CPT code 77424: Intraoperative radiation, X-ray delivery2026 Medicare rate & RVUs in Missouri
Reports x-ray radiation delivered to a surgical target during an operation as part of intraoperative radiation treatment.
CMS doesn’t publish an office rate for 77424 in Missouri.
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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What 77424 covers
77424 reports intraoperative radiation treatment delivered with x-rays to a target while surgery is underway. The radiation oncology team coordinates delivery with the operating surgeon so treatment can be directed to the operative site. The code identifies the radiation delivery service, rather than the broader radiation course or the physician’s management of intraoperative treatment. It distinguishes x-ray delivery from the intraoperative electron delivery represented by 77425.
Medicare classifies 77424 as status X, a statutory exclusion because it is not a physician service under the Medicare statute; the physician fee schedule does not pay it. When covered, Medicare pays it under another fee schedule or payment system. Radiation oncologists report it for the intraoperative delivery, while 77469 identifies intraoperative radiation treatment management.
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 77424 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 77424 rate is calculated
Each of 77424’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 · 77424
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77424
77424 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 77424
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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77424 isn’t priced in this setting.
77424 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77425Intraoperative radiationElectron beam
- Both describe intraoperative radiation delivery. Choose 77424 for x-rays and 77425 for electrons.
- 77469IORT managementDuring surgery
- 77424 identifies delivery of x-ray treatment during surgery; 77469 identifies intraoperative radiation treatment management.
- 77412Radiation deliveryComplex treatment
- 77412 is a level 3 radiation treatment delivery code. Use 77424 for x-ray radiation delivered during an operation.
77424 billing questions
How does 77424 differ from 77425?
77424 is for intraoperative treatment delivered with x-rays. 77425 is the sibling code for delivery using electrons.
Is 77424 the radiation management service?
No. It represents treatment delivery. Code 77469 identifies intraoperative radiation treatment management.
Is this the code for routine external-beam treatments?
No. 77424 is specific to radiation delivered during surgery. Codes such as 77402, 77407, and 77412 describe radiation treatment delivery at different levels.
How does Medicare treat 77424?
Its physician fee schedule status is X, a statutory exclusion. When covered, Medicare pays under another fee schedule or payment system.
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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