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CPT code 77435: SBRT management, per treatment course2026 Medicare rate & RVUs in Houston, TX

Reports the radiation oncologist’s professional management of an SBRT treatment course, including oversight for one or more targeted lesions.

CMS RVU26DEffective Oct 1, 2026One payment locality53.3K Medicare services in 2024

In Houston, TX, Medicare pays $654.37 for 77435 in the office and $654.37 when it’s performed in a hospital or facility.

$654.37Office (non-facility)
$654.37Hospital or facility
+2.0%vs the national office rate ($641.30)

Check a contract rate as a % of Medicare · 77435 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 77435 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 77435 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 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.

How Houston, TX compares for 77435

Across 109 of 109 payment localities, the office rate for 77435 runs from $594.79 in Arkansas to $835.29 in Alaska. Houston, TX pays $654.37. The RVUs are the same everywhere; the geographic indexes change the dollars.

77435 in Houston, TX vs other payment areas
  1. Houston, TX · this page$654.37
  2. Austin, TX · Texas$651.57−$2.80
  3. Beaumont, TX · Texas$618.94−$35.43
  4. Brazoria, TX · Texas$635.61−$18.76
  5. Dallas, TX · Texas$639.52−$14.85
  6. Fort Worth, TX · Texas$637.67−$16.70
  7. Galveston, TX · Texas$637.53−$16.84

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

77435 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$626.89$626.89
Los Angeles, CACalifornia$687.83$687.83
Washington, DC areaDistrict of Columbia$705.53$705.53
Miami, FLFlorida$697.47$697.47
Chicago, ILIllinois$684.92$684.92
Manhattan, NYNew York$720.34$720.34
AlaskaAlaska$835.29$835.29
AlabamaAlabama$599.95$599.95

77435 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
77435 office rate range by state
State / territoryOffice rate rangeLocalities
AK$835.291
AL$599.951
AR$594.791
AZ$629.921
CA$655.12–$768.6129
CO$653.551
CT$672.741
DC$705.531
DE$637.441
FL$646.89–$697.473
GA$622.99–$652.222
GU$659.061
HI$659.061
IA$603.721
ID$607.171
IL$639.10–$684.924
IN$609.141
KS$604.541
KY$613.811
LA$614.23–$632.252
MA$653.12–$697.242
MD$645.33–$705.533
ME$611.75–$627.942
MI$625.76–$654.532
MN$626.161
MO$609.57–$630.603
MS$602.121
MT$641.241
NC$615.191
ND$623.041
NE$604.931
NH$646.651
NJ$680.35–$703.592
NM$628.871
NV$636.391
NY$620.96–$734.725
OH$622.041
OK$610.461
OR$631.27–$664.492
PA$621.23–$663.372
PR$643.301
RI$652.721
SC$619.651
SD$620.891
TN$606.671
TX$618.94–$654.378
UT$624.721
VA$628.45–$705.532
VI$643.301
VT$623.881
WA$650.86–$705.872
WI$610.621
WV$625.181
WY$633.311

See 77435 in every payment locality

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

Office or facility?

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.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,107

Code
77435
Physician work
11.57
Practice expense
6.71
Malpractice
0.92

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 77435 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work11.57× 1.00811.6626
Practice expense6.71× 0.9936.6630
Malpractice0.92× 1.3761.2659
Total RVUs19.5915
Conversion factor× 33.4009

Office rate, Houston, TX$654.37

Office: (11.57 × 1.008 + 6.71 × 0.993 + 0.92 × 1.376) × $33.4009 = $654.37

Facility: (11.57 × 1.008 + 6.71 × 0.993 + 0.92 × 1.376) × $33.4009 = $654.37

Open 77435 in the RVU calculator

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

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.

Codes related to 77435

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 77435
CodeHow it relatesOffice range, Houston, TX
Includes component
77373SBRT delivery, per fraction, up to fiveSeparate SBRT delivery service, reported by fraction; 77435 represents physician course management.$974.99
Used instead
77432Stereotactic management, cranial, single-session courseManagement code for a complete single-session stereotactic treatment of cranial lesions.$432.89
77427Radiation treatment management, per five treatment fractionsRadiation management reported in five-treatment units rather than for an SBRT course.$199.04

How 77435 has changed in Houston, TX

77435 · Office / nonfacility

$654.37

Effective 2026-10-01

The base rate is $6.71 higher than on 2025-10-01, moving from $647.66 to $654.37 (1.0%).

