CPT code 77295: Radiotherapy plan, three-dimensional plan2026 Medicare rate & RVUs in North Carolina
Report this service for a three-dimensional radiation therapy plan that models the target and nearby normal tissues to guide dose delivery.
In North Carolina, Medicare pays $459.70 for 77295 in the office.
Check a contract rate as a % of Medicare · 77295 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 77295 covers
A radiation oncology team uses imaging data to map the treatment target and surrounding structures, arrange radiation beams, and calculate how the planned dose is distributed in three dimensions. The plan may include dose-volume analysis to assess target coverage and exposure to nearby organs at risk. Radiation oncologists and medical physicists typically develop or review the plan as part of external-beam treatment planning.
Select this code when the documented work supports a three-dimensional plan, rather than a treatment-planning complexity level or a simulation service. Records should support the modeled anatomy, planned beam arrangement, dose calculations, and dose-volume analysis. CMS recognizes professional and technical components: report modifier 26 for the professional interpretation, modifier TC for the technical work and resources, or no component modifier for the global service. The professional and technical components are separately priced by CMS.
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 77295
Across 109 of 109 payment localities, the office rate for 77295 runs from $433.70 in Arkansas to $645.91 in San Benito County, CA. North Carolina pays $459.70. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$459.70
- Los Angeles, CA · California$549.97+$90.27
- Washington, DC area · District of Columbia$553.85+$94.15
- Miami, FL · Florida$511.91+$52.21
- Chicago, IL · Illinois$498.79+$39.09
- Manhattan, NY · New York$553.79+$94.09
- Alaska · Alaska$573.30+$113.60
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $439.52 | — |
| ArkansasArkansas | $433.70 | — |
| ArizonaArizona | $473.65 | — |
| Bakersfield, CACalifornia | $517.09 | — |
| Chico, CACalifornia | $516.20 | — |
| El Centro, CACalifornia | $516.24 | — |
| Fresno, CACalifornia | $516.20 | — |
| Hanford, CACalifornia | $516.20 | — |
| Madera, CACalifornia | $516.20 | — |
| Merced, CACalifornia | $516.20 | — |
| Modesto, CACalifornia | $516.20 | — |
| Napa, CACalifornia | $597.28 | — |
| Oxnard, CACalifornia | $547.47 | — |
| Redding, CACalifornia | $516.20 | — |
| Rest of CaliforniaCalifornia | $516.20 | — |
| Riverside, CACalifornia | $518.99 | — |
| Sacramento, CACalifornia | $541.45 | — |
| Salinas, CACalifornia | $539.41 | — |
| San Diego, CACalifornia | $551.80 | — |
| Marin County, CACalifornia | $632.37 | — |
| San Francisco, CACalifornia | $632.09 | — |
| San Benito County, CACalifornia | $645.91 | — |
| Santa Clara County, CACalifornia | $644.75 | — |
| San Luis Obispo, CACalifornia | $530.71 | — |
| Santa Cruz, CACalifornia | $556.90 | — |
| Santa Maria, CACalifornia | $541.35 | — |
| Santa Rosa, CACalifornia | $562.54 | — |
| Stockton, CACalifornia | $516.20 | — |
| Vallejo, CACalifornia | $596.87 | — |
| Visalia, CACalifornia | $516.20 | — |
| Yuba City, CACalifornia | $516.20 | — |
| ColoradoColorado | $506.75 | — |
| ConnecticutConnecticut | $515.84 | — |
| DelawareDelaware | $481.12 | — |
| Fort Lauderdale, FLFlorida | $496.45 | — |
| Rest of FloridaFlorida | $474.67 | — |
| Atlanta, GAGeorgia | $492.81 | — |
| Rest of GeorgiaGeorgia | $450.48 | — |
| Hawaii, Guam, HIHawaii | $528.02 | — |
| IowaIowa | $451.61 | — |
| IdahoIdaho | $453.93 | — |
| East St. Louis, ILIllinois | $466.79 | — |
| Rest of IllinoisIllinois | $460.67 | — |
| Suburban Chicago, ILIllinois | $501.85 | — |
| IndianaIndiana | $456.40 | — |
| KansasKansas | $448.79 | — |
| KentuckyKentucky | $447.16 | — |
