CPT code 77280: Radiation simulation, simple field setup2026 Medicare rate & RVUs in North Carolina
Reports simple radiation treatment simulation to reproduce patient positioning and establish treatment-field geometry before external-beam therapy.
In North Carolina, Medicare pays $252.61 for 77280 in the office.
Check a contract rate as a % of Medicare · 77280 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 77280 covers
The radiation oncology team uses a simulator or treatment imaging system to reproduce the patient’s treatment position and establish basic beam geometry for a simple field setup. The radiation oncologist directs and interprets the simulation; radiation therapists commonly assist with positioning and image acquisition in a radiation oncology department. The service supports accurate setup before treatment begins or when a new setup is needed.
Select 77280 when the documented field-setting work meets the simple level; use 77285 or 77290 when the simulation complexity supports those levels. Documentation should identify the treatment site, patient position, field geometry, simulation images, and physician involvement. CMS recognizes modifier 26 for the professional component and modifier TC for the technical component; reporting without either modifier represents the global service.
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 77280
Across 109 of 109 payment localities, the office rate for 77280 runs from $234.28 in Arkansas to $379.93 in San Benito County, CA. North Carolina pays $252.61. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$252.61
- Los Angeles, CA · California$314.95+$62.34
- Washington, DC area · District of Columbia$314.62+$62.01
- Miami, FL · Florida$281.65+$29.04
- Chicago, IL · Illinois$272.66+$20.05
- Manhattan, NY · New York$311.55+$58.94
- Alaska · Alaska$296.26+$43.65
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $238.28 | — |
| ArkansasArkansas | $234.28 | — |
| ArizonaArizona | $261.74 | — |
| Bakersfield, CACalifornia | $293.02 | — |
| Chico, CACalifornia | $292.88 | — |
| El Centro, CACalifornia | $292.89 | — |
| Fresno, CACalifornia | $292.88 | — |
| Hanford, CACalifornia | $292.88 | — |
| Madera, CACalifornia | $292.88 | — |
| Merced, CACalifornia | $292.88 | — |
| Modesto, CACalifornia | $292.88 | — |
| Napa, CACalifornia | $348.39 | — |
| Oxnard, CACalifornia | $314.36 | — |
| Redding, CACalifornia | $292.88 | — |
| Rest of CaliforniaCalifornia | $292.88 | — |
| Riverside, CACalifornia | $293.33 | — |
| Sacramento, CACalifornia | $309.76 | — |
| Salinas, CACalifornia | $308.66 | — |
| San Diego, CACalifornia | $317.73 | — |
| Marin County, CACalifornia | $371.63 | — |
| San Francisco, CACalifornia | $371.59 | — |
| San Benito County, CACalifornia | $379.93 | — |
| Santa Clara County, CACalifornia | $379.75 | — |
| San Luis Obispo, CACalifornia | $303.44 | — |
| Santa Cruz, CACalifornia | $322.18 | — |
| Santa Maria, CACalifornia | $310.31 | — |
| Santa Rosa, CACalifornia | $325.58 | — |
| Stockton, CACalifornia | $292.88 | — |
| Vallejo, CACalifornia | $348.32 | — |
| Visalia, CACalifornia | $292.88 | — |
| Yuba City, CACalifornia | $292.88 | — |
| ColoradoColorado | $285.24 | — |
| ConnecticutConnecticut | $289.18 | — |
| DelawareDelaware | $266.58 | — |
| Fort Lauderdale, FLFlorida | $273.82 | — |
| Rest of FloridaFlorida | $259.42 | — |
| Atlanta, GAGeorgia | $273.81 | — |
| Rest of GeorgiaGeorgia | $243.29 | — |
| Hawaii, Guam, HIHawaii | $302.62 | — |
| IowaIowa | $247.87 | — |
| IdahoIdaho | $249.20 | — |
| East St. Louis, ILIllinois | $251.26 | — |
| Rest of IllinoisIllinois | $248.94 | — |
| Suburban Chicago, ILIllinois | $277.36 | — |
| IndianaIndiana | $250.94 | — |
| KansasKansas | $245.31 | — |
| KentuckyKentucky | $242.18 | — |
| New Orleans, LALouisiana | $255.24 | — |
| Rest of LouisianaLouisiana | $241.26 | — |
| Metropolitan Boston, MAMassachusetts | $317.96 | — |
| Rest of MassachusettsMassachusetts | $282.65 | — |
| Baltimore area, MDMaryland | $288.15 | — |
| Rest of MarylandMaryland | $272.61 | — |
| Rest of MaineMaine | $249.40 | — |
