CPT code 77318: Brachytherapy plan, complex isodose plan2026 Medicare rate & RVUs in Montana
Reports complex dose-distribution planning for brachytherapy, using the implant or applicator geometry to shape the prescribed radiation dose.
In Montana, Medicare pays $462.92 for 77318 in the office.
Check a contract rate as a % of Medicare · 77318 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 77318 covers
A radiation oncologist directs this planning service, with a medical physicist or dosimetrist typically developing the dose distribution. The work maps the brachytherapy source arrangement—such as sources placed through an interstitial implant or an intracavitary applicator—and evaluates how dose covers the target while limiting exposure to nearby tissues. It may support temporary or permanent implant treatment in settings such as a radiation oncology department or hospital.
Choose the complex level when the documented source arrangement and planning work meet the CPT criteria for complex brachytherapy planning; the treatment site alone does not determine the level. Keep the plan and supporting dose-distribution documentation in the record, including relevant source or applicator geometry and the prescription being planned. CMS recognizes professional and technical components: report modifier 26 for the interpretation, TC for equipment and staff, or neither modifier when billing 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 Montana compares for 77318
Across 109 of 109 payment localities, the office rate for 77318 runs from $408.81 in Arkansas to $630.42 in San Benito County, CA. Montana pays $462.92. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$462.92
- Los Angeles, CA · California$530.94+$68.02
- Washington, DC area · District of Columbia$533.21+$70.29
- Miami, FL · Florida$487.48+$24.56
- Chicago, IL · Illinois$473.63+$10.71
- Manhattan, NY · New York$531.36+$68.44
- Alaska · Alaska$530.88+$67.96
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $414.92 | — |
| ArkansasArkansas | $408.81 | — |
| ArizonaArizona | $450.80 | — |
| Bakersfield, CACalifornia | $497.01 | — |
| Chico, CACalifornia | $496.36 | — |
| El Centro, CACalifornia | $496.39 | — |
| Fresno, CACalifornia | $496.36 | — |
| Hanford, CACalifornia | $496.36 | — |
| Madera, CACalifornia | $496.36 | — |
| Merced, CACalifornia | $496.36 | — |
| Modesto, CACalifornia | $496.36 | — |
| Napa, CACalifornia | $580.91 | — |
| Oxnard, CACalifornia | $529.09 | — |
| Redding, CACalifornia | $496.36 | — |
| Rest of CaliforniaCalifornia | $496.36 | — |
| Riverside, CACalifornia | $498.46 | — |
| Sacramento, CACalifornia | $522.41 | — |
| Salinas, CACalifornia | $520.49 | — |
| San Diego, CACalifornia | $533.83 | — |
| Marin County, CACalifornia | $616.93 | — |
| San Francisco, CACalifornia | $616.71 | — |
| San Benito County, CACalifornia | $630.42 | — |
| Santa Clara County, CACalifornia | $629.54 | — |
| San Luis Obispo, CACalifornia | $511.93 | — |
| Santa Cruz, CACalifornia | $539.82 | — |
| Santa Maria, CACalifornia | $522.74 | — |
| Santa Rosa, CACalifornia | $545.38 | — |
| Stockton, CACalifornia | $496.36 | — |
