CPT code 77431: Radiation management, one or two treatments2026 Medicare rate & RVUs in Washington, DC area

Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval.

CMS RVU26DEffective Oct 1, 2026One payment locality5.7K Medicare services in 2024

In Washington, DC area, Medicare pays $117.92 for 77431 in the office and $117.92 when it’s performed in a hospital or facility.

$117.92Office (non-facility)
$117.92Hospital or facility
+10.7%vs the national office rate ($106.55)

Check a contract rate as a % of Medicare · 77431 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 77431 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 77431 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 77431 covers

Code 77431 represents the radiation oncologist’s management of a course with only one or two treatments. The physician’s work includes evaluating the patient during treatment and reviewing the treatment plan and relevant treatment information, such as dosimetry and imaging, to manage the course. It is distinct from coding the radiation delivery itself, which describes the technical treatment service. Radiation oncologists typically provide this management in a hospital or freestanding radiation therapy department.

Select 77431 when the course has one or two treatments; do not use it for a routine five-treatment management interval. The record should support the number of treatments and the physician’s management work. CMS identifies 77431 as a professional-component-only code for interpretation and report, with a separate code covering the technical portion. Report the professional service as represented by this code; do not treat it as a split professional-and-technical code.

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 Washington, DC area compares for 77431

Across 109 of 109 payment localities, the office rate for 77431 runs from $98.21 in Arkansas to $136.64 in Alaska. Washington, DC area pays $117.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

77431 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$117.92
  2. Los Angeles, CA · California$115.27−$2.65
  3. Miami, FL · Florida$115.47−$2.45
  4. Chicago, IL · Illinois$113.23−$4.69
  5. Manhattan, NY · New York$120.03+$2.11
  6. Alaska · Alaska$136.64+$18.72
  7. Alabama · Alabama$99.13−$18.79

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

77431 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$98.21$98.21
ArizonaArizona$104.54$104.54
Bakersfield, CACalifornia$109.97$109.97
Chico, CACalifornia$109.51$109.51
El Centro, CACalifornia$109.54$109.54
Fresno, CACalifornia$109.51$109.51
Hanford, CACalifornia$109.51$109.51
Madera, CACalifornia$109.51$109.51

77431 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$98.21

$136.64

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

View every state and territory as a table
77431 office rate range by state
State / territoryOffice rate rangeLocalities
AK$136.641
AL$99.131
AR$98.211
AZ$104.541
CA$109.51–$129.8929
CO$108.991
CT$112.021
DC$117.921
DE$105.851
FL$107.01–$115.473
GA$102.79–$108.352
GU$110.481
HI$110.481
IA$100.071
ID$100.641
IL$105.43–$113.234
IN$101.001
KS$100.091
KY$101.371
LA$101.40–$104.642
MA$108.82–$116.802
MD$107.27–$117.923
ME$101.33–$104.442
MI$103.40–$108.252
MN$104.511
MO$100.48–$104.493
MS$99.341
MT$106.541
NC$101.971
ND$103.771
NE$100.321
NH$107.731
NJ$113.32–$117.462
NM$103.911
NV$105.811
NY$103.01–$122.465
OH$102.841
OK$100.901
OR$104.99–$111.082
PA$102.76–$110.282
PR$106.951
RI$108.581
SC$102.571
SD$103.441
TN$100.461
TX$102.34–$108.638
UT$103.491
VA$104.44–$117.922
VI$106.951
VT$103.811
WA$108.48–$118.412
WI$101.501
WV$102.921
WY$105.331

See 77431 in every payment locality

How the 77431 rate is calculated

Each of 77431’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 · 77431

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.76

1.76 RVUs× 1.000 GPCI

Practice expense1.29

1.29 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

3.1900

Conversion factor

$33.4009

Medicare rate

$106.55

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,105

Code
77431
Physician work
1.76
Practice expense
1.29
Malpractice
0.14

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 77431 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.76× 1.0541.8550
Practice expense1.29× 1.1781.5196
Malpractice0.14× 1.1130.1558
Total RVUs3.5305
Conversion factor× 33.4009

Office rate, Washington, DC area$117.92

Office: (1.76 × 1.054 + 1.29 × 1.178 + 0.14 × 1.113) × $33.4009 = $117.92

Facility: (1.76 × 1.054 + 1.29 × 1.178 + 0.14 × 1.113) × $33.4009 = $117.92

Open 77431 in the RVU calculator

Payment rules and modifiers for 77431

The CMS indicators that decide how 77431 is paid alongside other services.

CMS payment indicators · 77431

Radiation management, one or two treatments

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/technical2Professional component only.

How 77431 has changed in Washington, DC area

77431 · Office / nonfacility

$117.92

Effective 2026-10-01

The base rate is $0.52 lower than on 2025-10-01, moving from $118.44 to $117.92 (0.4%).

