CPT code 77333: Radiation aid, intermediate complexity2026 Medicare rate & RVUs in Puerto Rico
Reports an intermediate-complexity device designed or constructed to shape, modify, or support a patient’s external-beam radiation treatment.
In Puerto Rico, Medicare pays $138.82 for 77333 in the office.
Check a contract rate as a % of Medicare · 77333 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 77333 covers
This code covers the design and construction of a radiation treatment aid used to shape or modify the beam or help position the patient reproducibly. Examples of treatment aids across this code family include shielding blocks, bolus, and immobilization devices. Radiation oncologists, dosimetrists, and radiation therapy teams use these devices in external-beam treatment planning and delivery. The intermediate level is selected by the device’s design and construction complexity, not simply by the diagnosis or treatment site.
Choose this level when the documented device is more involved than a simple aid but does not meet the complex level. Record what was designed or fabricated and how it supports treatment; report distinct devices at the applicable level when separately documented. CMS recognizes professional and technical components: modifier 26 identifies the professional component, modifier TC the technical component involving equipment and staff, and no modifier represents 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 Puerto Rico compares for 77333
Across 109 of 109 payment localities, the office rate for 77333 runs from $121.19 in Arkansas to $189.13 in San Benito County, CA. Puerto Rico pays $138.82. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$138.82
- Los Angeles, CA · California$158.64+$19.82
- Washington, DC area · District of Columbia$159.00+$20.18
- Miami, FL · Florida$144.24+$5.42
- Chicago, IL · Illinois$140.07+$1.25
- Manhattan, NY · New York$158.08+$19.26
- Alaska · Alaska$156.48+$17.66
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $123.05 | — |
| ArkansasArkansas | $121.19 | — |
| ArizonaArizona | $133.95 | — |
| Bakersfield, CACalifornia | $148.29 | — |
| Chico, CACalifornia | $148.15 | — |
| El Centro, CACalifornia | $148.15 | — |
| Fresno, CACalifornia | $148.15 | — |
| Hanford, CACalifornia | $148.15 | — |
| Madera, CACalifornia | $148.15 | — |
| Merced, CACalifornia | $148.15 | — |
| Modesto, CACalifornia | $148.15 | — |
| Napa, CACalifornia | $174.07 | — |
| Oxnard, CACalifornia | $158.16 | — |
| Redding, CACalifornia | $148.15 | — |
| Rest of CaliforniaCalifornia | $148.15 | — |
| Riverside, CACalifornia | $148.60 | — |
| Sacramento, CACalifornia | $156.11 | — |
| Salinas, CACalifornia | $155.54 | — |
| San Diego, CACalifornia | $159.66 | — |
| Marin County, CACalifornia | $185.08 | — |
| San Francisco, CACalifornia | $185.04 | — |
| San Benito County, CACalifornia | $189.13 | — |
| Santa Clara County, CACalifornia | $188.94 | — |
| San Luis Obispo, CACalifornia | $152.96 | — |
| Santa Cruz, CACalifornia | $161.56 | — |
| Santa Maria, CACalifornia | $156.25 | — |
| Santa Rosa, CACalifornia | $163.23 | — |
