CPT code 77432: Stereotactic management, cranial, single-session course2026 Medicare rate & RVUs in Puerto Rico
Report physician management for a complete, single-session stereotactic radiation course targeting one or more cranial lesions.
In Puerto Rico, Medicare pays $425.49 for 77432 in the office and $425.49 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 77432 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 77432 covers
77432 represents physician management of a complete stereotactic radiation course delivered in one session to one or more cranial lesions. It is used in stereotactic radiosurgery, commonly for intracranial targets treated by a radiation oncology team. The code describes the physician’s professional work, not the equipment-based delivery of radiation.
Select this code when the cranial stereotactic treatment course is completed in one session; a different management code is used for stereotactic body radiation therapy. Documentation should identify the cranial target or targets, the single-session course, and the physician’s management, interpretation, and report. CMS classifies 77432 as professional-component-only: the physician claim covers interpretation and report, while a separate code covers the technical portion of treatment delivery.
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 77432
Across 109 of 109 payment localities, the office rate for 77432 runs from $393.73 in Arkansas to $553.46 in Alaska. Puerto Rico pays $425.49. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$425.49
- Los Angeles, CA · California$454.63+$29.14
- Washington, DC area · District of Columbia$466.40+$40.91
- Miami, FL · Florida$461.33+$35.84
- Chicago, IL · Illinois$453.11+$27.62
- Manhattan, NY · New York$476.28+$50.79
- Alaska · Alaska$553.46+$127.97
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $397.10 | $397.10 |
| ArkansasArkansas | $393.73 | $393.73 |
| ArizonaArizona | $416.73 | $416.73 |
| Bakersfield, CACalifornia | $435.14 | $435.14 |
| Chico, CACalifornia | $433.13 | $433.13 |
| El Centro, CACalifornia | $433.24 | $433.24 |
| Fresno, CACalifornia | $433.13 | $433.13 |
| Hanford, CACalifornia | $433.13 | $433.13 |
| Madera, CACalifornia | $433.13 | $433.13 |
| Merced, CACalifornia | $433.13 | $433.13 |
| Modesto, CACalifornia | $433.13 | $433.13 |
| Napa, CACalifornia | $476.83 | $476.83 |
| Oxnard, CACalifornia | $450.30 | $450.30 |
| Redding, CACalifornia | $433.13 | $433.13 |
| Rest of CaliforniaCalifornia | $433.13 | $433.13 |
| Riverside, CACalifornia | $439.85 | $439.85 |
| Sacramento, CACalifornia | $447.81 | $447.81 |
| Salinas, CACalifornia | $445.94 | $445.94 |
| San Diego, CACalifornia | $451.20 | $451.20 |
| Marin County, CACalifornia | $497.51 | $497.51 |
| San Francisco, CACalifornia | $496.82 | $496.82 |
| San Benito County, CACalifornia | $507.62 | $507.62 |
| Santa Clara County, CACalifornia | $504.78 | $504.78 |
| San Luis Obispo, CACalifornia | $439.41 | $439.41 |
| Santa Cruz, CACalifornia | $451.53 | $451.53 |
| Santa Maria, CACalifornia | $446.19 | $446.19 |
| Santa Rosa, CACalifornia | $455.75 | $455.75 |
| Stockton, CACalifornia | $433.13 | $433.13 |
| Vallejo, CACalifornia | $475.83 | $475.83 |
| Visalia, CACalifornia | $433.13 | $433.13 |
| Yuba City, CACalifornia | $433.13 | $433.13 |
| ColoradoColorado | $432.17 | $432.17 |
