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CPT code 77280: Radiation simulation, simple field setup2026 Medicare rate & RVUs in Nevada

Reports simple radiation treatment simulation to reproduce patient positioning and establish treatment-field geometry before external-beam therapy.

CMS RVU26DEffective Oct 1, 2026One payment locality534K Medicare services in 2024

In Nevada, Medicare pays $269.57 for 77280 in the office.

$269.57Office (non-facility)
Not available in this settingHospital or facility
+0.0%vs the national office rate ($269.55)

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.

We’ll open 77280 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 77280 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 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 Nevada 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. Nevada pays $269.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

77280 in Nevada vs other payment areas
  1. Nevada · this page$269.57
  2. Los Angeles, CA · California$314.95+$45.38
  3. Washington, DC area · District of Columbia$314.62+$45.05
  4. Miami, FL · Florida$281.65+$12.08
  5. Chicago, IL · Illinois$272.66+$3.09
  6. Manhattan, NY · New York$311.55+$41.98
  7. Alaska · Alaska$296.26+$26.69

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

Every other payment area

77280 in every other Medicare payment locality
Payment localityOfficeFacility
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—

77280 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.

$234.28

$336.41

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

View every state and territory as a table
77280 office rate range by state
State / territoryOffice rate rangeLocalities
AK$296.261
AL$238.281
AR$234.281
AZ$261.741
CA$292.88–$379.9329
CO$285.241
CT$289.181
DC$314.621
DE$266.581
FL$259.42–$281.653
GA$243.29–$273.812
GU$302.621
HI$302.621
IA$247.871
ID$249.201
IL$248.94–$277.364
IN$250.941
KS$245.311
KY$242.181
LA$241.26–$255.242
MA$282.65–$317.962
MD$272.61–$314.623
ME$249.40–$266.842
MI$248.36–$261.872
MN$275.721
MO$235.63–$257.763
MS$235.071
MT$269.541
NC$252.611
ND$268.751
NE$249.811
NH$279.441
NJ$293.17–$310.352
NM$249.441
NV$269.571
NY$256.87–$318.545
OH$248.201
OK$242.981
OR$268.17–$296.822
PA$249.34–$280.282
PR$272.231
RI$277.931
SC$250.691
SD$268.661
TN$246.591
TX$247.36–$283.688
UT$254.681
VA$264.98–$314.622
VI$272.231
VT$266.431
WA$282.53–$326.162
WI$258.311
WV$237.961
WY$269.201

See 77280 in every payment locality

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

Office or facility?

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 Nevada 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

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 77280 in Nevada
ComponentRVULocality factorAdjusted
Physician work0.68× 1.0000.6800
Practice expense7.35× 1.0017.3573
Malpractice0.04× 0.8330.0333
Total RVUs8.0707
Conversion factor× 33.4009

Office rate, Nevada$269.57

Office: (0.68 × 1 + 7.35 × 1.001 + 0.04 × 0.833) × $33.4009 = $269.57

Open 77280 in the RVU calculator

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

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/technical1Diagnostic 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.

When to use modifier 26

Codes related to 77280

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

Codes related to 77280
CodeHow it relatesOffice range, Nevada
Used instead
77285Radiotherapy simulation, intermediate complexityUse instead when the documented simulation and field-setting work reaches the intermediate level.$453.00
77290Radiation simulation, complex setupUse instead when the documented simulation and field-setting work reaches the complex level.$441.39
Often billed with
77261Radiation planning, simple complexitySimple treatment planning is a distinct service from the simulation and field setup.$69.44
77295Radiotherapy plan, three-dimensional planThree-dimensional treatment planning is distinct from simulation and may be reported for the same treatment course.$484.26

How 77280 has changed in Nevada

77280 · Office / nonfacility

$269.57

Effective 2026-10-01

The base rate is $9.76 higher than on 2025-10-01, moving from $259.81 to $269.57 (3.8%).

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

    $259.81changed to$269.57

    • 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 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $268.76changed to$259.81

    • 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.

