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CPT code 77290: Radiation simulation, complex setup2026 Medicare rate & RVUs in Connecticut

Reports complex radiation treatment simulation used to establish patient positioning and treatment fields before delivery of a radiation therapy course.

CMS RVU26DEffective Oct 1, 2026One payment locality160.1K Medicare services in 2024

In Connecticut, Medicare pays $473.11 for 77290 in the office.

$473.11Office (non-facility)
Not available in this settingHospital or facility
+7.1%vs the national office rate ($441.56)

Check a contract rate as a % of Medicare · 77290 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 77290 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 77290 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 77290 covers

The radiation oncology team uses simulation to reproduce the treatment position and define the fields for a planned course of radiation therapy. The patient is positioned as they will be for treatment, and imaging and setup devices help the team identify and document the treatment geometry. This complex level is selected when the simulation and field arrangement require greater complexity than a simple or intermediate setup; the treating site and arrangement of fields support that distinction.

Report 77290 for the simulation service, not as a substitute for the separate work of evaluating treatment-planning complexity or developing a three-dimensional plan. The record should support the complexity of the setup, including the positioning, imaging, devices, and field arrangement used. CMS recognizes separately priced professional and technical components: bill modifier 26 for the professional interpretation, modifier TC for the equipment and staff portion, or no component modifier for 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 Connecticut compares for 77290

Across 109 of 109 payment localities, the office rate for 77290 runs from $385.31 in Arkansas to $616.85 in San Benito County, CA. Connecticut pays $473.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

77290 in Connecticut vs other payment areas
  1. Connecticut · this page$473.11
  2. Los Angeles, CA · California$513.42+$40.31
  3. Washington, DC area · District of Columbia$513.65+$40.54
  4. Miami, FL · Florida$462.55−$10.56
  5. Chicago, IL · Illinois$448.18−$24.93
  6. Manhattan, NY · New York$509.53+$36.42
  7. Alaska · Alaska$490.63+$17.52

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

Every other payment area

77290 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$391.68—
ArkansasArkansas$385.31—
ArizonaArizona$429.07—
Bakersfield, CACalifornia$478.41—
Chico, CACalifornia$478.07—
El Centro, CACalifornia$478.09—
Fresno, CACalifornia$478.07—
Hanford, CACalifornia$478.07—

77290 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.

$385.31

$547.46

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

View every state and territory as a table
77290 office rate range by state
State / territoryOffice rate rangeLocalities
AK$490.631
AL$391.681
AR$385.311
AZ$429.071
CA$478.07–$616.8529
CO$466.231
CT$473.111
DC$513.651
DE$436.831
FL$426.19–$462.553
GA$400.36–$448.582
GU$493.231
HI$493.231
IA$406.611
ID$408.801
IL$409.73–$454.954
IN$411.561
KS$402.711
KY$398.271
LA$396.86–$419.152
MA$462.23–$518.442
MD$446.44–$513.653
ME$409.30–$436.842
MI$408.28–$430.292
MN$450.441
MO$388.00–$422.973
MS$386.831
MT$441.551
NC$414.391
ND$439.581
NE$409.651
NH$457.031
NJ$479.56–$506.982
NM$410.071
NV$441.391
NY$421.20–$520.905
OH$407.881
OK$399.361
OR$439.02–$484.522
PA$409.61–$459.002
PR$445.771
RI$454.951
SC$411.611
SD$439.341
TN$404.761
TX$406.45–$463.758
UT$417.971
VA$433.99–$513.652
VI$445.771
VT$436.041
WA$461.96–$531.442
WI$422.981
WV$392.241
WY$440.691

See 77290 in every payment locality

How the 77290 rate is calculated

Each of 77290’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 · 77290

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.52

1.52 RVUs× 1.000 GPCI

Practice expense11.60

11.60 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

13.2200

Conversion factor

$33.4009

Medicare rate

$441.56

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,035

Code
77290
Physician work
1.52
Practice expense
11.60
Malpractice
0.10

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 77290 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.52× 1.0201.5504
Practice expense11.60× 1.07712.4932
Malpractice0.10× 1.2100.1210
Total RVUs14.1646
Conversion factor× 33.4009

Office rate, Connecticut$473.11

Office: (1.52 × 1.02 + 11.6 × 1.077 + 0.1 × 1.21) × $33.4009 = $473.11

Open 77290 in the RVU calculator

Payment rules and modifiers for 77290

The CMS indicators that decide how 77290 is paid alongside other services.

CMS payment indicators · 77290

Radiation simulation, complex 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

77290 without 26 · national office

$441.56

Radiation simulation, complex setup

77290-26 · Professional component

$81.83

Pays only the interpretation and report.