| ConnecticutConnecticut | $444.87 | $444.87 |
| DelawareDelaware | $421.67 | $421.67 |
| Fort Lauderdale, FLFlorida | $442.55 | $442.55 |
| Rest of FloridaFlorida | $428.02 | $428.02 |
| Atlanta, GAGeorgia | $431.40 | $431.40 |
| Rest of GeorgiaGeorgia | $412.34 | $412.34 |
| Hawaii, Guam, HIHawaii | $435.61 | $435.61 |
| IowaIowa | $399.50 | $399.50 |
| IdahoIdaho | $401.78 | $401.78 |
| East St. Louis, ILIllinois | $433.17 | $433.17 |
| Rest of IllinoisIllinois | $422.96 | $422.96 |
| Suburban Chicago, ILIllinois | $445.67 | $445.67 |
| IndianaIndiana | $403.06 | $403.06 |
| KansasKansas | $400.07 | $400.07 |
| KentuckyKentucky | $406.26 | $406.26 |
| New Orleans, LALouisiana | $418.35 | $418.35 |
| Rest of LouisianaLouisiana | $406.55 | $406.55 |
| Metropolitan Boston, MAMassachusetts | $460.84 | $460.84 |
| Rest of MassachusettsMassachusetts | $431.92 | $431.92 |
| Baltimore area, MDMaryland | $443.80 | $443.80 |
| Rest of MarylandMaryland | $426.85 | $426.85 |
| Rest of MaineMaine | $404.81 | $404.81 |
| Southern Maine, MEMaine | $415.36 | $415.36 |
| Detroit, MIMichigan | $433.06 | $433.06 |
| Rest of MichiganMichigan | $414.12 | $414.12 |
| MinnesotaMinnesota | $414.08 | $414.08 |
| Metropolitan Kansas City, MOMissouri | $414.82 | $414.82 |
| Metropolitan St. Louis, MOMissouri | $417.23 | $417.23 |
| Rest of MissouriMissouri | $403.52 | $403.52 |
| MississippiMississippi | $398.58 | $398.58 |
| MontanaMontana | $424.15 | $424.15 |
| North CarolinaNorth Carolina | $407.06 | $407.06 |
| North DakotaNorth Dakota | $412.09 | $412.09 |
| NebraskaNebraska | $400.28 | $400.28 |
| New HampshireNew Hampshire | $427.63 | $427.63 |
| Northern New JerseyNew Jersey | $465.18 | $465.18 |
| Rest of New JerseyNew Jersey | $449.91 | $449.91 |
| New MexicoNew Mexico | $416.17 | $416.17 |
| NevadaNevada | $420.93 | $420.93 |
| NYC suburbs and Long Island, NYNew York | $485.74 | $485.74 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $453.94 | $453.94 |
| Queens, NYNew York | $476.26 | $476.26 |
| Rest of New YorkNew York | $410.84 | $410.84 |
| OhioOhio | $411.66 | $411.66 |
| OklahomaOklahoma | $404.03 | $404.03 |
| Portland, OROregon | $439.30 | $439.30 |
| Rest of OregonOregon | $417.56 | $417.56 |
| Metropolitan Philadelphia, PAPennsylvania | $438.75 | $438.75 |
| Rest of PennsylvaniaPennsylvania | $411.10 | $411.10 |
| Rhode IslandRhode Island | $431.71 | $431.71 |
| South CarolinaSouth Carolina | $410.04 | $410.04 |
| South DakotaSouth Dakota | $410.66 | $410.66 |
| TennesseeTennessee | $401.48 | $401.48 |
| Austin, TXTexas | $430.85 | $430.85 |
| Beaumont, TXTexas | $409.61 | $409.61 |
| Brazoria, TXTexas | $420.46 | $420.46 |
| Dallas, TXTexas | $423.04 | $423.04 |
| Fort Worth, TXTexas | $421.84 | $421.84 |
| Galveston, TXTexas | $421.73 | $421.73 |
| Houston, TXTexas | $432.89 | $432.89 |
| Rest of TexasTexas | $414.77 | $414.77 |
| UtahUtah | $413.36 | $413.36 |
| VirginiaVirginia | $415.72 | $415.72 |
| Virgin Islands, VIUnited States Virgin Islands | $425.49 | $425.49 |
| VermontVermont | $412.67 | $412.67 |
| Rest of WashingtonWashington | $430.41 | $430.41 |
| King County, WAWashington | $466.49 | $466.49 |
| WisconsinWisconsin | $403.96 | $403.96 |
| West VirginiaWest Virginia | $413.85 | $413.85 |
| WyomingWyoming | $418.89 | $418.89 |
77432 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.