  3. March 9, 2024

    RVU24AR

    $264.37changed to$268.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $273.64changed to$264.37

    • 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
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $276.19changed to$273.64

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.21 changed to 7.32
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $290.35changed to$276.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.55 changed to 7.21

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $283.59changed to$290.35

    • 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
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $286.82changed to$283.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.10 changed to 7.11
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $291.63changed to$286.82

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.24 changed to 7.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $287.46changed to$291.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.03 changed to 7.24
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $288.88changed to$287.46

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.97 changed to 7.03
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $285.39changed to$288.88

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.85 changed to 6.97

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $283.97changed to$285.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $285.19changed to$283.97

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.84 changed to 6.85
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $190.36changed to$285.19

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.58 changed to 6.84
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$190.36

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$269.57Not available in this settingRVU26D
2026-07-01$269.57Not available in this settingRVU26C
2026-04-01$269.57Not available in this settingRVU26B
2026-01-01$269.57Not available in this settingRVU26A
2025-10-01$259.81Not available in this settingRVU25D
2025-07-01$259.81Not available in this settingRVU25C
2025-04-01$259.81Not available in this settingRVU25B
2025-01-01$259.81Not available in this settingRVU25A
2024-10-01$268.76Not available in this settingRVU24D
2024-07-01$268.76Not available in this settingRVU24C
2024-04-01$268.76Not available in this settingRVU24B
2024-03-09$268.76Not available in this settingRVU24AR
2024-01-01$264.37Not available in this settingRVU24A
2023-10-01$273.64Not available in this settingRVU23D
2023-07-01$273.64Not available in this settingRVU23C
2023-04-01$273.64Not available in this settingRVU23B
2023-01-01$273.64Not available in this settingRVU23A
2022-10-01$276.19Not available in this settingRVU22D
2022-07-01$276.19Not available in this settingRVU22C
2022-04-01$276.19Not available in this settingRVU22B
2022-01-01$276.19Not available in this settingRVU22A
2021-10-01$290.35Not available in this settingRVU21D
2021-07-01$290.35Not available in this settingRVU21C
2021-04-01$290.35Not available in this settingRVU21B
2021-01-01$290.35Not available in this settingRVU21A
2020-10-01$283.59Not available in this settingRVU20D
2020-07-01$283.59Not available in this settingRVU20C
2020-04-01$283.59Not available in this settingRVU20B
2020-01-01$283.59Not available in this settingRVU20A
2019-10-01$286.82Not available in this settingRVU19D
2019-07-01$286.82Not available in this settingRVU19C
2019-04-01$286.82Not available in this settingRVU19B
2019-01-01$286.82Not available in this settingRVU19A
2018-10-01$291.63Not available in this settingRVU18D
2018-07-01$291.63Not available in this settingRVU18C
2018-04-01$291.63Not available in this settingRVU18B
2018-01-01$291.63Not available in this settingRVU18AR1
2017-10-01$287.46Not available in this settingRVU17D
2017-07-01$287.46Not available in this settingRVU17C
2017-04-01$287.46Not available in this settingRVU17B
2017-01-01$287.46Not available in this settingRVU17A
2016-10-01$288.88Not available in this settingRVU16D
2016-07-01$288.88Not available in this settingRVU16C
2016-04-01$288.88Not available in this settingRVU16B
2016-01-01$288.88Not available in this settingRVU16A
2015-10-01$285.39Not available in this settingRVU15D
2015-07-01$285.39Not available in this settingRVU15C
2015-04-01$283.97Not available in this settingRVU15B
2015-01-01$283.97Not available in this settingRVU15A
2014-10-01$285.19Not available in this settingRVU14D
2014-07-01$285.19Not available in this settingRVU14C
2014-04-01$285.19Not available in this settingRVU14B
2014-01-01$285.19Not available in this settingRVU14A
2013-10-01$190.36Not available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 77280 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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
RVUs for 77280PPRRVU2026_Oct_nonQPP.csv, line 9,029 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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