CPT code 77435: SBRT management, per treatment course2026 Medicare rate & RVUs
Reports the radiation oncologist’s professional management of an SBRT treatment course, including oversight for one or more targeted lesions.
Medicare pays $641.30 for 77435 nationally in the office and $641.30 in a hospital or facility. Local office rates run $594.79–$835.29.
Medicare rate · 77435
SBRT management, per treatment course
- Work RVUs
- 11.57
- Total RVUs
- 19.20
- Global days
- XXX
National rate · 2026
$641.30
Office setting, before claim adjustments.
See every locality for 77435 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 77435 covers
77435 represents the radiation oncologist’s management of a stereotactic body radiation therapy course, rather than delivery of each radiation fraction. The physician oversees treatment for one or more targeted lesions, reviews the patient’s progress and treatment information, and addresses clinical issues during the course. SBRT is commonly used for carefully targeted tumors, including lesions in the lung, liver, or spine. Radiation oncologists typically provide this service in hospital outpatient departments and freestanding radiation oncology centers.
Report 77435 once for the treatment course, not once per lesion or fraction. Documentation should identify the SBRT course and lesions treated and support the physician’s management of the patient during treatment. CMS classifies 77435 as professional-component-only: it represents the physician’s interpretation and report, while a separate code covers the technical service. The SBRT delivery service is reported separately with 77373 when appropriate; 77435 is not the fraction-by-fraction delivery 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.
Where 77435 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$594.79 to $835.29
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $599.95 | $599.95 |
| Alaska | $835.29 | $835.29 |
| Arizona | $629.92 | $629.92 |
| Arkansas | $594.79 | $594.79 |
| Atlanta, GA | $652.22 | $652.22 |
| Austin, TX | $651.57 | $651.57 |
| Bakersfield, CA | $658.14 | $658.14 |
| Baltimore area, MD | $671.12 | $671.12 |
| Beaumont, TX | $618.94 | $618.94 |
| Brazoria, TX | $635.61 | $635.61 |
| Chicago, IL | $684.92 | $684.92 |
| Chico, CA | $655.12 | $655.12 |
| Colorado | $653.55 | $653.55 |
| Connecticut | $672.74 | $672.74 |
| Dallas, TX | $639.52 | $639.52 |
| Delaware | $637.44 | $637.44 |
| Detroit, MI | $654.53 | $654.53 |
| East St. Louis, IL | $654.53 | $654.53 |
| El Centro, CA | $655.28 | $655.28 |
| Fort Lauderdale, FL | $669.04 | $669.04 |
| Fort Worth, TX | $637.67 | $637.67 |
| Fresno, CA | $655.12 | $655.12 |
| Galveston, TX | $637.53 | $637.53 |
| Hanford, CA | $655.12 | $655.12 |
| Hawaii, Guam, HI | $659.06 | $659.06 |
| Houston, TX | $654.37 | $654.37 |
| Idaho | $607.17 | $607.17 |
| Indiana | $609.14 | $609.14 |
| Iowa | $603.72 | $603.72 |
| Kansas | $604.54 | $604.54 |
| Kentucky | $613.81 | $613.81 |
| King County, WA | $705.87 | $705.87 |
| Los Angeles, CA | $687.83 | $687.83 |