| New Orleans, LALouisiana | $466.55 | — |
| Rest of LouisianaLouisiana | $446.17 | — |
| Metropolitan Boston, MAMassachusetts | $555.57 | — |
| Rest of MassachusettsMassachusetts | $503.73 | — |
| Baltimore area, MDMaryland | $514.15 | — |
| Rest of MarylandMaryland | $490.07 | — |
| Rest of MaineMaine | $455.17 | — |
| Southern Maine, MEMaine | $479.20 | — |
| Detroit, MIMichigan | $479.24 | — |
| Rest of MichiganMichigan | $457.04 | — |
| MinnesotaMinnesota | $489.22 | — |
| Metropolitan Kansas City, MOMissouri | $464.54 | — |
| Metropolitan St. Louis, MOMissouri | $469.14 | — |
| Rest of MissouriMissouri | $438.54 | — |
| MississippiMississippi | $436.24 | — |
| MontanaMontana | $485.30 | — |
| North DakotaNorth Dakota | $480.36 | — |
| NebraskaNebraska | $454.15 | — |
| New HampshireNew Hampshire | $498.10 | — |
| Northern New JerseyNew Jersey | $548.65 | — |
| Rest of New JerseyNew Jersey | $522.75 | — |
| New MexicoNew Mexico | $458.99 | — |
| NevadaNevada | $484.26 | — |
| NYC suburbs and Long Island, NYNew York | $565.17 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $525.40 | — |
| Queens, NYNew York | $559.34 | — |
| Rest of New YorkNew York | $465.97 | — |
| OhioOhio | $456.03 | — |
| OklahomaOklahoma | $447.36 | — |
| Portland, OROregon | $522.86 | — |
| Rest of OregonOregon | $481.49 | — |
| Metropolitan Philadelphia, PAPennsylvania | $503.27 | — |
| Rest of PennsylvaniaPennsylvania | $457.19 | — |
| Puerto RicoPuerto Rico | $488.90 | — |
| Rhode IslandRhode Island | $498.20 | — |
| South CarolinaSouth Carolina | $458.42 | — |
| South DakotaSouth Dakota | $479.77 | — |
| TennesseeTennessee | $450.75 | — |
| Austin, TXTexas | $504.21 | — |
| Beaumont, TXTexas | $454.36 | — |
| Brazoria, TXTexas | $481.56 | — |
| Dallas, TXTexas | $484.04 | — |
| Fort Worth, TXTexas | $480.77 | — |
| Galveston, TXTexas | $482.63 | — |
| Houston, TXTexas | $487.21 | — |
| Rest of TexasTexas | $467.30 | — |
| UtahUtah | $464.22 | — |
| VirginiaVirginia | $477.13 | — |
| Virgin Islands, VIUnited States Virgin Islands | $488.90 | — |
| VermontVermont | $477.82 | — |
| Rest of WashingtonWashington | $503.01 | — |
| King County, WAWashington | $567.35 | — |
| WisconsinWisconsin | $465.37 | — |
| West VirginiaWest Virginia | $444.72 | — |
| WyomingWyoming | $483.14 | — |
77295 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.
$433.70
$581.06
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 | $573.30 | 1 |
| AL | $439.52 | 1 |
| AR | $433.70 | 1 |
| AZ | $473.65 | 1 |
| CA | $516.20–$645.91 | 29 |
| CO | $506.75 | 1 |
| CT | $515.84 | 1 |
| DC | $553.85 | 1 |
| DE | $481.12 | 1 |
| FL | $474.67–$511.91 | 3 |
| GA | $450.48–$492.81 | 2 |
| GU | $528.02 | 1 |
| HI | $528.02 | 1 |
| IA | $451.61 | 1 |
| ID | $453.93 | 1 |
| IL | $460.67–$501.85 | 4 |
| IN | $456.40 | 1 |
| KS | $448.79 | 1 |
| KY | $447.16 | 1 |
| LA | $446.17–$466.55 | 2 |
| MA | $503.73–$555.57 | 2 |
| MD | $490.07–$553.85 | 3 |
| ME | $455.17–$479.20 | 2 |
| MI | $457.04–$479.24 | 2 |
| MN | $489.22 | 1 |
| MO | $438.54–$469.14 | 3 |
| MS | $436.24 | 1 |
| MT | $485.30 | 1 |
| NC | $459.70 | 1 |
| ND | $480.36 | 1 |
| NE | $454.15 | 1 |
| NH | $498.10 | 1 |
| NJ | $522.75–$548.65 | 2 |
| NM | $458.99 | 1 |
| NV | $484.26 | 1 |
| NY | $465.97–$565.17 | 5 |
| OH | $456.03 | 1 |
| OK | $447.36 | 1 |
| OR | $481.49–$522.86 | 2 |
| PA | $457.19–$503.27 | 2 |
| PR | $488.90 | 1 |
| RI | $498.20 | 1 |
| SC | $458.42 | 1 |
| SD | $479.77 | 1 |
| TN | $450.75 | 1 |
| TX | $454.36–$504.21 | 8 |
| UT | $464.22 | 1 |
| VA | $477.13–$553.85 | 2 |
| VI | $488.90 | 1 |
| VT | $477.82 | 1 |
| WA | $503.01–$567.35 | 2 |
| WI | $465.37 | 1 |
| WV | $444.72 | 1 |
| WY | $483.14 | 1 |
How the 77295 rate is calculated
Each of 77295’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 · 77295
RVUs × geographic indexes × conversion factor
Work4.18
4.18 RVUs× 1.000 GPCI