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

    $118.44changed to$117.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.81 changed to 1.76
    • Practice expense RVU 1.31 changed to 1.29
    • Malpractice RVU 0.16 changed to 0.14
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $119.51changed to$118.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.26 changed to 1.31
    • Malpractice RVU 0.15 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $117.56changed to$119.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $121.62changed to$117.56

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.24 changed to 1.26
    • Malpractice RVU 0.14 changed to 0.15
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $122.29changed to$121.62

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.19 changed to 1.24
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $122.05changed to$122.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.14 changed to 1.19
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $122.10changed to$122.05

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.08 changed to 1.14
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $118.37changed to$122.10

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.02 changed to 1.08
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $116.50changed to$118.37

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.98 changed to 1.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $115.52changed to$116.50

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.96 changed to 0.98
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $114.62changed to$115.52

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.94 changed to 0.96
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $114.20changed to$114.62

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.91 changed to 0.94
    • Malpractice RVU 0.14 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $113.63changed to$114.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $112.88changed to$113.63

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $107.89changed to$112.88

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.93 changed to 0.91
    • Malpractice RVU 0.14 changed to 0.13
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $107.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$117.92$117.92RVU26D
2026-07-01$117.92$117.92RVU26C
2026-04-01$117.92$117.92RVU26B
2026-01-01$117.92$117.92RVU26A
2025-10-01$118.44$118.44RVU25D
2025-07-01$118.44$118.44RVU25C
2025-04-01$118.44$118.44RVU25B
2025-01-01$118.44$118.44RVU25A
2024-10-01$119.51$119.51RVU24D
2024-07-01$119.51$119.51RVU24C
2024-04-01$119.51$119.51RVU24B
2024-03-09$119.51$119.51RVU24AR
2024-01-01$117.56$117.56RVU24A
2023-10-01$121.62$121.62RVU23D
2023-07-01$121.62$121.62RVU23C
2023-04-01$121.62$121.62RVU23B
2023-01-01$121.62$121.62RVU23A
2022-10-01$122.29$122.29RVU22D
2022-07-01$122.29$122.29RVU22C
2022-04-01$122.29$122.29RVU22B
2022-01-01$122.29$122.29RVU22A
2021-10-01$122.05$122.05RVU21D
2021-07-01$122.05$122.05RVU21C
2021-04-01$122.05$122.05RVU21B
2021-01-01$122.05$122.05RVU21A
2020-10-01$122.10$122.10RVU20D
2020-07-01$122.10$122.10RVU20C
2020-04-01$122.10$122.10RVU20B
2020-01-01$122.10$122.10RVU20A
2019-10-01$118.37$118.37RVU19D
2019-07-01$118.37$118.37RVU19C
2019-04-01$118.37$118.37RVU19B
2019-01-01$118.37$118.37RVU19A
2018-10-01$116.50$116.50RVU18D
2018-07-01$116.50$116.50RVU18C
2018-04-01$116.50$116.50RVU18B
2018-01-01$116.50$116.50RVU18AR1
2017-10-01$115.52$115.52RVU17D
2017-07-01$115.52$115.52RVU17C
2017-04-01$115.52$115.52RVU17B
2017-01-01$115.52$115.52RVU17A
2016-10-01$114.62$114.62RVU16D
2016-07-01$114.62$114.62RVU16C
2016-04-01$114.62$114.62RVU16B
2016-01-01$114.62$114.62RVU16A
2015-10-01$114.20$114.20RVU15D
2015-07-01$114.20$114.20RVU15C
2015-04-01$113.63$113.63RVU15B
2015-01-01$113.63$113.63RVU15A
2014-10-01$112.88$112.88RVU14D
2014-07-01$112.88$112.88RVU14C
2014-04-01$112.88$112.88RVU14B
2014-01-01$112.88$112.88RVU14A
2013-10-01$107.89$107.89RVU13D
2013-07-01$107.89$107.89RVU13C
2013-04-01$107.89$107.89RVU13B
2013-01-01$107.89$107.89RVU13AR

Price 77431 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

77431 billing questions

When should 77431 be selected instead of 77427?

Use 77431 for management of a course with only one or two treatments. Code 77427 represents the usual five-treatment management interval.

Can radiation delivery be reported separately?

Yes. The management service is distinct from the technical radiation delivery service, which is represented by a separate code when supported.

Should modifier 26 or TC be appended?

No. CMS identifies 77431 as professional-component-only, covering interpretation and report; it is not a code split into professional and technical portions.

What documentation supports reporting 77431?

Document the course’s one- or two-treatment count and the radiation oncologist’s management work, including review of relevant treatment information.

Is 77431 the management code for stereotactic treatment?

Not when a more specific stereotactic management code describes the service. Codes 77432 and 77435 address stereotactic treatment circumstances.

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 77431PPRRVU2026_Oct_nonQPP.csv, line 9,105 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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