| Southern Maine, MEMaine | $266.84 | — |
| Detroit, MIMichigan | $261.87 | — |
| Rest of MichiganMichigan | $248.36 | — |
| MinnesotaMinnesota | $275.72 | — |
| Metropolitan Kansas City, MOMissouri | $254.54 | — |
| Metropolitan St. Louis, MOMissouri | $257.76 | — |
| Rest of MissouriMissouri | $235.63 | — |
| MississippiMississippi | $235.07 | — |
| MontanaMontana | $269.54 | — |
| North DakotaNorth Dakota | $268.75 | — |
| NebraskaNebraska | $249.81 | — |
| New HampshireNew Hampshire | $279.44 | — |
| Northern New JerseyNew Jersey | $310.35 | — |
| Rest of New JerseyNew Jersey | $293.17 | — |
| New MexicoNew Mexico | $249.44 | — |
| NevadaNevada | $269.57 | — |
| NYC suburbs and Long Island, NYNew York | $318.54 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $294.17 | — |
| Queens, NYNew York | $316.27 | — |
| Rest of New YorkNew York | $256.87 | — |
| OhioOhio | $248.20 | — |
| OklahomaOklahoma | $242.98 | — |
| Portland, OROregon | $296.82 | — |
| Rest of OregonOregon | $268.17 | — |
| Metropolitan Philadelphia, PAPennsylvania | $280.28 | — |
| Rest of PennsylvaniaPennsylvania | $249.34 | — |
| Puerto RicoPuerto Rico | $272.23 | — |
| Rhode IslandRhode Island | $277.93 | — |
| South CarolinaSouth Carolina | $250.69 | — |
| South DakotaSouth Dakota | $268.66 | — |
| TennesseeTennessee | $246.59 | — |
| Austin, TXTexas | $283.68 | — |
| Beaumont, TXTexas | $247.36 | — |
| Brazoria, TXTexas | $267.22 | — |
| Dallas, TXTexas | $268.58 | — |
| Fort Worth, TXTexas | $266.14 | — |
| Galveston, TXTexas | $267.78 | — |
| Houston, TXTexas | $268.51 | — |
| Rest of TexasTexas | $256.90 | — |
| UtahUtah | $254.68 | — |
| VirginiaVirginia | $264.98 | — |
| Virgin Islands, VIUnited States Virgin Islands | $272.23 | — |
| VermontVermont | $266.43 | — |
| Rest of WashingtonWashington | $282.53 | — |
| King County, WAWashington | $326.16 | — |
| WisconsinWisconsin | $258.31 | — |
| West VirginiaWest Virginia | $237.96 | — |
| WyomingWyoming | $269.20 | — |
77280 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.
$234.28
$336.41
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $296.26 | 1 |
| AL | $238.28 | 1 |
| AR | $234.28 | 1 |
| AZ | $261.74 | 1 |
| CA | $292.88–$379.93 | 29 |
| CO | $285.24 | 1 |
| CT | $289.18 | 1 |
| DC | $314.62 | 1 |
| DE | $266.58 | 1 |
| FL | $259.42–$281.65 | 3 |
| GA | $243.29–$273.81 | 2 |
| GU | $302.62 | 1 |
| HI | $302.62 | 1 |
| IA | $247.87 | 1 |
| ID | $249.20 | 1 |
| IL | $248.94–$277.36 | 4 |
| IN | $250.94 | 1 |
| KS | $245.31 | 1 |
| KY | $242.18 | 1 |
| LA | $241.26–$255.24 | 2 |
| MA | $282.65–$317.96 | 2 |
| MD | $272.61–$314.62 | 3 |
| ME | $249.40–$266.84 | 2 |
| MI | $248.36–$261.87 | 2 |
| MN | $275.72 | 1 |
| MO | $235.63–$257.76 | 3 |
| MS | $235.07 | 1 |
| MT | $269.54 | 1 |
| NC | $252.61 | 1 |
| ND | $268.75 | 1 |
| NE | $249.81 | 1 |
| NH | $279.44 | 1 |
| NJ | $293.17–$310.35 | 2 |
| NM | $249.44 | 1 |
| NV | $269.57 | 1 |
| NY | $256.87–$318.54 | 5 |
| OH | $248.20 | 1 |
| OK | $242.98 | 1 |
| OR | $268.17–$296.82 | 2 |
| PA | $249.34–$280.28 | 2 |
| PR | $272.23 | 1 |
| RI | $277.93 | 1 |
| SC | $250.69 | 1 |
| SD | $268.66 | 1 |
| TN | $246.59 | 1 |
| TX | $247.36–$283.68 | 8 |
| UT | $254.68 | 1 |
| VA | $264.98–$314.62 | 2 |
| VI | $272.23 | 1 |
| VT | $266.43 | 1 |
| WA | $282.53–$326.16 | 2 |
| WI | $258.31 | 1 |
| WV | $237.96 | 1 |
| WY | $269.20 | 1 |
How the 77280 rate is calculated
Each of 77280’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 · 77280
RVUs × geographic indexes × conversion factor
Work0.68
0.68 RVUs× 1.000 GPCI
Practice expense7.35
7.35 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
8.0700
Conversion factor
$33.4009
Medicare rate
$269.55
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
9,029
- Code
- 77280
- Physician work
- 0.68
- Practice expense
- 7.35
- Malpractice
- 0.04
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.68 | × 1.000 | 0.6800 |
| Practice expense | 7.35 | × 0.933 | 6.8575 |
| Malpractice | 0.04 | × 0.639 | 0.0256 |
| Total RVUs | 7.5631 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$252.61
