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CPT code 77263: Treatment planning, complex planning2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $189.00 for 77263 in the office and $189.00 when it’s performed in a hospital or facility.

$189.00Office (non-facility)
$189.00Hospital or facility
+12.3%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $189.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

77263 in Queens, NY vs other payment areas
  1. Queens, NY · this page$189.00
  2. Manhattan, NY · New York$188.99−$0.01
  3. NYC suburbs and Long Island, NY · New York$192.74+$3.74
  4. Poughkeepsie and northern NYC suburbs, NY · New York$180.14−$8.86
  5. Rest of New York · New York$163.05−$25.95
  6. Los Angeles, CA · California$180.47−$8.53
  7. Washington, DC area · District of Columbia$185.11−$3.89

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

77263 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$182.98$182.98
Chicago, ILIllinois$179.73$179.73
AlaskaAlaska$219.62$219.62
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 77263 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work3.06× 1.0643.2558
Practice expense1.74× 1.1822.0567
Malpractice0.24× 1.4420.3461
Total RVUs5.6586
Conversion factor× 33.4009

Office rate, Queens, NY$189.00

Office: (3.06 × 1.064 + 1.74 × 1.182 + 0.24 × 1.442) × $33.4009 = $189.00

Facility: (3.06 × 1.064 + 1.74 × 1.182 + 0.24 × 1.442) × $33.4009 = $189.00

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, Queens, NY
Same family
77261Radiation planning, simple complexitySame treatment-planning series for simple rather than complex planning.$78.12
77262Radiation planning, intermediate complexitySame treatment-planning series for intermediate rather than complex planning.$120.09
Often billed with
77290Radiation simulation, complex setupSimulation may be performed as a separate service during the treatment-planning encounter.$516.80
77295Radiotherapy plan, three-dimensional planA separate three-dimensional radiotherapy plan may accompany complex treatment planning.$559.34

How 77263 has changed in Queens, NY

77263 · Office / nonfacility

$189.00

Effective 2026-10-01

The base rate is $3.00 higher than on 2025-10-01, moving from $186.00 to $189.00 (1.6%).

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

    $186.00changed to$189.00

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $187.84changed to$186.00

    • 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

    $184.77changed to$187.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $197.30changed to$184.77

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $201.80changed to$197.30

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $200.83changed to$201.80

    • 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

    $203.25changed to$200.83

    • 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
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $197.61changed to$203.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.41 changed to 1.46
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $195.66changed to$197.61

    • 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

    $194.01changed to$195.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.34 changed to 1.37
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $192.47changed to$194.01

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.31 changed to 1.34
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $191.79changed to$192.47

    • 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

    $190.84changed to$191.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $189.37changed to$190.84

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $178.28changed to$189.37

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $178.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$189.00$189.00RVU26D
2026-07-01$189.00$189.00RVU26C
2026-04-01$189.00$189.00RVU26B
2026-01-01$189.00$189.00RVU26A
2025-10-01$186.00$186.00RVU25D
2025-07-01$186.00$186.00RVU25C
2025-04-01$186.00$186.00RVU25B
2025-01-01$186.00$186.00RVU25A
2024-10-01$187.84$187.84RVU24D
2024-07-01$187.84$187.84RVU24C
2024-04-01$187.84$187.84RVU24B
2024-03-09$187.84$187.84RVU24AR
2024-01-01$184.77$184.77RVU24A
2023-10-01$197.30$197.30RVU23D
2023-07-01$197.30$197.30RVU23C
2023-04-01$197.30$197.30RVU23B
2023-01-01$197.30$197.30RVU23A
2022-10-01$201.80$201.80RVU22D
2022-07-01$201.80$201.80RVU22C
2022-04-01$201.80$201.80RVU22B
2022-01-01$201.80$201.80RVU22A
2021-10-01$200.83$200.83RVU21D
2021-07-01$200.83$200.83RVU21C
2021-04-01$200.83$200.83RVU21B
2021-01-01$200.83$200.83RVU21A
2020-10-01$203.25$203.25RVU20D
2020-07-01$203.25$203.25RVU20C
2020-04-01$203.25$203.25RVU20B
2020-01-01$203.25$203.25RVU20A
2019-10-01$197.61$197.61RVU19D
2019-07-01$197.61$197.61RVU19C
2019-04-01$197.61$197.61RVU19B
2019-01-01$197.61$197.61RVU19A
2018-10-01$195.66$195.66RVU18D
2018-07-01$195.66$195.66RVU18C
2018-04-01$195.66$195.66RVU18B
2018-01-01$195.66$195.66RVU18AR1
2017-10-01$194.01$194.01RVU17D
2017-07-01$194.01$194.01RVU17C
2017-04-01$194.01$194.01RVU17B
2017-01-01$194.01$194.01RVU17A
2016-10-01$192.47$192.47RVU16D
2016-07-01$192.47$192.47RVU16C
2016-04-01$192.47$192.47RVU16B
2016-01-01$192.47$192.47RVU16A
2015-10-01$191.79$191.79RVU15D
2015-07-01$191.79$191.79RVU15C
2015-04-01$190.84$190.84RVU15B
2015-01-01$190.84$190.84RVU15A
2014-10-01$189.37$189.37RVU14D
2014-07-01$189.37$189.37RVU14C
2014-04-01$189.37$189.37RVU14B
2014-01-01$189.37$189.37RVU14A
2013-10-01$178.28$178.28RVU13D
2013-07-01$178.28$178.28RVU13C
2013-04-01$178.28$178.28RVU13B
2013-01-01$178.28$178.28RVU13AR

Price 77263 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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