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CPT code 77295: Radiotherapy plan, three-dimensional plan2026 Medicare rate & RVUs in Utah

Report this service for a three-dimensional radiation therapy plan that models the target and nearby normal tissues to guide dose delivery.

CMS RVU26DEffective Oct 1, 2026One payment locality101.1K Medicare services in 2024

In Utah, Medicare pays $464.22 for 77295 in the office.

$464.22Office (non-facility)
Not available in this settingHospital or facility
−4.3%vs the national office rate ($485.32)

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.

We’ll open 77295 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 77295 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 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 Utah 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. Utah pays $464.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

77295 in Utah vs other payment areas
  1. Utah · this page$464.22
  2. Los Angeles, CA · California$549.97+$85.75
  3. Washington, DC area · District of Columbia$553.85+$89.63
  4. Miami, FL · Florida$511.91+$47.69
  5. Chicago, IL · Illinois$498.79+$34.57
  6. Manhattan, NY · New York$553.79+$89.57
  7. Alaska · Alaska$573.30+$109.08

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

Every other payment area

77295 in every other Medicare payment locality
Payment localityOfficeFacility
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—

77295 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.

$433.70

$581.06

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

View every state and territory as a table
77295 office rate range by state
State / territoryOffice rate rangeLocalities
AK$573.301
AL$439.521
AR$433.701
AZ$473.651
CA$516.20–$645.9129
CO$506.751
CT$515.841
DC$553.851
DE$481.121
FL$474.67–$511.913
GA$450.48–$492.812
GU$528.021
HI$528.021
IA$451.611
ID$453.931
IL$460.67–$501.854
IN$456.401
KS$448.791
KY$447.161
LA$446.17–$466.552
MA$503.73–$555.572
MD$490.07–$553.853
ME$455.17–$479.202
MI$457.04–$479.242
MN$489.221
MO$438.54–$469.143
MS$436.241
MT$485.301
NC$459.701
ND$480.361
NE$454.151
NH$498.101
NJ$522.75–$548.652
NM$458.991
NV$484.261
NY$465.97–$565.175
OH$456.031
OK$447.361
OR$481.49–$522.862
PA$457.19–$503.272
PR$488.901
RI$498.201
SC$458.421
SD$479.771
TN$450.751
TX$454.36–$504.218
UT$464.221
VA$477.13–$553.852
VI$488.901
VT$477.821
WA$503.01–$567.352
WI$465.371
WV$444.721
WY$483.141

See 77295 in every payment locality

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

Office or facility?

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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 77295 in Utah
ComponentRVULocality factorAdjusted
Physician work4.18× 1.0004.1800
Practice expense10.10× 0.9409.4940
Malpractice0.25× 0.8980.2245
Total RVUs13.8985
Conversion factor× 33.4009

Office rate, Utah$464.22

Office: (4.18 × 1 + 10.1 × 0.94 + 0.25 × 0.898) × $33.4009 = $464.22

Open 77295 in the RVU calculator

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

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

77295 without 26 · national office

$485.32

Radiotherapy plan, three-dimensional plan

77295-26 · Professional component

$224.79

Pays only the interpretation and report.

When to use modifier 26

Codes related to 77295

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

Codes related to 77295
CodeHow it relatesOffice range, Utah
Often billed with
77290Radiation simulation, complex setupComplex treatment simulation may be part of the same radiation-planning encounter.$417.97
77280Radiation simulation, simple field setupSimple treatment simulation is a separate setup service that may accompany a planning encounter.$254.68
Used instead
77263Treatment planning, complex planningComplexity-level treatment planning differs from three-dimensional planning.$164.04
77301IMRT planning, dose optimization and volume analysisUsed for intensity-modulated radiotherapy planning rather than a three-dimensional plan.$1,857.31

How 77295 has changed in Utah

77295 · Office / nonfacility

$464.22

Effective 2026-10-01

The base rate is $14.63 higher than on 2025-10-01, moving from $449.59 to $464.22 (3.3%).

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

    $449.59changed to$464.22

    • 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 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $457.39changed to$449.59

    • 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.