Practice expense10.10
10.10 RVUs× 1.000 GPCI
Malpractice0.25
0.25 RVUs× 1.000 GPCI
Adjusted RVUs
14.5300
Conversion factor
$33.4009
Medicare rate
$485.32
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
9,041
- Code
- 77295
- Physician work
- 4.18
- Practice expense
- 10.10
- Malpractice
- 0.25
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.18 | × 1.000 | 4.1800 |
| Practice expense | 10.10 | × 0.933 | 9.4233 |
| Malpractice | 0.25 | × 0.639 | 0.1598 |
| Total RVUs | 13.7630 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$459.70
Office: (4.18 × 1 + 10.1 × 0.933 + 0.25 × 0.639) × $33.4009 = $459.70
Payment rules and modifiers for 77295
The CMS indicators that decide how 77295 is paid alongside other services.
CMS payment indicators · 77295
Radiotherapy plan, three-dimensional plan
| 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
77295 without 26 · national office
$485.32
Radiotherapy plan, three-dimensional plan
77295-26 · Professional component
$224.79
Pays only the interpretation and report.
How 77295 has changed in North Carolina
77295 · Office / nonfacility
$459.70
Effective 2026-10-01
The base rate is $14.45 higher than on 2025-10-01, moving from $445.25 to $459.70 (3.2%).
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
$445.25changed to$459.70
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.29 changed to 4.18
- Practice expense RVU 10.06 changed to 10.10
- Malpractice RVU 0.24 changed to 0.25
- 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
$452.88changed to$445.25
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.88 changed to 10.06
- Malpractice RVU 0.25 changed to 0.24
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$445.49changed to$452.88
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$457.94changed to$445.49
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.75 changed to 9.88
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$457.78changed to$457.94
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.42 changed to 9.75
- Malpractice RVU 0.24 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.
January 1, 2022
RVU22A
$465.61changed to$457.78
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.58 changed to 9.42
- Malpractice RVU 0.20 changed to 0.24
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$472.70changed to$465.61
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 9.30 changed to 9.58
- Malpractice RVU 0.21 changed to 0.20
- 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
$476.43changed to$472.70
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 9.42 changed to 9.30
- Malpractice RVU 0.23 changed to 0.21
- 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
$482.61changed to$476.43
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 9.62 changed to 9.42
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$474.08changed to$482.61
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 9.40 changed to 9.62
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$470.60changed to$474.08
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 9.33 changed to 9.40
- 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
$466.44changed to$470.60
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.13 changed to 9.33
- Malpractice RVU 0.26 changed to 0.23
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$464.12changed to$466.44
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$459.75changed to$464.12
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 9.00 changed to 9.13
- Malpractice RVU 0.25 changed to 0.26
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$421.97changed to$459.75
- Conversion factor 34.0230 changed to 35.8228
- Work RVU 4.56 changed to 4.29
- Practice expense RVU 8.25 changed to 9.00
- Malpractice RVU 0.28 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.