| Vallejo, CACalifornia | $580.60 | — |
| Visalia, CACalifornia | $496.36 | — |
| Yuba City, CACalifornia | $496.36 | — |
| ColoradoColorado | $485.85 | — |
| ConnecticutConnecticut | $494.04 | — |
| DelawareDelaware | $458.42 | — |
| Fort Lauderdale, FLFlorida | $472.77 | — |
| Rest of FloridaFlorida | $450.20 | — |
| Atlanta, GAGeorgia | $470.29 | — |
| Rest of GeorgiaGeorgia | $425.05 | — |
| Hawaii, Guam, HIHawaii | $509.87 | — |
| IowaIowa | $428.33 | — |
| IdahoIdaho | $430.63 | — |
| East St. Louis, ILIllinois | $440.41 | — |
| Rest of IllinoisIllinois | $435.01 | — |
| Suburban Chicago, ILIllinois | $478.27 | — |
| IndianaIndiana | $433.24 | — |
| KansasKansas | $425.03 | — |
| KentuckyKentucky | $422.21 | — |
| New Orleans, LALouisiana | $442.44 | — |
| Rest of LouisianaLouisiana | $421.03 | — |
| Metropolitan Boston, MAMassachusetts | $536.35 | — |
| Rest of MassachusettsMassachusetts | $482.35 | — |
| Baltimore area, MDMaryland | $492.38 | — |
| Rest of MarylandMaryland | $467.71 | — |
| Rest of MaineMaine | $431.57 | — |
| Southern Maine, MEMaine | $457.34 | — |
| Detroit, MIMichigan | $454.62 | — |
| Rest of MichiganMichigan | $432.26 | — |
| MinnesotaMinnesota | $468.97 | — |
| Metropolitan Kansas City, MOMissouri | $440.70 | — |
| Metropolitan St. Louis, MOMissouri | $445.57 | — |
| Rest of MissouriMissouri | $412.81 | — |
| MississippiMississippi | $410.95 | — |
| North CarolinaNorth Carolina | $436.39 | — |
| North DakotaNorth Dakota | $459.17 | — |
| NebraskaNebraska | $431.11 | — |
| New HampshireNew Hampshire | $476.99 | — |
| Northern New JerseyNew Jersey | $527.25 | — |
| Rest of New JerseyNew Jersey | $500.64 | — |
| New MexicoNew Mexico | $434.16 | — |
| NevadaNevada | $462.24 | — |
| NYC suburbs and Long Island, NYNew York | $542.86 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $502.92 | — |
| Queens, NYNew York | $537.69 | — |
| Rest of New YorkNew York | $442.95 | — |
| OhioOhio | $431.49 | — |
| OklahomaOklahoma | $422.78 | — |
| Portland, OROregon | $503.01 | — |
| Rest of OregonOregon | $459.60 | — |
| Metropolitan Philadelphia, PAPennsylvania | $480.71 | — |
| Rest of PennsylvaniaPennsylvania | $432.90 | — |
| Puerto RicoPuerto Rico | $466.82 | — |
| Rhode IslandRhode Island | $476.00 | — |
| South CarolinaSouth Carolina | $434.47 | — |
| South DakotaSouth Dakota | $458.72 | — |
| TennesseeTennessee | $427.05 | — |
| Austin, TXTexas | $483.40 | — |
| Beaumont, TXTexas | $429.90 | — |
| Brazoria, TXTexas | $459.04 | — |
| Dallas, TXTexas | $461.44 | — |
| Fort Worth, TXTexas | $457.90 | — |
| Galveston, TXTexas | $460.07 | — |
| Houston, TXTexas | $463.54 | — |
| Rest of TexasTexas | $443.86 | — |
| UtahUtah | $440.57 | — |
| VirginiaVirginia | $454.92 | — |
| Virgin Islands, VIUnited States Virgin Islands | $466.82 | — |
| VermontVermont | $456.18 | — |
| Rest of WashingtonWashington | $481.84 | — |
| King County, WAWashington | $548.69 | — |
| WisconsinWisconsin | $443.34 | — |
| West VirginiaWest Virginia | $418.24 | — |
| WyomingWyoming | $461.29 | — |
77318 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.