| Stockton, CACalifornia | $148.15 | — |
| Vallejo, CACalifornia | $174.01 | — |
| Visalia, CACalifornia | $148.15 | — |
| Yuba City, CACalifornia | $148.15 | — |
| ColoradoColorado | $144.77 | — |
| ConnecticutConnecticut | $147.00 | — |
| DelawareDelaware | $136.26 | — |
| Fort Lauderdale, FLFlorida | $140.15 | — |
| Rest of FloridaFlorida | $133.36 | — |
| Atlanta, GAGeorgia | $139.74 | — |
| Rest of GeorgiaGeorgia | $125.78 | — |
| Hawaii, Guam, HIHawaii | $152.38 | — |
| IowaIowa | $127.30 | — |
| IdahoIdaho | $127.96 | — |
| East St. Louis, ILIllinois | $130.02 | — |
| Rest of IllinoisIllinois | $128.63 | — |
| Suburban Chicago, ILIllinois | $141.83 | — |
| IndianaIndiana | $128.76 | — |
| KansasKansas | $126.21 | — |
| KentuckyKentucky | $125.08 | — |
| New Orleans, LALouisiana | $131.19 | — |
| Rest of LouisianaLouisiana | $124.69 | — |
| Metropolitan Boston, MAMassachusetts | $160.17 | — |
| Rest of MassachusettsMassachusetts | $143.66 | — |
| Baltimore area, MDMaryland | $146.49 | — |
| Rest of MarylandMaryland | $139.09 | — |
| Rest of MaineMaine | $128.16 | — |
| Southern Maine, MEMaine | $136.11 | — |
| Detroit, MIMichigan | $134.61 | — |
| Rest of MichiganMichigan | $128.05 | — |
| MinnesotaMinnesota | $139.92 | — |
| Metropolitan Kansas City, MOMissouri | $130.76 | — |
| Metropolitan St. Louis, MOMissouri | $132.24 | — |
| Rest of MissouriMissouri | $122.14 | — |
| MississippiMississippi | $121.71 | — |
| MontanaMontana | $137.61 | — |
| North CarolinaNorth Carolina | $129.63 | — |
| North DakotaNorth Dakota | $136.82 | — |
| NebraskaNebraska | $128.16 | — |
| New HampshireNew Hampshire | $142.03 | — |
| Northern New JerseyNew Jersey | $157.14 | — |
| Rest of New JerseyNew Jersey | $149.01 | — |
| New MexicoNew Mexico | $128.59 | — |
| NevadaNevada | $137.50 | — |
| NYC suburbs and Long Island, NYNew York | $161.46 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $149.62 | — |
| Queens, NYNew York | $160.13 | — |
| Rest of New YorkNew York | $131.62 | — |
| OhioOhio | $127.89 | — |
| OklahomaOklahoma | $125.34 | — |
| Portland, OROregon | $150.08 | — |
| Rest of OregonOregon | $136.77 | — |
| Metropolitan Philadelphia, PAPennsylvania | $142.90 | — |
| Rest of PennsylvaniaPennsylvania | $128.36 | — |
| Rhode IslandRhode Island | $141.62 | — |
| South CarolinaSouth Carolina | $128.91 | — |
| South DakotaSouth Dakota | $136.72 | — |
| TennesseeTennessee | $126.81 | — |
| Austin, TXTexas | $144.00 | — |
| Beaumont, TXTexas | $127.45 | — |
| Brazoria, TXTexas | $136.51 | — |
| Dallas, TXTexas | $137.19 | — |
| Fort Worth, TXTexas | $136.09 | — |
| Galveston, TXTexas | $136.79 | — |
| Houston, TXTexas | $137.53 | — |
| Rest of TexasTexas | $131.78 | — |
| UtahUtah | $130.76 | — |
| VirginiaVirginia | $135.32 | — |
| Virgin Islands, VIUnited States Virgin Islands | $138.82 | — |
| VermontVermont | $135.83 | — |
| Rest of WashingtonWashington | $143.54 | — |
| King County, WAWashington | $163.99 | — |
| WisconsinWisconsin | $131.99 | — |
| West VirginiaWest Virginia | $123.53 | — |
| WyomingWyoming | $137.26 | — |
77333 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.
