CPT code 77318: Brachytherapy plan, complex isodose plan2026 Medicare rate & RVUs in Texas
Reports complex dose-distribution planning for brachytherapy, using the implant or applicator geometry to shape the prescribed radiation dose.
Medicare pays $429.90–$483.40 for 77318 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 77318 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$429.90 to $483.40
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $483.40 | Unavailable |
| Beaumont, TX | $429.90 | Unavailable |
| Brazoria, TX | $459.04 | Unavailable |
| Dallas, TX | $461.44 | Unavailable |
| Fort Worth, TX | $457.90 | Unavailable |
| Galveston, TX | $460.07 | Unavailable |
| Houston, TX | $463.54 | Unavailable |
| Rest of Texas | $443.86 | Unavailable |
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.
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.
77318 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77316Brachytherapy planSimple source or point count
- Use 77316 for brachytherapy planning at the simple level. 77318 requires documentation supporting complex-level planning.
- 77317Brachytherapy planIntermediate complexity
- Both codes plan brachytherapy dose distribution; 77317 is the intermediate level, while 77318 is the complex level.
- 77307Isodose planningComplex teletherapy plan
- 77307 describes a complex teletherapy isodose plan. 77318 plans dose distribution for brachytherapy sources or applicators.
- 77300Dosimetry calculationBasic, per calculation
- 77300 is a basic radiation dosimetry calculation, not the complex brachytherapy source-distribution plan represented by 77318.
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
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