When to use modifier 26

Codes related to 77290

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

Codes related to 77290
CodeHow it relatesOffice range, Connecticut
Same family
77280Radiation simulation, simple field setupSimulation sibling for a simple treatment setup.$289.18
77285Radiotherapy simulation, intermediate complexitySimulation sibling for an intermediate treatment setup.$486.12
Often billed with
77295Radiotherapy plan, three-dimensional planThree-dimensional treatment planning may be reported for distinct planning work in the same treatment-planning episode.$515.84
77263Treatment planning, complex planningComplex treatment-planning evaluation is distinct from simulation and may occur in the same planning episode.$176.54

How 77290 has changed in Connecticut

77290 · Office / nonfacility

$473.11

Effective 2026-10-01

The base rate is $9.72 higher than on 2025-10-01, moving from $463.39 to $473.11 (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

    $463.39changed to$473.11

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.56 changed to 1.52
    • Practice expense RVU 11.57 changed to 11.60
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $484.54changed to$463.39

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.77 changed to 11.57
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $476.63changed to$484.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $501.73changed to$476.63

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.89 changed to 11.77
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $518.04changed to$501.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.91 changed to 11.89
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $553.94changed to$518.04

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.74 changed to 11.91
    • Malpractice RVU 0.07 changed to 0.09

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $560.78changed to$553.94

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.44 changed to 12.74
    • Malpractice RVU 0.08 changed to 0.07
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $573.59changed to$560.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.79 changed to 12.44
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $594.22changed to$573.59

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.31 changed to 12.79
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $581.99changed to$594.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.00 changed to 13.31
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $578.49changed to$581.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.90 changed to 13.00
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $570.46changed to$578.49

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.66 changed to 12.90
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $567.63changed to$570.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $561.29changed to$567.63

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.52 changed to 12.66
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $585.67changed to$561.29

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.98 changed to 12.52
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $585.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$473.11Not available in this settingRVU26D
2026-07-01$473.11Not available in this settingRVU26C
2026-04-01$473.11Not available in this settingRVU26B
2026-01-01$473.11Not available in this settingRVU26A
2025-10-01$463.39Not available in this settingRVU25D
2025-07-01$463.39Not available in this settingRVU25C
2025-04-01$463.39Not available in this settingRVU25B
2025-01-01$463.39Not available in this settingRVU25A
2024-10-01$484.54Not available in this settingRVU24D
2024-07-01$484.54Not available in this settingRVU24C
2024-04-01$484.54Not available in this settingRVU24B
2024-03-09$484.54Not available in this settingRVU24AR
2024-01-01$476.63Not available in this settingRVU24A
2023-10-01$501.73Not available in this settingRVU23D
2023-07-01$501.73Not available in this settingRVU23C
2023-04-01$501.73Not available in this settingRVU23B
2023-01-01$501.73Not available in this settingRVU23A
2022-10-01$518.04Not available in this settingRVU22D
2022-07-01$518.04Not available in this settingRVU22C
2022-04-01$518.04Not available in this settingRVU22B
2022-01-01$518.04Not available in this settingRVU22A
2021-10-01$553.94Not available in this settingRVU21D
2021-07-01$553.94Not available in this settingRVU21C
2021-04-01$553.94Not available in this settingRVU21B
2021-01-01$553.94Not available in this settingRVU21A
2020-10-01$560.78Not available in this settingRVU20D
2020-07-01$560.78Not available in this settingRVU20C
2020-04-01$560.78Not available in this settingRVU20B
2020-01-01$560.78Not available in this settingRVU20A
2019-10-01$573.59Not available in this settingRVU19D
2019-07-01$573.59Not available in this settingRVU19C
2019-04-01$573.59Not available in this settingRVU19B
2019-01-01$573.59Not available in this settingRVU19A
2018-10-01$594.22Not available in this settingRVU18D
2018-07-01$594.22Not available in this settingRVU18C
2018-04-01$594.22Not available in this settingRVU18B
2018-01-01$594.22Not available in this settingRVU18AR1
2017-10-01$581.99Not available in this settingRVU17D
2017-07-01$581.99Not available in this settingRVU17C
2017-04-01$581.99Not available in this settingRVU17B
2017-01-01$581.99Not available in this settingRVU17A
2016-10-01$578.49Not available in this settingRVU16D
2016-07-01$578.49Not available in this settingRVU16C
2016-04-01$578.49Not available in this settingRVU16B
2016-01-01$578.49Not available in this settingRVU16A
2015-10-01$570.46Not available in this settingRVU15D
2015-07-01$570.46Not available in this settingRVU15C
2015-04-01$567.63Not available in this settingRVU15B
2015-01-01$567.63Not available in this settingRVU15A
2014-10-01$561.29Not available in this settingRVU14D
2014-07-01$561.29Not available in this settingRVU14C
2014-04-01$561.29Not available in this settingRVU14B
2014-01-01$561.29Not available in this settingRVU14A
2013-10-01$585.67Not available in this settingRVU13D
2013-07-01$585.67Not available in this settingRVU13C
2013-04-01$585.67Not available in this settingRVU13B
2013-01-01$585.67Not available in this settingRVU13AR

Price 77290 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

77290 billing questions

How does 77290 differ from 77280 or 77285?

The three codes distinguish simulation complexity. Use 77290 when the documented setup and field arrangement are complex rather than simple or intermediate.

Does 77290 include three-dimensional treatment planning?

No. 77290 describes the simulation service, while 77295 represents three-dimensional treatment planning. Report each when its distinct work is performed and documented.

When should modifier 26 or TC be used?

Use modifier 26 for the professional interpretation and modifier TC for the technical portion involving equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports the complex level?

Document the patient setup, imaging or positioning aids, and treatment-field arrangement that make the simulation complex. The record should show why the setup is beyond a simple or intermediate simulation.

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 77290PPRRVU2026_Oct_nonQPP.csv, line 9,035 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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