$121.19
$168.64
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 | $156.48 | 1 |
| AL | $123.05 | 1 |
| AR | $121.19 | 1 |
| AZ | $133.95 | 1 |
| CA | $148.15–$189.13 | 29 |
| CO | $144.77 | 1 |
| CT | $147.00 | 1 |
| DC | $159.00 | 1 |
| DE | $136.26 | 1 |
| FL | $133.36–$144.24 | 3 |
| GA | $125.78–$139.74 | 2 |
| GU | $152.38 | 1 |
| HI | $152.38 | 1 |
| IA | $127.30 | 1 |
| ID | $127.96 | 1 |
| IL | $128.63–$141.83 | 4 |
| IN | $128.76 | 1 |
| KS | $126.21 | 1 |
| KY | $125.08 | 1 |
| LA | $124.69–$131.19 | 2 |
| MA | $143.66–$160.17 | 2 |
| MD | $139.09–$159.00 | 3 |
| ME | $128.16–$136.11 | 2 |
| MI | $128.05–$134.61 | 2 |
| MN | $139.92 | 1 |
| MO | $122.14–$132.24 | 3 |
| MS | $121.71 | 1 |
| MT | $137.61 | 1 |
| NC | $129.63 | 1 |
| ND | $136.82 | 1 |
| NE | $128.16 | 1 |
| NH | $142.03 | 1 |
| NJ | $149.01–$157.14 | 2 |
| NM | $128.59 | 1 |
| NV | $137.50 | 1 |
| NY | $131.62–$161.46 | 5 |
| OH | $127.89 | 1 |
| OK | $125.34 | 1 |
| OR | $136.77–$150.08 | 2 |
| PA | $128.36–$142.90 | 2 |
| PR | $138.82 | 1 |
| RI | $141.62 | 1 |
| SC | $128.91 | 1 |
| SD | $136.72 | 1 |
| TN | $126.81 | 1 |
| TX | $127.45–$144.00 | 8 |
| UT | $130.76 | 1 |
| VA | $135.32–$159.00 | 2 |
| VI | $138.82 | 1 |
| VT | $135.83 | 1 |
| WA | $143.54–$163.99 | 2 |
| WI | $131.99 | 1 |
| WV | $123.53 | 1 |
| WY | $137.26 | 1 |
How the 77333 rate is calculated
Each of 77333’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 · 77333
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense3.35
3.35 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
4.1200
Conversion factor
$33.4009
Medicare rate
$137.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,077
- Code
- 77333
- Physician work
- 0.73
- Practice expense
- 3.35
- Malpractice
- 0.04
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 3.35 | × 1.011 | 3.3868 |
| Malpractice | 0.04 | × 0.985 | 0.0394 |
| Total RVUs | 4.1562 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$138.82
Office: (0.73 × 1 + 3.35 × 1.011 + 0.04 × 0.985) × $33.4009 = $138.82
Payment rules and modifiers for 77333
The CMS indicators that decide how 77333 is paid alongside other services.
CMS payment indicators · 77333
Radiation aid, intermediate complexity
| 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
77333 without 26 · national office
$137.61
Radiation aid, intermediate complexity
77333-26 · Professional component
$39.08
Pays only the interpretation and report.
How 77333 has changed in Puerto Rico
77333 · Office / nonfacility
$138.82
Effective 2026-10-01
The base rate is $5.15 higher than on 2025-10-01, moving from $133.67 to $138.82 (3.9%).
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
$133.67changed to$138.82
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.75 changed to 0.73
- Practice expense RVU 3.32 changed to 3.35
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$137.56changed to$133.67
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$135.32changed to$137.56
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$140.49changed to$135.32
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$139.62changed to$140.49
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$143.12changed to$139.62
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.31 changed to 3.32
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$136.57changed to$143.12
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.09 changed to 3.31
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$123.80changed to$136.57
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.62 changed to 3.09
- Malpractice RVU 0.04 changed to 0.05
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$112.29changed to$123.80
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.31 changed to 2.62
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$100.93changed to$112.29
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.00 changed to 2.31
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$87.74changed to$100.93
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.95 changed to 2.00
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$46.00changed to$87.74
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 0.84 changed to 0.75
- Practice expense RVU 0.61 changed to 1.95
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$45.66changed to$46.00
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.59 changed to 0.61
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$45.43changed to$45.66
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$45.20changed to$45.43
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$43.07changed to$45.20
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.61 changed to 0.59
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $43.07
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $138.82 | Not available in this setting | RVU26D |
| 2026-07-01 | $138.82 | Not available in this setting | RVU26C |