$408.81
$563.39
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 | $530.88 | 1 |
| AL | $414.92 | 1 |
| AR | $408.81 | 1 |
| AZ | $450.80 | 1 |
| CA | $496.36–$630.42 | 29 |
| CO | $485.85 | 1 |
| CT | $494.04 | 1 |
| DC | $533.21 | 1 |
| DE | $458.42 | 1 |
| FL | $450.20–$487.48 | 3 |
| GA | $425.05–$470.29 | 2 |
| GU | $509.87 | 1 |
| HI | $509.87 | 1 |
| IA | $428.33 | 1 |
| ID | $430.63 | 1 |
| IL | $435.01–$478.27 | 4 |
| IN | $433.24 | 1 |
| KS | $425.03 | 1 |
| KY | $422.21 | 1 |
| LA | $421.03–$442.44 | 2 |
| MA | $482.35–$536.35 | 2 |
| MD | $467.71–$533.21 | 3 |
| ME | $431.57–$457.34 | 2 |
| MI | $432.26–$454.62 | 2 |
| MN | $468.97 | 1 |
| MO | $412.81–$445.57 | 3 |
| MS | $410.95 | 1 |
| MT | $462.92 | 1 |
| NC | $436.39 | 1 |
| ND | $459.17 | 1 |
| NE | $431.11 | 1 |
| NH | $476.99 | 1 |
| NJ | $500.64–$527.25 | 2 |
| NM | $434.16 | 1 |
| NV | $462.24 | 1 |
| NY | $442.95–$542.86 | 5 |
| OH | $431.49 | 1 |
| OK | $422.78 | 1 |
| OR | $459.60–$503.01 | 2 |
| PA | $432.90–$480.71 | 2 |
| PR | $466.82 | 1 |
| RI | $476.00 | 1 |
| SC | $434.47 | 1 |
| SD | $458.72 | 1 |
| TN | $427.05 | 1 |
| TX | $429.90–$483.40 | 8 |
| UT | $440.57 | 1 |
| VA | $454.92–$533.21 | 2 |
| VI | $466.82 | 1 |
| VT | $456.18 | 1 |
| WA | $481.84–$548.69 | 2 |
| WI | $443.34 | 1 |
| WV | $418.24 | 1 |
| WY | $461.29 | 1 |
How the 77318 rate is calculated
Each of 77318’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 · 77318
RVUs × geographic indexes × conversion factor
Work2.83
2.83 RVUs× 1.000 GPCI
Practice expense10.84
10.84 RVUs× 1.000 GPCI
Malpractice0.19
0.19 RVUs× 1.000 GPCI
Adjusted RVUs
13.8600
Conversion factor
$33.4009
Medicare rate
$462.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,065
- Code
- 77318
- Physician work
- 2.83
- Practice expense
- 10.84
- Malpractice
- 0.19
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.83 | × 1.000 | 2.8300 |
| Practice expense | 10.84 | × 1.000 | 10.8400 |
| Malpractice | 0.19 | × 0.998 | 0.1896 |
| Total RVUs | 13.8596 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$462.92
Office: (2.83 × 1 + 10.84 × 1 + 0.19 × 0.998) × $33.4009 = $462.92
Payment rules and modifiers for 77318
The CMS indicators that decide how 77318 is paid alongside other services.
CMS payment indicators · 77318
Brachytherapy plan, complex isodose 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
77318 without 26 · national office
$462.94
Brachytherapy plan, complex isodose plan
77318-26 · Professional component
$151.97
Pays only the interpretation and report.
How 77318 has changed in Montana
77318 · Office / nonfacility
$462.92
Effective 2026-10-01
The base rate is $12.81 higher than on 2025-10-01, moving from $450.11 to $462.92 (2.8%).
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
$450.11changed to$462.92
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.90 changed to 2.83
- Practice expense RVU 10.81 changed to 10.84
- Malpractice RVU 0.21 changed to 0.19
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$458.55changed to$450.11
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 10.67 changed to 10.81
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$451.06changed to$458.55
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$461.73changed to$451.06
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 10.53 changed to 10.67
- Malpractice RVU 0.20 changed to 0.21
January 1, 2023
RVU23A
$461.14changed to$461.73
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 10.23 changed to 10.53
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$442.31changed to$461.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.61 changed to 10.23
- Malpractice RVU 0.17 changed to 0.20
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$419.64changed to$442.31
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.48 changed to 9.61
- Malpractice RVU 0.19 changed to 0.17
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$396.20changed to$419.64
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.80 changed to 8.48
- Malpractice RVU 0.18 changed to 0.19
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$372.36changed to$396.20
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.15 changed to 7.80
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$364.17changed to$372.36
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 6.99 changed to 7.15
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$359.86changed to$364.17
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.93 changed to 6.99
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$356.21changed to$359.86
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.78 changed to 6.93