January 1, 2013
RVU13AR
Earliest loaded release: $421.97
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $459.70 | Not available in this setting | RVU26D |
| 2026-07-01 | $459.70 | Not available in this setting | RVU26C |
| 2026-04-01 | $459.70 | Not available in this setting | RVU26B |
| 2026-01-01 | $459.70 | Not available in this setting | RVU26A |
| 2025-10-01 | $445.25 | Not available in this setting | RVU25D |
| 2025-07-01 | $445.25 | Not available in this setting | RVU25C |
| 2025-04-01 | $445.25 | Not available in this setting | RVU25B |
| 2025-01-01 | $445.25 | Not available in this setting | RVU25A |
| 2024-10-01 | $452.88 | Not available in this setting | RVU24D |
| 2024-07-01 | $452.88 | Not available in this setting | RVU24C |
| 2024-04-01 | $452.88 | Not available in this setting | RVU24B |
| 2024-03-09 | $452.88 | Not available in this setting | RVU24AR |
| 2024-01-01 | $445.49 | Not available in this setting | RVU24A |
| 2023-10-01 | $457.94 | Not available in this setting | RVU23D |
| 2023-07-01 | $457.94 | Not available in this setting | RVU23C |
| 2023-04-01 | $457.94 | Not available in this setting | RVU23B |
| 2023-01-01 | $457.94 | Not available in this setting | RVU23A |
| 2022-10-01 | $457.78 | Not available in this setting | RVU22D |
| 2022-07-01 | $457.78 | Not available in this setting | RVU22C |
| 2022-04-01 | $457.78 | Not available in this setting | RVU22B |
| 2022-01-01 | $457.78 | Not available in this setting | RVU22A |
| 2021-10-01 | $465.61 | Not available in this setting | RVU21D |
| 2021-07-01 | $465.61 | Not available in this setting | RVU21C |
| 2021-04-01 | $465.61 | Not available in this setting | RVU21B |
| 2021-01-01 | $465.61 | Not available in this setting | RVU21A |
| 2020-10-01 | $472.70 | Not available in this setting | RVU20D |
| 2020-07-01 | $472.70 | Not available in this setting | RVU20C |
| 2020-04-01 | $472.70 | Not available in this setting | RVU20B |
| 2020-01-01 | $472.70 | Not available in this setting | RVU20A |
| 2019-10-01 | $476.43 | Not available in this setting | RVU19D |
| 2019-07-01 | $476.43 | Not available in this setting | RVU19C |
| 2019-04-01 | $476.43 | Not available in this setting | RVU19B |
| 2019-01-01 | $476.43 | Not available in this setting | RVU19A |
| 2018-10-01 | $482.61 | Not available in this setting | RVU18D |
| 2018-07-01 | $482.61 | Not available in this setting | RVU18C |
| 2018-04-01 | $482.61 | Not available in this setting | RVU18B |
| 2018-01-01 | $482.61 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $474.08 | Not available in this setting | RVU17D |
| 2017-07-01 | $474.08 | Not available in this setting | RVU17C |
| 2017-04-01 | $474.08 | Not available in this setting | RVU17B |
| 2017-01-01 | $474.08 | Not available in this setting | RVU17A |
| 2016-10-01 | $470.60 | Not available in this setting | RVU16D |
| 2016-07-01 | $470.60 | Not available in this setting | RVU16C |
| 2016-04-01 | $470.60 | Not available in this setting | RVU16B |
| 2016-01-01 | $470.60 | Not available in this setting | RVU16A |
| 2015-10-01 | $466.44 | Not available in this setting | RVU15D |
| 2015-07-01 | $466.44 | Not available in this setting | RVU15C |
| 2015-04-01 | $464.12 | Not available in this setting | RVU15B |
| 2015-01-01 | $464.12 | Not available in this setting | RVU15A |
| 2014-10-01 | $459.75 | Not available in this setting | RVU14D |
| 2014-07-01 | $459.75 | Not available in this setting | RVU14C |
| 2014-04-01 | $459.75 | Not available in this setting | RVU14B |
| 2014-01-01 | $459.75 | Not available in this setting | RVU14A |
| 2013-10-01 | $421.97 | Not available in this setting | RVU13D |
| 2013-07-01 | $421.97 | Not available in this setting | RVU13C |
| 2013-04-01 | $421.97 | Not available in this setting | RVU13B |
| 2013-01-01 | $421.97 | 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
77295 billing questions
How is this different from 77263?
77295 represents a three-dimensional radiation plan. Code 77263 describes a treatment-planning complexity level; select based on the service documented rather than treating the codes as interchangeable.
Is this the same service as simulation under 77290?
No. Simulation establishes or verifies treatment setup and fields; 77295 covers development of the three-dimensional plan. The services may be part of the same treatment-planning process.
Which modifier should be used for a split-component claim?
Use modifier 26 for the professional interpretation or modifier TC for the technical portion. Submit without either modifier when billing the global service.
What documentation supports reporting 77295?
The record should support three-dimensional modeling of the target and surrounding anatomy, planned beam arrangement, dose calculations, and dose-volume analysis.
How does 77295 differ from an IMRT plan?
77295 describes three-dimensional radiotherapy planning. Code 77301 is used for intensity-modulated radiotherapy planning, a distinct planning method.
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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