| 2026-04-01 | $138.82 | Not available in this setting | RVU26B |
| 2026-01-01 | $138.82 | Not available in this setting | RVU26A |
| 2025-10-01 | $133.67 | Not available in this setting | RVU25D |
| 2025-07-01 | $133.67 | Not available in this setting | RVU25C |
| 2025-04-01 | $133.67 | Not available in this setting | RVU25B |
| 2025-01-01 | $133.67 | Not available in this setting | RVU25A |
| 2024-10-01 | $137.56 | Not available in this setting | RVU24D |
| 2024-07-01 | $137.56 | Not available in this setting | RVU24C |
| 2024-04-01 | $137.56 | Not available in this setting | RVU24B |
| 2024-03-09 | $137.56 | Not available in this setting | RVU24AR |
| 2024-01-01 | $135.32 | Not available in this setting | RVU24A |
| 2023-10-01 | $140.49 | Not available in this setting | RVU23D |
| 2023-07-01 | $139.62 | Not available in this setting | RVU23C |
| 2023-04-01 | $139.62 | Not available in this setting | RVU23B |
| 2023-01-01 | $139.62 | Not available in this setting | RVU23A |
| 2022-10-01 | $143.12 | Not available in this setting | RVU22D |
| 2022-07-01 | $143.12 | Not available in this setting | RVU22C |
| 2022-04-01 | $143.12 | Not available in this setting | RVU22B |
| 2022-01-01 | $143.12 | Not available in this setting | RVU22A |
| 2021-10-01 | $136.57 | Not available in this setting | RVU21D |
| 2021-07-01 | $136.57 | Not available in this setting | RVU21C |
| 2021-04-01 | $136.57 | Not available in this setting | RVU21B |
| 2021-01-01 | $136.57 | Not available in this setting | RVU21A |
| 2020-10-01 | $123.80 | Not available in this setting | RVU20D |
| 2020-07-01 | $123.80 | Not available in this setting | RVU20C |
| 2020-04-01 | $123.80 | Not available in this setting | RVU20B |
| 2020-01-01 | $123.80 | Not available in this setting | RVU20A |
| 2019-10-01 | $112.29 | Not available in this setting | RVU19D |
| 2019-07-01 | $112.29 | Not available in this setting | RVU19C |
| 2019-04-01 | $112.29 | Not available in this setting | RVU19B |
| 2019-01-01 | $112.29 | Not available in this setting | RVU19A |
| 2018-10-01 | $100.93 | Not available in this setting | RVU18D |
| 2018-07-01 | $100.93 | Not available in this setting | RVU18C |
| 2018-04-01 | $100.93 | Not available in this setting | RVU18B |
| 2018-01-01 | $100.93 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $87.74 | Not available in this setting | RVU17D |
| 2017-07-01 | $87.74 | Not available in this setting | RVU17C |
| 2017-04-01 | $87.74 | Not available in this setting | RVU17B |
| 2017-01-01 | $87.74 | Not available in this setting | RVU17A |
| 2016-10-01 | $46.00 | Not available in this setting | RVU16D |
| 2016-07-01 | $46.00 | Not available in this setting | RVU16C |
| 2016-04-01 | $46.00 | Not available in this setting | RVU16B |
| 2016-01-01 | $46.00 | Not available in this setting | RVU16A |
| 2015-10-01 | $45.66 | Not available in this setting | RVU15D |
| 2015-07-01 | $45.66 | Not available in this setting | RVU15C |
| 2015-04-01 | $45.43 | Not available in this setting | RVU15B |
| 2015-01-01 | $45.43 | Not available in this setting | RVU15A |
| 2014-10-01 | $45.20 | Not available in this setting | RVU14D |
| 2014-07-01 | $45.20 | Not available in this setting | RVU14C |
| 2014-04-01 | $45.20 | Not available in this setting | RVU14B |
| 2014-01-01 | $45.20 | Not available in this setting | RVU14A |
| 2013-10-01 | $43.07 | Not available in this setting | RVU13D |
| 2013-07-01 | $43.07 | Not available in this setting | RVU13C |
| 2013-04-01 | $43.07 | Not available in this setting | RVU13B |
| 2013-01-01 | $43.07 | Not available in this setting | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
77333 billing questions
How does 77333 differ from 77332 and 77334?
These codes distinguish treatment aids by design and construction complexity. Use 77332 for the simple level, 77333 for the intermediate level, and 77334 for the complex level.
What documentation supports 77333?
Document the particular aid designed or constructed and its role in shaping the radiation beam or supporting reproducible patient positioning. The record should support the intermediate complexity level.
Can 77333 be reported with modifier 26 or TC?
CMS recognizes separately priced professional and technical components. Modifier 26 identifies the professional component, TC identifies the equipment-and-staff component, and billing without either modifier represents the global service.
How should units be determined?
Base reporting on each distinct treatment aid furnished and documented, rather than the number of treatment fractions or beam angles. Select the appropriate complexity level for each aid.
Is dose calculation included in 77333?
77333 represents the treatment aid, while 77300 represents a radiation therapy dose calculation. Report both only when the record supports each as a distinct service.
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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