CPT code 77431: Radiation management, one or two treatments2026 Medicare rate & RVUs in North Carolina
Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval.
In North Carolina, Medicare pays $101.97 for 77431 in the office and $101.97 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $101.97. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$101.97
- Los Angeles, CA · California$115.27+$13.30
- Washington, DC area · District of Columbia$117.92+$15.95
- Miami, FL · Florida$115.47+$13.50
- Chicago, IL · Illinois$113.23+$11.26
- Manhattan, NY · New York$120.03+$18.06
- Alaska · Alaska$136.64+$34.67
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $99.13 | $99.13 |
| 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 |
| Merced, CACalifornia | $109.51 | $109.51 |
| Modesto, CACalifornia | $109.51 | $109.51 |
| Napa, CACalifornia | $121.65 | $121.65 |
| Oxnard, CACalifornia | $114.27 | $114.27 |
| Redding, CACalifornia | $109.51 | $109.51 |
| Rest of CaliforniaCalifornia | $109.51 | $109.51 |
| Riverside, CACalifornia | $111.06 | $111.06 |
| Sacramento, CACalifornia | $113.52 | $113.52 |
| Salinas, CACalifornia | $113.05 | $113.05 |
| San Diego, CACalifornia | $114.62 | $114.62 |
| Marin County, CACalifornia | $127.27 | $127.27 |
| San Francisco, CACalifornia | $127.11 | $127.11 |
| San Benito County, CACalifornia | $129.89 | $129.89 |
| Santa Clara County, CACalifornia | $129.24 | $129.24 |
| San Luis Obispo, CACalifornia | $111.37 | $111.37 |
| Santa Cruz, CACalifornia | $114.88 | $114.88 |
| Santa Maria, CACalifornia | $113.18 | $113.18 |
| Santa Rosa, CACalifornia | $115.97 | $115.97 |
| Stockton, CACalifornia | $109.51 | $109.51 |
| Vallejo, CACalifornia | $121.42 | $121.42 |
| Visalia, CACalifornia | $109.51 | $109.51 |
| Yuba City, CACalifornia | $109.51 | $109.51 |
| ColoradoColorado | $108.99 | $108.99 |
| ConnecticutConnecticut | $112.02 | $112.02 |
| DelawareDelaware | $105.85 | $105.85 |
| Fort Lauderdale, FLFlorida | $110.89 | $110.89 |
| Rest of FloridaFlorida | $107.01 | $107.01 |
| Atlanta, GAGeorgia | $108.35 | $108.35 |
| Rest of GeorgiaGeorgia | $102.79 | $102.79 |
| Hawaii, Guam, HIHawaii | $110.48 | $110.48 |
| IowaIowa | $100.07 | $100.07 |
| IdahoIdaho | $100.64 | $100.64 |
| East St. Louis, ILIllinois | $107.84 | $107.84 |
| Rest of IllinoisIllinois | $105.43 | $105.43 |
| Suburban Chicago, ILIllinois | $111.73 | $111.73 |
| IndianaIndiana | $101.00 | $101.00 |
| KansasKansas | $100.09 | $100.09 |
| KentuckyKentucky | $101.37 | $101.37 |
| New Orleans, LALouisiana | $104.64 | $104.64 |
| Rest of LouisianaLouisiana | $101.40 | $101.40 |
| Metropolitan Boston, MAMassachusetts | $116.80 | $116.80 |
| Rest of MassachusettsMassachusetts | $108.82 | $108.82 |
| Baltimore area, MDMaryland | $111.74 | $111.74 |
| Rest of MarylandMaryland | $107.27 | $107.27 |
| Rest of MaineMaine | $101.33 | $101.33 |
| Southern Maine, MEMaine | $104.44 | $104.44 |
| Detroit, MIMichigan | $108.25 | $108.25 |
| Rest of MichiganMichigan | $103.40 | $103.40 |
| MinnesotaMinnesota | $104.51 | $104.51 |
| Metropolitan Kansas City, MOMissouri | $103.81 | $103.81 |
| Metropolitan St. Louis, MOMissouri | $104.49 | $104.49 |
| Rest of MissouriMissouri | $100.48 | $100.48 |
| MississippiMississippi | $99.34 | $99.34 |
| MontanaMontana | $106.54 | $106.54 |
| North DakotaNorth Dakota | $103.77 | $103.77 |
| NebraskaNebraska | $100.32 | $100.32 |
| New HampshireNew Hampshire | $107.73 | $107.73 |
| Northern New JerseyNew Jersey | $117.46 | $117.46 |
| Rest of New JerseyNew Jersey | $113.32 | $113.32 |
| New MexicoNew Mexico | $103.91 | $103.91 |
| NevadaNevada | $105.81 | $105.81 |
