FeeBase
Log inGet started
Menu

CPT code 77263: Treatment planning, complex planning2026 Medicare rate & RVUs in North Carolina

Reports a radiation oncologist’s complex treatment-planning work, including decisions about treatment approach, target coverage, and dose delivery for a radiation course.

CMS RVU26DEffective Oct 1, 2026One payment locality292.3K Medicare services in 2024

In North Carolina, Medicare pays $161.55 for 77263 in the office and $161.55 when it’s performed in a hospital or facility.

$161.55Office (non-facility)
$161.55Hospital or facility
−4.0%vs the national office rate ($168.34)

Check a contract rate as a % of Medicare · 77263 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 77263 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 77263 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 77263 covers

A radiation oncologist uses this service to develop a complex external-beam radiation treatment plan. The work can include reviewing the patient’s clinical history and diagnostic studies, defining the treatment target, selecting the treatment approach, and determining how dose will be delivered across the planned course. It is reported when the physician’s planning work is complex, such as when multiple treatment areas, modalities, or demanding dose and field-shaping decisions require substantial analysis. Complexity is supported by the documented planning work, not by the diagnosis or body site alone.

Report 77263 for the physician’s planning service, not for each radiation fraction delivered. The record should describe the treatment approach and the specific factors that make the planning complex, such as the areas treated, modalities considered, and dose or field decisions. CMS identifies this as a professional-component-only code for interpretation and report; a separate code covers the technical portion. Simulation and three-dimensional planning are distinct services and should be reported separately when performed and supported by their own documentation.

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 North Carolina compares for 77263

Across 109 of 109 payment localities, the office rate for 77263 runs from $156.26 in Arkansas to $219.62 in Alaska. North Carolina pays $161.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

77263 in North Carolina vs other payment areas
  1. North Carolina · this page$161.55
  2. Los Angeles, CA · California$180.47+$18.92
  3. Washington, DC area · District of Columbia$185.11+$23.56
  4. Miami, FL · Florida$182.98+$21.43
  5. Chicago, IL · Illinois$179.73+$18.18
  6. Manhattan, NY · New York$188.99+$27.44
  7. Alaska · Alaska$219.62+$58.07

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

77263 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$157.60$157.60
ArkansasArkansas$156.26$156.26
ArizonaArizona$165.38$165.38
Bakersfield, CACalifornia$172.73$172.73
Chico, CACalifornia$171.94$171.94
El Centro, CACalifornia$171.98$171.98
Fresno, CACalifornia$171.94$171.94
Hanford, CACalifornia$171.94$171.94

77263 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$156.26

$219.62

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

View every state and territory as a table
77263 office rate range by state
State / territoryOffice rate rangeLocalities
AK$219.621
AL$157.601
AR$156.261
AZ$165.381
CA$171.94–$201.5529
CO$171.531
CT$176.541
DC$185.111
DE$167.341
FL$169.82–$182.983
GA$163.60–$171.192
GU$172.931
HI$172.931
IA$158.571
ID$159.471
IL$167.80–$179.734
IN$159.981
KS$158.791
KY$161.211
LA$161.32–$166.002
MA$171.43–$182.922
MD$169.40–$185.113
ME$160.66–$164.862
MI$164.32–$171.812
MN$164.381
MO$160.11–$165.573
MS$158.171
MT$168.321
NC$161.551
ND$163.581
NE$158.881
NH$169.721
NJ$178.55–$184.622
NM$165.131
NV$167.061
NY$163.05–$192.745
OH$163.351
OK$160.331
OR$165.73–$174.372
PA$163.13–$174.112
PR$168.861
RI$171.331
SC$162.721
SD$163.021
TN$159.341
TX$162.54–$171.778
UT$164.041
VA$165.00–$185.112
VI$168.861
VT$163.801
WA$170.83–$185.182
WI$160.351
WV$164.181
WY$166.261

See 77263 in every payment locality

How the 77263 rate is calculated

Each of 77263’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 · 77263

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.06

3.06 RVUs× 1.000 GPCI

Practice expense1.74

1.74 RVUs× 1.000 GPCI

Malpractice0.24

0.24 RVUs× 1.000 GPCI

Adjusted RVUs

5.0400

Conversion factor

$33.4009

Medicare rate

$168.34

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,028

Code
77263
Physician work
3.06
Practice expense
1.74
Malpractice
0.24

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 77263 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.06× 1.0003.0600
Practice expense1.74× 0.9331.6234
Malpractice0.24× 0.6390.1534
Total RVUs4.8368
Conversion factor× 33.4009

Office rate, North Carolina$161.55

Office: (3.06 × 1 + 1.74 × 0.933 + 0.24 × 0.639) × $33.4009 = $161.55

Facility: (3.06 × 1 + 1.74 × 0.933 + 0.24 × 0.639) × $33.4009 = $161.55

Open 77263 in the RVU calculator

Payment rules and modifiers for 77263

The CMS indicators that decide how 77263 is paid alongside other services.

CMS payment indicators · 77263

Treatment planning, complex planning

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.