$393.73
$553.46
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 | $553.46 | 1 |
| AL | $397.10 | 1 |
| AR | $393.73 | 1 |
| AZ | $416.73 | 1 |
| CA | $433.13–$507.62 | 29 |
| CO | $432.17 | 1 |
| CT | $444.87 | 1 |
| DC | $466.40 | 1 |
| DE | $421.67 | 1 |
| FL | $428.02–$461.33 | 3 |
| GA | $412.34–$431.40 | 2 |
| GU | $435.61 | 1 |
| HI | $435.61 | 1 |
| IA | $399.50 | 1 |
| ID | $401.78 | 1 |
| IL | $422.96–$453.11 | 4 |
| IN | $403.06 | 1 |
| KS | $400.07 | 1 |
| KY | $406.26 | 1 |
| LA | $406.55–$418.35 | 2 |
| MA | $431.92–$460.84 | 2 |
| MD | $426.85–$466.40 | 3 |
| ME | $404.81–$415.36 | 2 |
| MI | $414.12–$433.06 | 2 |
| MN | $414.08 | 1 |
| MO | $403.52–$417.23 | 3 |
| MS | $398.58 | 1 |
| MT | $424.15 | 1 |
| NC | $407.06 | 1 |
| ND | $412.09 | 1 |
| NE | $400.28 | 1 |
| NH | $427.63 | 1 |
| NJ | $449.91–$465.18 | 2 |
| NM | $416.17 | 1 |
| NV | $420.93 | 1 |
| NY | $410.84–$485.74 | 5 |
| OH | $411.66 | 1 |
| OK | $404.03 | 1 |
| OR | $417.56–$439.30 | 2 |
| PA | $411.10–$438.75 | 2 |
| PR | $425.49 | 1 |
| RI | $431.71 | 1 |
| SC | $410.04 | 1 |
| SD | $410.66 | 1 |
| TN | $401.48 | 1 |
| TX | $409.61–$432.89 | 8 |
| UT | $413.36 | 1 |
| VA | $415.72–$466.40 | 2 |
| VI | $425.49 | 1 |
| VT | $412.67 | 1 |
| WA | $430.41–$466.49 | 2 |
| WI | $403.96 | 1 |
| WV | $413.85 | 1 |
| WY | $418.89 | 1 |
How the 77432 rate is calculated
Each of 77432’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 · 77432
RVUs × geographic indexes × conversion factor
Work7.72
7.72 RVUs× 1.000 GPCI
Practice expense4.37
4.37 RVUs× 1.000 GPCI
Malpractice0.61
0.61 RVUs× 1.000 GPCI
Adjusted RVUs
12.7000
Conversion factor
$33.4009
Medicare rate
$424.19
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
9,106
- Code
- 77432
- Physician work
- 7.72
- Practice expense
- 4.37
- Malpractice
- 0.61
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.72 | × 1.000 | 7.7200 |
| Practice expense | 4.37 | × 1.011 | 4.4181 |
| Malpractice | 0.61 | × 0.985 | 0.6008 |
| Total RVUs | 12.7389 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$425.49
Office: (7.72 × 1 + 4.37 × 1.011 + 0.61 × 0.985) × $33.4009 = $425.49
Facility: (7.72 × 1 + 4.37 × 1.011 + 0.61 × 0.985) × $33.4009 = $425.49
Payment rules and modifiers for 77432
The CMS indicators that decide how 77432 is paid alongside other services.
CMS payment indicators · 77432
Stereotactic management, cranial, single-session course
| 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 77432 has changed in Puerto Rico
77432 · Office / nonfacility
$425.49
Effective 2026-10-01
The base rate is $8.25 higher than on 2025-10-01, moving from $417.24 to $425.49 (2.0%).
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
$417.24changed to$425.49
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 7.92 changed to 7.72
- Practice expense RVU 4.33 changed to 4.37
- Malpractice RVU 0.63 changed to 0.61
- 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
$422.34changed to$417.24
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.12 changed to 4.33
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$415.44changed to$422.34
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$429.13changed to$415.44
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.60 changed to 0.63
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$428.33changed to$429.13
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$430.95changed to$428.33
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.91 changed to 4.12
- 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
$429.61changed to$430.95
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.79 changed to 3.91
- Malpractice RVU 0.58 changed to 0.60
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$439.67changed to$429.61
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.68 changed to 3.79
- Malpractice RVU 0.56 changed to 0.58
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$434.96changed to$439.67
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.56 changed to 3.68
- Malpractice RVU 0.57 changed to 0.56
- 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
$430.86changed to$434.96
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.46 changed to 3.56
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$401.13changed to$430.86
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.37 changed to 3.46
- Malpractice RVU 0.58 changed to 0.57