| NYC suburbs and Long Island, NYNew York | $122.46 | $122.46 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $114.27 | $114.27 |
| Queens, NYNew York | $120.22 | $120.22 |
| Rest of New YorkNew York | $103.01 | $103.01 |
| OhioOhio | $102.84 | $102.84 |
| OklahomaOklahoma | $100.90 | $100.90 |
| Portland, OROregon | $111.08 | $111.08 |
| Rest of OregonOregon | $104.99 | $104.99 |
| Metropolitan Philadelphia, PAPennsylvania | $110.28 | $110.28 |
| Rest of PennsylvaniaPennsylvania | $102.76 | $102.76 |
| Puerto RicoPuerto Rico | $106.95 | $106.95 |
| Rhode IslandRhode Island | $108.58 | $108.58 |
| South CarolinaSouth Carolina | $102.57 | $102.57 |
| South DakotaSouth Dakota | $103.44 | $103.44 |
| TennesseeTennessee | $100.46 | $100.46 |
| Austin, TXTexas | $108.63 | $108.63 |
| Beaumont, TXTexas | $102.34 | $102.34 |
| Brazoria, TXTexas | $105.60 | $105.60 |
| Dallas, TXTexas | $106.24 | $106.24 |
| Fort Worth, TXTexas | $105.87 | $105.87 |
| Galveston, TXTexas | $105.91 | $105.91 |
| Houston, TXTexas | $108.48 | $108.48 |
| Rest of TexasTexas | $103.90 | $103.90 |
| UtahUtah | $103.49 | $103.49 |
| VirginiaVirginia | $104.44 | $104.44 |
| Virgin Islands, VIUnited States Virgin Islands | $106.95 | $106.95 |
| VermontVermont | $103.81 | $103.81 |
| Rest of WashingtonWashington | $108.48 | $108.48 |
| King County, WAWashington | $118.41 | $118.41 |
| WisconsinWisconsin | $101.50 | $101.50 |
| West VirginiaWest Virginia | $102.92 | $102.92 |
| WyomingWyoming | $105.33 | $105.33 |
77431 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.
$98.21
$136.64
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 | $136.64 | 1 |
| AL | $99.13 | 1 |
| AR | $98.21 | 1 |
| AZ | $104.54 | 1 |
| CA | $109.51–$129.89 | 29 |
| CO | $108.99 | 1 |
| CT | $112.02 | 1 |
| DC | $117.92 | 1 |
| DE | $105.85 | 1 |
| FL | $107.01–$115.47 | 3 |
| GA | $102.79–$108.35 | 2 |
| GU | $110.48 | 1 |
| HI | $110.48 | 1 |
| IA | $100.07 | 1 |
| ID | $100.64 | 1 |
| IL | $105.43–$113.23 | 4 |
| IN | $101.00 | 1 |
| KS | $100.09 | 1 |
| KY | $101.37 | 1 |
| LA | $101.40–$104.64 | 2 |
| MA | $108.82–$116.80 | 2 |
| MD | $107.27–$117.92 | 3 |
| ME | $101.33–$104.44 | 2 |
| MI | $103.40–$108.25 | 2 |
| MN | $104.51 | 1 |
| MO | $100.48–$104.49 | 3 |
| MS | $99.34 | 1 |
| MT | $106.54 | 1 |
| NC | $101.97 | 1 |
| ND | $103.77 | 1 |
| NE | $100.32 | 1 |
| NH | $107.73 | 1 |
| NJ | $113.32–$117.46 | 2 |
| NM | $103.91 | 1 |
| NV | $105.81 | 1 |
| NY | $103.01–$122.46 | 5 |
| OH | $102.84 | 1 |
| OK | $100.90 | 1 |
| OR | $104.99–$111.08 | 2 |
| PA | $102.76–$110.28 | 2 |
| PR | $106.95 | 1 |
| RI | $108.58 | 1 |
| SC | $102.57 | 1 |
| SD | $103.44 | 1 |
| TN | $100.46 | 1 |
| TX | $102.34–$108.63 | 8 |
| UT | $103.49 | 1 |
| VA | $104.44–$117.92 | 2 |
| VI | $106.95 | 1 |
| VT | $103.81 | 1 |
| WA | $108.48–$118.41 | 2 |
| WI | $101.50 | 1 |
| WV | $102.92 | 1 |
| WY | $105.33 | 1 |
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
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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.76 | × 1.000 | 1.7600 |
| Practice expense | 1.29 | × 0.933 | 1.2036 |
| Malpractice | 0.14 | × 0.639 | 0.0895 |
| Total RVUs | 3.0530 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$101.97
Office: (1.76 × 1 + 1.29 × 0.933 + 0.14 × 0.639) × $33.4009 = $101.97
Facility: (1.76 × 1 + 1.29 × 0.933 + 0.14 × 0.639) × $33.4009 = $101.97
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
| 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 | 2 | Professional component only. |
How 77431 has changed in North Carolina
77431 · Office / nonfacility
$101.97
Effective 2026-10-01
The base rate is $0.74 higher than on 2025-10-01, moving from $101.23 to $101.97 (0.7%).