| Madera, CA | $655.12 | $655.12 |
| Manhattan, NY | $720.34 | $720.34 |
| Marin County, CA | $753.27 | $753.27 |
| Merced, CA | $655.12 | $655.12 |
| Metropolitan Boston, MA | $697.24 | $697.24 |
| Metropolitan Kansas City, MO | $626.92 | $626.92 |
| Metropolitan Philadelphia, PA | $663.37 | $663.37 |
| Metropolitan St. Louis, MO | $630.60 | $630.60 |
| Miami, FL | $697.47 | $697.47 |
| Minnesota | $626.16 | $626.16 |
| Mississippi | $602.12 | $602.12 |
| Modesto, CA | $655.12 | $655.12 |
| Montana | $641.24 | $641.24 |
| Napa, CA | $721.80 | $721.80 |
| Nebraska | $604.93 | $604.93 |
| Nevada | $636.39 | $636.39 |
| New Hampshire | $646.65 | $646.65 |
| New Mexico | $628.87 | $628.87 |
| New Orleans, LA | $632.25 | $632.25 |
| North Carolina | $615.19 | $615.19 |
| North Dakota | $623.04 | $623.04 |
| Northern New Jersey | $703.59 | $703.59 |
| NYC suburbs and Long Island, NY | $734.72 | $734.72 |
| Ohio | $622.04 | $622.04 |
| Oklahoma | $610.46 | $610.46 |
| Oxnard, CA | $681.32 | $681.32 |
| Portland, OR | $664.49 | $664.49 |
| Poughkeepsie and northern NYC suburbs, NY | $686.43 | $686.43 |
| Puerto Rico | $643.30 | $643.30 |
| Queens, NY | $720.40 | $720.40 |
| Redding, CA | $655.12 | $655.12 |
| Rest of California | $655.12 | $655.12 |
| Rest of Florida | $646.89 | $646.89 |
| Rest of Georgia | $622.99 | $622.99 |
| Rest of Illinois | $639.10 | $639.10 |
| Rest of Louisiana | $614.23 | $614.23 |
| Rest of Maine | $611.75 | $611.75 |
| Rest of Maryland | $645.33 | $645.33 |
| Rest of Massachusetts | $653.12 | $653.12 |
| Rest of Michigan | $625.76 | $625.76 |
| Rest of Missouri | $609.57 | $609.57 |
| Rest of New Jersey | $680.35 | $680.35 |
| Rest of New York | $620.96 | $620.96 |
| Rest of Oregon | $631.27 | $631.27 |
| Rest of Pennsylvania | $621.23 | $621.23 |
| Rest of Texas | $626.89 | $626.89 |
| Rest of Washington | $650.86 | $650.86 |
| Rhode Island | $652.72 | $652.72 |
| Riverside, CA | $665.25 | $665.25 |
| Sacramento, CA | $677.48 | $677.48 |
| Salinas, CA | $674.65 | $674.65 |
| San Benito County, CA | $768.61 | $768.61 |
| San Diego, CA | $682.74 | $682.74 |
| San Francisco, CA | $752.23 | $752.23 |
| San Luis Obispo, CA | $664.76 | $664.76 |
| Santa Clara County, CA | $764.34 | $764.34 |
| Santa Cruz, CA | $683.34 | $683.34 |
| Santa Maria, CA | $675.06 | $675.06 |
| Santa Rosa, CA | $689.73 | $689.73 |
| South Carolina | $619.65 | $619.65 |
| South Dakota | $620.89 | $620.89 |
| Southern Maine, ME | $627.94 | $627.94 |
| Stockton, CA | $655.12 | $655.12 |
| Suburban Chicago, IL | $673.78 | $673.78 |
| Tennessee | $606.67 | $606.67 |
| Utah | $624.72 | $624.72 |
| Vallejo, CA | $720.29 | $720.29 |
| Vermont | $623.88 | $623.88 |
| Virgin Islands, VI | $643.30 | $643.30 |
| Virginia | $628.45 | $628.45 |
| Visalia, CA | $655.12 | $655.12 |
| Washington, DC area | $705.53 | $705.53 |
| West Virginia | $625.18 | $625.18 |
| Wisconsin | $610.62 | $610.62 |
| Wyoming | $633.31 | $633.31 |
| Yuba City, CA | $655.12 | $655.12 |
77435 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.