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

    $647.66changed to$654.37

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 11.87 changed to 11.57
    • Practice expense RVU 6.67 changed to 6.71
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $656.89changed to$647.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.34 changed to 6.67
    • Malpractice RVU 0.95 changed to 0.92

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $646.17changed to$656.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $664.33changed to$646.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.31 changed to 6.34
    • Malpractice RVU 0.91 changed to 0.95
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $664.94changed to$664.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.99 changed to 6.31
    • Malpractice RVU 0.89 changed to 0.91
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $663.05changed to$664.94

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.81 changed to 5.99
    • Malpractice RVU 0.86 changed to 0.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $675.30changed to$663.05

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.64 changed to 5.81
    • Malpractice RVU 0.85 changed to 0.86
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $663.81changed to$675.30

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.46 changed to 5.64
    • Malpractice RVU 0.84 changed to 0.85
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $657.59changed to$663.81

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.30 changed to 5.46
    • Malpractice RVU 0.85 changed to 0.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $650.59changed to$657.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.17 changed to 5.30
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $645.46changed to$650.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.08 changed to 5.17
    • Malpractice RVU 0.86 changed to 0.85
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $642.60changed to$645.46

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.87 changed to 5.08
    • Malpractice RVU 0.93 changed to 0.86

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $639.40changed to$642.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $638.28changed to$639.40

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.95 changed to 0.93
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $606.99changed to$638.28

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.94 changed to 4.87
    • Malpractice RVU 0.99 changed to 0.95
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $606.99

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$654.37$654.37RVU26D
2026-07-01$654.37$654.37RVU26C
2026-04-01$654.37$654.37RVU26B
2026-01-01$654.37$654.37RVU26A
2025-10-01$647.66$647.66RVU25D
2025-07-01$647.66$647.66RVU25C
2025-04-01$647.66$647.66RVU25B
2025-01-01$647.66$647.66RVU25A
2024-10-01$656.89$656.89RVU24D
2024-07-01$656.89$656.89RVU24C
2024-04-01$656.89$656.89RVU24B
2024-03-09$656.89$656.89RVU24AR
2024-01-01$646.17$646.17RVU24A
2023-10-01$664.33$664.33RVU23D
2023-07-01$664.33$664.33RVU23C
2023-04-01$664.33$664.33RVU23B
2023-01-01$664.33$664.33RVU23A
2022-10-01$664.94$664.94RVU22D
2022-07-01$664.94$664.94RVU22C
2022-04-01$664.94$664.94RVU22B
2022-01-01$664.94$664.94RVU22A
2021-10-01$663.05$663.05RVU21D
2021-07-01$663.05$663.05RVU21C
2021-04-01$663.05$663.05RVU21B
2021-01-01$663.05$663.05RVU21A
2020-10-01$675.30$675.30RVU20D
2020-07-01$675.30$675.30RVU20C
2020-04-01$675.30$675.30RVU20B
2020-01-01$675.30$675.30RVU20A
2019-10-01$663.81$663.81RVU19D
2019-07-01$663.81$663.81RVU19C
2019-04-01$663.81$663.81RVU19B
2019-01-01$663.81$663.81RVU19A
2018-10-01$657.59$657.59RVU18D
2018-07-01$657.59$657.59RVU18C
2018-04-01$657.59$657.59RVU18B
2018-01-01$657.59$657.59RVU18AR1
2017-10-01$650.59$650.59RVU17D
2017-07-01$650.59$650.59RVU17C
2017-04-01$650.59$650.59RVU17B
2017-01-01$650.59$650.59RVU17A
2016-10-01$645.46$645.46RVU16D
2016-07-01$645.46$645.46RVU16C
2016-04-01$645.46$645.46RVU16B
2016-01-01$645.46$645.46RVU16A
2015-10-01$642.60$642.23RVU15D
2015-07-01$642.60$642.23RVU15C
2015-04-01$639.40$639.04RVU15B
2015-01-01$639.40$639.04RVU15A
2014-10-01$638.28$638.28RVU14D
2014-07-01$638.28$638.28RVU14C
2014-04-01$638.28$638.28RVU14B
2014-01-01$638.28$638.28RVU14A
2013-10-01$606.99$606.99RVU13D
2013-07-01$606.99$606.99RVU13C
2013-04-01$606.99$606.99RVU13B
2013-01-01$606.99$606.99RVU13AR

Price 77435 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 77435PPRRVU2026_Oct_nonQPP.csv, line 9,107 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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