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
$101.23changed to$101.97
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$102.41changed to$101.23
- 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.
March 9, 2024
RVU24AR
$100.74changed to$102.41
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$103.81changed to$100.74
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$104.25changed to$103.81
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$104.07changed to$104.25
- 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.
January 1, 2021
RVU21A
$105.12changed to$104.07
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$102.71changed to$105.12
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.02 changed to 1.08
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$101.26changed to$102.71
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.98 changed to 1.02
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$100.45changed to$101.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.96 changed to 0.98
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$99.68changed to$100.45
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.94 changed to 0.96
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$99.31changed to$99.68
- 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.
July 1, 2015
RVU15C
$98.82changed to$99.31
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$98.53changed to$98.82
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.13 changed to 0.14
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$94.22changed to$98.53
- 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
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $94.22
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $101.97 | $101.97 | RVU26D |
| 2026-07-01 | $101.97 | $101.97 | RVU26C |
| 2026-04-01 | $101.97 | $101.97 | RVU26B |
| 2026-01-01 | $101.97 | $101.97 | RVU26A |
| 2025-10-01 | $101.23 | $101.23 | RVU25D |
| 2025-07-01 | $101.23 | $101.23 | RVU25C |
| 2025-04-01 | $101.23 | $101.23 | RVU25B |
| 2025-01-01 | $101.23 | $101.23 | RVU25A |
| 2024-10-01 | $102.41 | $102.41 | RVU24D |
| 2024-07-01 | $102.41 | $102.41 | RVU24C |
| 2024-04-01 | $102.41 | $102.41 | RVU24B |
| 2024-03-09 | $102.41 | $102.41 | RVU24AR |
| 2024-01-01 | $100.74 | $100.74 | RVU24A |
| 2023-10-01 | $103.81 | $103.81 | RVU23D |
| 2023-07-01 | $103.81 | $103.81 | RVU23C |
| 2023-04-01 | $103.81 | $103.81 | RVU23B |
| 2023-01-01 | $103.81 | $103.81 | RVU23A |
| 2022-10-01 | $104.25 | $104.25 | RVU22D |
| 2022-07-01 | $104.25 | $104.25 | RVU22C |
| 2022-04-01 | $104.25 | $104.25 | RVU22B |
| 2022-01-01 | $104.25 | $104.25 | RVU22A |
| 2021-10-01 | $104.07 | $104.07 | RVU21D |
| 2021-07-01 | $104.07 | $104.07 | RVU21C |
| 2021-04-01 | $104.07 | $104.07 | RVU21B |
| 2021-01-01 | $104.07 | $104.07 | RVU21A |
| 2020-10-01 | $105.12 | $105.12 | RVU20D |
| 2020-07-01 | $105.12 | $105.12 | RVU20C |
| 2020-04-01 | $105.12 | $105.12 | RVU20B |
| 2020-01-01 | $105.12 | $105.12 | RVU20A |
| 2019-10-01 | $102.71 | $102.71 | RVU19D |
| 2019-07-01 | $102.71 | $102.71 | RVU19C |
| 2019-04-01 | $102.71 | $102.71 | RVU19B |
| 2019-01-01 | $102.71 | $102.71 | RVU19A |
| 2018-10-01 | $101.26 | $101.26 | RVU18D |
| 2018-07-01 | $101.26 | $101.26 | RVU18C |
| 2018-04-01 | $101.26 | $101.26 | RVU18B |
| 2018-01-01 | $101.26 | $101.26 | RVU18AR1 |
| 2017-10-01 | $100.45 | $100.45 | RVU17D |
| 2017-07-01 | $100.45 | $100.45 | RVU17C |
| 2017-04-01 | $100.45 | $100.45 | RVU17B |
| 2017-01-01 | $100.45 | $100.45 | RVU17A |
| 2016-10-01 | $99.68 | $99.68 | RVU16D |
| 2016-07-01 | $99.68 | $99.68 | RVU16C |
| 2016-04-01 | $99.68 | $99.68 | RVU16B |
| 2016-01-01 | $99.68 | $99.68 | RVU16A |
| 2015-10-01 | $99.31 | $99.31 | RVU15D |
| 2015-07-01 | $99.31 | $99.31 | RVU15C |
| 2015-04-01 | $98.82 | $98.82 | RVU15B |
| 2015-01-01 | $98.82 | $98.82 | RVU15A |
| 2014-10-01 | $98.53 | $98.53 | RVU14D |
| 2014-07-01 | $98.53 | $98.53 | RVU14C |
| 2014-04-01 | $98.53 | $98.53 | RVU14B |
| 2014-01-01 | $98.53 | $98.53 | RVU14A |
| 2013-10-01 | $94.22 | $94.22 | RVU13D |
| 2013-07-01 | $94.22 | $94.22 | RVU13C |
| 2013-04-01 | $94.22 | $94.22 | RVU13B |
| 2013-01-01 | $94.22 | $94.22 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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