Office: (0.68 × 1 + 7.35 × 0.933 + 0.04 × 0.639) × $33.4009 = $252.61
Payment rules and modifiers for 77280
The CMS indicators that decide how 77280 is paid alongside other services.
CMS payment indicators · 77280
Radiation simulation, simple field setup
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
77280 without 26 · national office
$269.55
Radiation simulation, simple field setup
77280-26 · Professional component
$37.07
Pays only the interpretation and report.
How 77280 has changed in North Carolina
77280 · Office / nonfacility
$252.61
Effective 2026-10-01
The base rate is $10.54 higher than on 2025-10-01, moving from $242.07 to $252.61 (4.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$242.07changed to$252.61
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.70 changed to 0.68
- Practice expense RVU 7.29 changed to 7.35
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$250.44changed to$242.07
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.34 changed to 7.29
- Malpractice RVU 0.04 changed to 0.05
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$246.35changed to$250.44
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$254.92changed to$246.35
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.32 changed to 7.34
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$257.19changed to$254.92
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.21 changed to 7.32
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$270.33changed to$257.19
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 7.55 changed to 7.21
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$264.99changed to$270.33
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.11 changed to 7.55
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$264.45changed to$264.99
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.10 changed to 7.11
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$268.85changed to$264.45
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.24 changed to 7.10
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$261.06changed to$268.85
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.03 changed to 7.24
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$258.25changed to$261.06
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.97 changed to 7.03
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$255.17changed to$258.25
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.85 changed to 6.97
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$253.90changed to$255.17
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$253.76changed to$253.90
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.84 changed to 6.85
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$169.21changed to$253.76
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 4.58 changed to 6.84
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $169.21
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $252.61 | Not available in this setting | RVU26D |
| 2026-07-01 | $252.61 | Not available in this setting | RVU26C |
| 2026-04-01 | $252.61 | Not available in this setting | RVU26B |
| 2026-01-01 | $252.61 | Not available in this setting | RVU26A |
| 2025-10-01 | $242.07 | Not available in this setting | RVU25D |
| 2025-07-01 | $242.07 | Not available in this setting | RVU25C |
| 2025-04-01 | $242.07 | Not available in this setting | RVU25B |
| 2025-01-01 | $242.07 | Not available in this setting | RVU25A |
| 2024-10-01 | $250.44 | Not available in this setting | RVU24D |
| 2024-07-01 | $250.44 | Not available in this setting | RVU24C |
| 2024-04-01 | $250.44 | Not available in this setting | RVU24B |
| 2024-03-09 | $250.44 | Not available in this setting | RVU24AR |
| 2024-01-01 | $246.35 | Not available in this setting | RVU24A |
| 2023-10-01 | $254.92 | Not available in this setting | RVU23D |
| 2023-07-01 | $254.92 | Not available in this setting | RVU23C |
| 2023-04-01 | $254.92 | Not available in this setting | RVU23B |