- Malpractice RVU 0.19 changed to 0.18
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$354.43changed to$356.21
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$354.43
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $462.92 | Not available in this setting | RVU26D |
| 2026-07-01 | $462.92 | Not available in this setting | RVU26C |
| 2026-04-01 | $462.92 | Not available in this setting | RVU26B |
| 2026-01-01 | $462.92 | Not available in this setting | RVU26A |
| 2025-10-01 | $450.11 | Not available in this setting | RVU25D |
| 2025-07-01 | $450.11 | Not available in this setting | RVU25C |
| 2025-04-01 | $450.11 | Not available in this setting | RVU25B |
| 2025-01-01 | $450.11 | Not available in this setting | RVU25A |
| 2024-10-01 | $458.55 | Not available in this setting | RVU24D |
| 2024-07-01 | $458.55 | Not available in this setting | RVU24C |
| 2024-04-01 | $458.55 | Not available in this setting | RVU24B |
| 2024-03-09 | $458.55 | Not available in this setting | RVU24AR |
| 2024-01-01 | $451.06 | Not available in this setting | RVU24A |
| 2023-10-01 | $461.73 | Not available in this setting | RVU23D |
| 2023-07-01 | $461.73 | Not available in this setting | RVU23C |
| 2023-04-01 | $461.73 | Not available in this setting | RVU23B |
| 2023-01-01 | $461.73 | Not available in this setting | RVU23A |
| 2022-10-01 | $461.14 | Not available in this setting | RVU22D |
| 2022-07-01 | $461.14 | Not available in this setting | RVU22C |
| 2022-04-01 | $461.14 | Not available in this setting | RVU22B |
| 2022-01-01 | $461.14 | Not available in this setting | RVU22A |
| 2021-10-01 | $442.31 | Not available in this setting | RVU21D |
| 2021-07-01 | $442.31 | Not available in this setting | RVU21C |
| 2021-04-01 | $442.31 | Not available in this setting | RVU21B |
| 2021-01-01 | $442.31 | Not available in this setting | RVU21A |
| 2020-10-01 | $419.64 | Not available in this setting | RVU20D |
| 2020-07-01 | $419.64 | Not available in this setting | RVU20C |
| 2020-04-01 | $419.64 | Not available in this setting | RVU20B |
| 2020-01-01 | $419.64 | Not available in this setting | RVU20A |
| 2019-10-01 | $396.20 | Not available in this setting | RVU19D |
| 2019-07-01 | $396.20 | Not available in this setting | RVU19C |
| 2019-04-01 | $396.20 | Not available in this setting | RVU19B |
| 2019-01-01 | $396.20 | Not available in this setting | RVU19A |
| 2018-10-01 | $372.36 | Not available in this setting | RVU18D |
| 2018-07-01 | $372.36 | Not available in this setting | RVU18C |
| 2018-04-01 | $372.36 | Not available in this setting | RVU18B |
| 2018-01-01 | $372.36 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $364.17 | Not available in this setting | RVU17D |
| 2017-07-01 | $364.17 | Not available in this setting | RVU17C |
| 2017-04-01 | $364.17 | Not available in this setting | RVU17B |
| 2017-01-01 | $364.17 | Not available in this setting | RVU17A |
| 2016-10-01 | $359.86 | Not available in this setting | RVU16D |
| 2016-07-01 | $359.86 | Not available in this setting | RVU16C |
| 2016-04-01 | $359.86 | Not available in this setting | RVU16B |
| 2016-01-01 | $359.86 | Not available in this setting | RVU16A |
| 2015-10-01 | $356.21 | Not available in this setting | RVU15D |
| 2015-07-01 | $356.21 | Not available in this setting | RVU15C |
| 2015-04-01 | $354.43 | Not available in this setting | RVU15B |
| 2015-01-01 | $354.43 | Not available in this setting | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
77318 billing questions
How is 77318 distinguished from 77316 and 77317?
All three are brachytherapy planning levels. Select 77318 only when the source arrangement and planning meet the complex-level CPT criteria; do not select it solely because of the treatment site.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service involving equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports the complex level?
Retain the brachytherapy plan and documentation of the source or applicator arrangement, planned dose distribution, and prescription. The record should support why the plan meets the complex level.
Is 77318 for an external-beam isodose plan?
No. It is for brachytherapy source planning. External-beam isodose planning is represented by a different code family, including 77306 and 77307.
Does the treatment site determine the code level?
No. The level depends on the complexity of the brachytherapy planning work and source arrangement, not simply whether treatment is for the prostate, cervix, or another site.
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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