- 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
$373.21changed to$401.13
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.31 changed to 3.37
- 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
$371.43changed to$373.21
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.17 changed to 3.31
- Malpractice RVU 0.62 changed to 0.58
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$369.58changed to$371.43
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$368.32changed to$369.58
- 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
$349.25changed to$368.32
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.22 changed to 3.17
- Malpractice RVU 0.65 changed to 0.62
- 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: $349.25
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $425.49 | $425.49 | RVU26D |
| 2026-07-01 | $425.49 | $425.49 | RVU26C |
| 2026-04-01 | $425.49 | $425.49 | RVU26B |
| 2026-01-01 | $425.49 | $425.49 | RVU26A |
| 2025-10-01 | $417.24 | $417.24 | RVU25D |
| 2025-07-01 | $417.24 | $417.24 | RVU25C |
| 2025-04-01 | $417.24 | $417.24 | RVU25B |
| 2025-01-01 | $417.24 | $417.24 | RVU25A |
| 2024-10-01 | $422.34 | $422.34 | RVU24D |
| 2024-07-01 | $422.34 | $422.34 | RVU24C |
| 2024-04-01 | $422.34 | $422.34 | RVU24B |
| 2024-03-09 | $422.34 | $422.34 | RVU24AR |
| 2024-01-01 | $415.44 | $415.44 | RVU24A |
| 2023-10-01 | $429.13 | $429.13 | RVU23D |
| 2023-07-01 | $428.33 | $428.33 | RVU23C |
| 2023-04-01 | $428.33 | $428.33 | RVU23B |
| 2023-01-01 | $428.33 | $428.33 | RVU23A |
| 2022-10-01 | $430.95 | $430.95 | RVU22D |
| 2022-07-01 | $430.95 | $430.95 | RVU22C |
| 2022-04-01 | $430.95 | $430.95 | RVU22B |
| 2022-01-01 | $430.95 | $430.95 | RVU22A |
| 2021-10-01 | $429.61 | $429.61 | RVU21D |
| 2021-07-01 | $429.61 | $429.61 | RVU21C |
| 2021-04-01 | $429.61 | $429.61 | RVU21B |
| 2021-01-01 | $429.61 | $429.61 | RVU21A |
| 2020-10-01 | $439.67 | $439.67 | RVU20D |
| 2020-07-01 | $439.67 | $439.67 | RVU20C |
| 2020-04-01 | $439.67 | $439.67 | RVU20B |
| 2020-01-01 | $439.67 | $439.67 | RVU20A |
| 2019-10-01 | $434.96 | $434.96 | RVU19D |
| 2019-07-01 | $434.96 | $434.96 | RVU19C |
| 2019-04-01 | $434.96 | $434.96 | RVU19B |
| 2019-01-01 | $434.96 | $434.96 | RVU19A |
| 2018-10-01 | $430.86 | $430.86 | RVU18D |
| 2018-07-01 | $430.86 | $430.86 | RVU18C |
| 2018-04-01 | $430.86 | $430.86 | RVU18B |
| 2018-01-01 | $430.86 | $430.86 | RVU18AR1 |
| 2017-10-01 | $401.13 | $401.13 | RVU17D |
| 2017-07-01 | $401.13 | $401.13 | RVU17C |
| 2017-04-01 | $401.13 | $401.13 | RVU17B |
| 2017-01-01 | $401.13 | $401.13 | RVU17A |
| 2016-10-01 | $373.21 | $373.21 | RVU16D |
| 2016-07-01 | $373.21 | $373.21 | RVU16C |
| 2016-04-01 | $373.21 | $373.21 | RVU16B |
| 2016-01-01 | $373.21 | $373.21 | RVU16A |
| 2015-10-01 | $371.43 | $371.17 | RVU15D |
| 2015-07-01 | $371.43 | $371.17 | RVU15C |
| 2015-04-01 | $369.58 | $369.33 | RVU15B |
| 2015-01-01 | $369.58 | $369.33 | RVU15A |
| 2014-10-01 | $368.32 | $368.32 | RVU14D |
| 2014-07-01 | $368.32 | $368.32 | RVU14C |
| 2014-04-01 | $368.32 | $368.32 | RVU14B |
| 2014-01-01 | $368.32 | $368.32 | RVU14A |
| 2013-10-01 | $349.25 | $349.25 | RVU13D |
| 2013-07-01 | $349.25 | $349.25 | RVU13C |
| 2013-04-01 | $349.25 | $349.25 | RVU13B |
| 2013-01-01 | $349.25 | $349.25 | 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
77432 billing questions
When should 77432 be used instead of 77435?
Use 77432 for management of a complete, single-session stereotactic course for cranial lesions. 77435 is the management code associated with stereotactic body radiation therapy.
Is the radiation delivery included in 77432?
No. 77432 represents the professional interpretation and report; a separate code covers the technical treatment delivery.
Can 77432 be reported once for each cranial lesion?
The code describes management of the complete one-session course for one or more cranial lesions, not a separate unit for each lesion.
What documentation supports 77432?
Document the cranial target or targets, that the complete course was delivered in one session, and the physician’s management, interpretation, and report.
How does 77432 differ from 77371?
77432 is the professional management service. 77371 represents the technical delivery for a complete single-session cranial stereotactic radiosurgery course.
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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