$594.79
$835.29
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 | $835.29 | 1 |
| AL | $599.95 | 1 |
| AR | $594.79 | 1 |
| AZ | $629.92 | 1 |
| CA | $655.12–$768.61 | 29 |
| CO | $653.55 | 1 |
| CT | $672.74 | 1 |
| DC | $705.53 | 1 |
| DE | $637.44 | 1 |
| FL | $646.89–$697.47 | 3 |
| GA | $622.99–$652.22 | 2 |
| GU | $659.06 | 1 |
| HI | $659.06 | 1 |
| IA | $603.72 | 1 |
| ID | $607.17 | 1 |
| IL | $639.10–$684.92 | 4 |
| IN | $609.14 | 1 |
| KS | $604.54 | 1 |
| KY | $613.81 | 1 |
| LA | $614.23–$632.25 | 2 |
| MA | $653.12–$697.24 | 2 |
| MD | $645.33–$705.53 | 3 |
| ME | $611.75–$627.94 | 2 |
| MI | $625.76–$654.53 | 2 |
| MN | $626.16 | 1 |
| MO | $609.57–$630.60 | 3 |
| MS | $602.12 | 1 |
| MT | $641.24 | 1 |
| NC | $615.19 | 1 |
| ND | $623.04 | 1 |
| NE | $604.93 | 1 |
| NH | $646.65 | 1 |
| NJ | $680.35–$703.59 | 2 |
| NM | $628.87 | 1 |
| NV | $636.39 | 1 |
| NY | $620.96–$734.72 | 5 |
| OH | $622.04 | 1 |
| OK | $610.46 | 1 |
| OR | $631.27–$664.49 | 2 |
| PA | $621.23–$663.37 | 2 |
| PR | $643.30 | 1 |
| RI | $652.72 | 1 |
| SC | $619.65 | 1 |
| SD | $620.89 | 1 |
| TN | $606.67 | 1 |
| TX | $618.94–$654.37 | 8 |
| UT | $624.72 | 1 |
| VA | $628.45–$705.53 | 2 |
| VI | $643.30 | 1 |
| VT | $623.88 | 1 |
| WA | $650.86–$705.87 | 2 |
| WI | $610.62 | 1 |
| WV | $625.18 | 1 |
| WY | $633.31 | 1 |
How the 77435 rate is calculated
Each of 77435’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 · 77435
RVUs × geographic indexes × conversion factor
Work11.57
11.57 RVUs× 1.000 GPCI
Practice expense6.71
6.71 RVUs× 1.000 GPCI
Malpractice0.92
0.92 RVUs× 1.000 GPCI
Adjusted RVUs
19.2000
Conversion factor
$33.4009
Medicare rate
$641.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77435
The CMS indicators that decide how 77435 is paid alongside other services.
CMS payment indicators · 77435
SBRT management, per treatment 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. |
77435 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77373SBRT deliveryPer fraction, up to five
- 77373 reports SBRT treatment delivery by fraction. 77435 reports the physician’s professional management of the treatment course.
- 77432Stereotactic managementCranial, single-session course
- 77432 applies to management of a complete one-session stereotactic treatment for cranial lesions; 77435 describes SBRT course management.
- 77427Radiation treatment managementPer five treatment fractions
- 77427 is used for radiation management counted in five-treatment units. 77435 is specific to management of an SBRT course.
77435 billing questions
Is 77435 reported per fraction or per treatment course?
Report it for the SBRT treatment course, not for each delivery fraction. The number of lesions treated does not create additional units of 77435.
How does 77435 differ from 77373?
77435 represents the radiation oncologist’s professional management of the course. 77373 reports SBRT treatment delivery by fraction.
Should modifier 26 be appended to 77435?
No. CMS identifies 77435 as professional-component-only, so modifier 26 is not needed to designate its professional service. The technical service is reported separately.
Can 77435 be reported for a single-session cranial stereotactic treatment?
Compare the clinical service with 77432, which describes management of a complete one-session stereotactic treatment for cranial lesions. 77435 is for SBRT course management.
When would 77427 be considered instead?
77427 describes radiation treatment management in a five-treatment unit for conventional radiation therapy. Use 77435 for management of an SBRT course, not routine management counted in five-treatment units.
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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