  3. March 9, 2024

    RVU24AR

    $449.92changed to$457.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $458.65changed to$449.92

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.75 changed to 9.88
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $454.68changed to$458.65

    • 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 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $462.47changed to$454.68

    • 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.

  7. January 1, 2021

    RVU21A

    $472.06changed to$462.47

    • 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 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $478.97changed to$472.06

    • 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 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $485.12changed to$478.97

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.62 changed to 9.42

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $475.65changed to$485.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.40 changed to 9.62
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $471.23changed to$475.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.33 changed to 9.40
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $467.56changed to$471.23

    • 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.

  13. July 1, 2015

    RVU15C

    $465.23changed to$467.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $460.14changed to$465.23

    • 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 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $422.75changed to$460.14

    • 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 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $422.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$464.22Not available in this settingRVU26D
2026-07-01$464.22Not available in this settingRVU26C
2026-04-01$464.22Not available in this settingRVU26B
2026-01-01$464.22Not available in this settingRVU26A
2025-10-01$449.59Not available in this settingRVU25D
2025-07-01$449.59Not available in this settingRVU25C
2025-04-01$449.59Not available in this settingRVU25B
2025-01-01$449.59Not available in this settingRVU25A
2024-10-01$457.39Not available in this settingRVU24D
2024-07-01$457.39Not available in this settingRVU24C
2024-04-01$457.39Not available in this settingRVU24B
2024-03-09$457.39Not available in this settingRVU24AR
2024-01-01$449.92Not available in this settingRVU24A
2023-10-01$458.65Not available in this settingRVU23D
2023-07-01$458.65Not available in this settingRVU23C
2023-04-01$458.65Not available in this settingRVU23B
2023-01-01$458.65Not available in this settingRVU23A
2022-10-01$454.68Not available in this settingRVU22D
2022-07-01$454.68Not available in this settingRVU22C
2022-04-01$454.68Not available in this settingRVU22B
2022-01-01$454.68Not available in this settingRVU22A
2021-10-01$462.47Not available in this settingRVU21D
2021-07-01$462.47Not available in this settingRVU21C
2021-04-01$462.47Not available in this settingRVU21B
2021-01-01$462.47Not available in this settingRVU21A
2020-10-01$472.06Not available in this settingRVU20D
2020-07-01$472.06Not available in this settingRVU20C
2020-04-01$472.06Not available in this settingRVU20B
2020-01-01$472.06Not available in this settingRVU20A
2019-10-01$478.97Not available in this settingRVU19D
2019-07-01$478.97Not available in this settingRVU19C
2019-04-01$478.97Not available in this settingRVU19B
2019-01-01$478.97Not available in this settingRVU19A
2018-10-01$485.12Not available in this settingRVU18D
2018-07-01$485.12Not available in this settingRVU18C
2018-04-01$485.12Not available in this settingRVU18B
2018-01-01$485.12Not available in this settingRVU18AR1
2017-10-01$475.65Not available in this settingRVU17D
2017-07-01$475.65Not available in this settingRVU17C
2017-04-01$475.65Not available in this settingRVU17B
2017-01-01$475.65Not available in this settingRVU17A
2016-10-01$471.23Not available in this settingRVU16D
2016-07-01$471.23Not available in this settingRVU16C
2016-04-01$471.23Not available in this settingRVU16B
2016-01-01$471.23Not available in this settingRVU16A
2015-10-01$467.56Not available in this settingRVU15D
2015-07-01$467.56Not available in this settingRVU15C
2015-04-01$465.23Not available in this settingRVU15B
2015-01-01$465.23Not available in this settingRVU15A
2014-10-01$460.14Not available in this settingRVU14D
2014-07-01$460.14Not available in this settingRVU14C
2014-04-01$460.14Not available in this settingRVU14B
2014-01-01$460.14Not available in this settingRVU14A
2013-10-01$422.75Not available in this settingRVU13D
2013-07-01$422.75Not available in this settingRVU13C
2013-04-01$422.75Not available in this settingRVU13B
2013-01-01$422.75Not available in this settingRVU13AR

Price 77295 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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
RVUs for 77295PPRRVU2026_Oct_nonQPP.csv, line 9,041 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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