| 2023-01-01 | $254.92 | Not available in this setting | RVU23A |
| 2022-10-01 | $257.19 | Not available in this setting | RVU22D |
| 2022-07-01 | $257.19 | Not available in this setting | RVU22C |
| 2022-04-01 | $257.19 | Not available in this setting | RVU22B |
| 2022-01-01 | $257.19 | Not available in this setting | RVU22A |
| 2021-10-01 | $270.33 | Not available in this setting | RVU21D |
| 2021-07-01 | $270.33 | Not available in this setting | RVU21C |
| 2021-04-01 | $270.33 | Not available in this setting | RVU21B |
| 2021-01-01 | $270.33 | Not available in this setting | RVU21A |
| 2020-10-01 | $264.99 | Not available in this setting | RVU20D |
| 2020-07-01 | $264.99 | Not available in this setting | RVU20C |
| 2020-04-01 | $264.99 | Not available in this setting | RVU20B |
| 2020-01-01 | $264.99 | Not available in this setting | RVU20A |
| 2019-10-01 | $264.45 | Not available in this setting | RVU19D |
| 2019-07-01 | $264.45 | Not available in this setting | RVU19C |
| 2019-04-01 | $264.45 | Not available in this setting | RVU19B |
| 2019-01-01 | $264.45 | Not available in this setting | RVU19A |
| 2018-10-01 | $268.85 | Not available in this setting | RVU18D |
| 2018-07-01 | $268.85 | Not available in this setting | RVU18C |
| 2018-04-01 | $268.85 | Not available in this setting | RVU18B |
| 2018-01-01 | $268.85 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $261.06 | Not available in this setting | RVU17D |
| 2017-07-01 | $261.06 | Not available in this setting | RVU17C |
| 2017-04-01 | $261.06 | Not available in this setting | RVU17B |
| 2017-01-01 | $261.06 | Not available in this setting | RVU17A |
| 2016-10-01 | $258.25 | Not available in this setting | RVU16D |
| 2016-07-01 | $258.25 | Not available in this setting | RVU16C |
| 2016-04-01 | $258.25 | Not available in this setting | RVU16B |
| 2016-01-01 | $258.25 | Not available in this setting | RVU16A |
| 2015-10-01 | $255.17 | Not available in this setting | RVU15D |
| 2015-07-01 | $255.17 | Not available in this setting | RVU15C |
| 2015-04-01 | $253.90 | Not available in this setting | RVU15B |
| 2015-01-01 | $253.90 | Not available in this setting | RVU15A |
| 2014-10-01 | $253.76 | Not available in this setting | RVU14D |
| 2014-07-01 | $253.76 | Not available in this setting | RVU14C |
| 2014-04-01 | $253.76 | Not available in this setting | RVU14B |
| 2014-01-01 | $253.76 | Not available in this setting | RVU14A |
| 2013-10-01 | $169.21 | Not available in this setting | RVU13D |
| 2013-07-01 | $169.21 | Not available in this setting | RVU13C |
| 2013-04-01 | $169.21 | Not available in this setting | RVU13B |
| 2013-01-01 | $169.21 | Not available in this setting | RVU13AR |
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
77280 billing questions
How does 77280 differ from 77285 or 77290?
The distinction is the complexity of the simulation and field-setting work. Report 77280 for a simple setup; use 77285 or 77290 when the documented work meets an intermediate or complex level.
Is 77280 the same service as radiation treatment planning?
No. This code represents simulation and field setup; codes 77261–77263 describe treatment-planning levels. A planning service is distinct from simply establishing the simulation setup.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional component, including interpretation, or TC for the technical component, including equipment and staff. Without either modifier, the code represents the global service.
Does 77280 represent each image or each radiation fraction?
It reports the simple simulation service, not each treatment fraction. Document the simulation and field-setting work performed rather than treating routine treatment delivery as another simulation.
What documentation supports reporting 77280?
Record the treatment site, patient positioning, field geometry, simulation imaging, and the radiation oncologist’s direction or interpretation. The record should support a simple—not intermediate or complex—simulation 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
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