermediate level?
Document the clinical information and imaging reviewed, the treatment approach selected, and the reasoning supporting intermediate planning complexity. A diagnosis or anatomic site alone does not establish the 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.
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