Codes related to 77263

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 77263
CodeHow it relatesOffice range, North Carolina
Same family
77261Radiation planning, simple complexitySame treatment-planning series for simple rather than complex planning.$67.29
77262Radiation planning, intermediate complexitySame treatment-planning series for intermediate rather than complex planning.$103.22
Often billed with
77290Radiation simulation, complex setupSimulation may be performed as a separate service during the treatment-planning encounter.$414.39
77295Radiotherapy plan, three-dimensional planA separate three-dimensional radiotherapy plan may accompany complex treatment planning.$459.70

How 77263 has changed in North Carolina

77263 · Office / nonfacility

$161.55

Effective 2026-10-01

The base rate is $3.30 higher than on 2025-10-01, moving from $158.25 to $161.55 (2.1%).

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

    $158.25changed to$161.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.14 changed to 3.06
    • Practice expense RVU 1.72 changed to 1.74
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $160.08changed to$158.25

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.63 changed to 1.72

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $157.47changed to$160.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $163.90changed to$157.47

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.25 changed to 0.24
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $164.96changed to$163.90

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.55 changed to 1.63
    • Malpractice RVU 0.23 changed to 0.25
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $164.75changed to$164.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.51 changed to 1.55
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $168.61changed to$164.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.46 changed to 1.51
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $166.23changed to$168.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.41 changed to 1.46
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $164.71changed to$166.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.37 changed to 1.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $163.51changed to$164.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.34 changed to 1.37
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $162.37changed to$163.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.31 changed to 1.34
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $161.56changed to$162.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.26 changed to 1.31
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $160.76changed to$161.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $160.97changed to$160.76

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.25 changed to 0.24
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $153.04changed to$160.97

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.27 changed to 1.26
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $153.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$161.55$161.55RVU26D
2026-07-01$161.55$161.55RVU26C
2026-04-01$161.55$161.55RVU26B
2026-01-01$161.55$161.55RVU26A
2025-10-01$158.25$158.25RVU25D
2025-07-01$158.25$158.25RVU25C
2025-04-01$158.25$158.25RVU25B
2025-01-01$158.25$158.25RVU25A
2024-10-01$160.08$160.08RVU24D
2024-07-01$160.08$160.08RVU24C
2024-04-01$160.08$160.08RVU24B
2024-03-09$160.08$160.08RVU24AR
2024-01-01$157.47$157.47RVU24A
2023-10-01$163.90$163.90RVU23D
2023-07-01$163.90$163.90RVU23C
2023-04-01$163.90$163.90RVU23B
2023-01-01$163.90$163.90RVU23A
2022-10-01$164.96$164.96RVU22D
2022-07-01$164.96$164.96RVU22C
2022-04-01$164.96$164.96RVU22B
2022-01-01$164.96$164.96RVU22A
2021-10-01$164.75$164.75RVU21D
2021-07-01$164.75$164.75RVU21C
2021-04-01$164.75$164.75RVU21B
2021-01-01$164.75$164.75RVU21A
2020-10-01$168.61$168.61RVU20D
2020-07-01$168.61$168.61RVU20C
2020-04-01$168.61$168.61RVU20B
2020-01-01$168.61$168.61RVU20A
2019-10-01$166.23$166.23RVU19D
2019-07-01$166.23$166.23RVU19C
2019-04-01$166.23$166.23RVU19B
2019-01-01$166.23$166.23RVU19A
2018-10-01$164.71$164.71RVU18D
2018-07-01$164.71$164.71RVU18C
2018-04-01$164.71$164.71RVU18B
2018-01-01$164.71$164.71RVU18AR1
2017-10-01$163.51$163.51RVU17D
2017-07-01$163.51$163.51RVU17C
2017-04-01$163.51$163.51RVU17B
2017-01-01$163.51$163.51RVU17A
2016-10-01$162.37$162.37RVU16D
2016-07-01$162.37$162.37RVU16C
2016-04-01$162.37$162.37RVU16B
2016-01-01$162.37$162.37RVU16A
2015-10-01$161.56$161.56RVU15D
2015-07-01$161.56$161.56RVU15C
2015-04-01$160.76$160.76RVU15B
2015-01-01$160.76$160.76RVU15A
2014-10-01$160.97$160.97RVU14D
2014-07-01$160.97$160.97RVU14C
2014-04-01$160.97$160.97RVU14B
2014-01-01$160.97$160.97RVU14A
2013-10-01$153.04$153.04RVU13D
2013-07-01$153.04$153.04RVU13C
2013-04-01$153.04$153.04RVU13B
2013-01-01$153.04$153.04RVU13AR

Price 77263 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

77263 billing questions

How does 77263 differ from 77261 and 77262?

These codes represent different levels of treatment-planning complexity. Use 77263 when the documented planning work is complex rather than simple or intermediate; the diagnosis or treatment site alone does not establish the level.

Is 77263 the same service as radiation simulation?

No. Treatment planning determines the approach and dose strategy; simulation establishes treatment geometry and setup. Report simulation separately when performed and documented.

Does 77263 include a three-dimensional radiotherapy plan?

The planning service and a three-dimensional radiotherapy plan are distinct. When a separate 3D plan is performed and documented, code 77295 may also be reported.

Should 77263 be billed for every treatment fraction?

No. It reports planning work, not each delivered fraction. Documentation should support the complex planning service for the radiation course.

How should the professional and technical work be reported?

CMS identifies 77263 as professional-component-only for interpretation and report. A separate code covers the technical portion; the record should support the physician’s planning work.

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 77263PPRRVU2026_Oct_nonQPP.csv, line 9,028 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 77263 pays in North Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 77263 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist