CPT code 77435: SBRT management, per treatment course2026 Medicare rate & RVUs in Virginia
Reports the radiation oncologist’s professional management of an SBRT treatment course, including oversight for one or more targeted lesions.
In Virginia, Medicare pays $628.45 for 77435 in the office and $628.45 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How Virginia 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. Virginia pays $628.45. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$628.45
- Los Angeles, CA · California$687.83+$59.38
- Washington, DC area · District of Columbia$705.53+$77.08
- Miami, FL · Florida$697.47+$69.02
- Chicago, IL · Illinois$684.92+$56.47
- Manhattan, NY · New York$720.34+$91.89
- Alaska · Alaska$835.29+$206.84
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $599.95 | $599.95 |
| ArkansasArkansas | $594.79 | $594.79 |
| ArizonaArizona | $629.92 | $629.92 |
| Bakersfield, CACalifornia | $658.14 | $658.14 |
| Chico, CACalifornia | $655.12 | $655.12 |
| El Centro, CACalifornia | $655.28 | $655.28 |
| Fresno, CACalifornia | $655.12 | $655.12 |
| Hanford, CACalifornia | $655.12 | $655.12 |
| Madera, CACalifornia | $655.12 | $655.12 |
| Merced, CACalifornia | $655.12 | $655.12 |
| Modesto, CACalifornia | $655.12 | $655.12 |
| Napa, CACalifornia | $721.80 | $721.80 |
| Oxnard, CACalifornia | $681.32 | $681.32 |
| Redding, CACalifornia | $655.12 | $655.12 |
| Rest of CaliforniaCalifornia | $655.12 | $655.12 |
| Riverside, CACalifornia | $665.25 | $665.25 |
| Sacramento, CACalifornia | $677.48 | $677.48 |
| Salinas, CACalifornia | $674.65 | $674.65 |
| San Diego, CACalifornia | $682.74 | $682.74 |
| Marin County, CACalifornia | $753.27 | $753.27 |
| San Francisco, CACalifornia | $752.23 | $752.23 |
| San Benito County, CACalifornia | $768.61 | $768.61 |
| Santa Clara County, CACalifornia | $764.34 | $764.34 |
| San Luis Obispo, CACalifornia | $664.76 | $664.76 |
| Santa Cruz, CACalifornia | $683.34 | $683.34 |
| Santa Maria, CACalifornia | $675.06 | $675.06 |
| Santa Rosa, CACalifornia | $689.73 | $689.73 |
| Stockton, CACalifornia | $655.12 | $655.12 |
| Vallejo, CACalifornia | $720.29 | $720.29 |
| Visalia, CACalifornia | $655.12 | $655.12 |
| Yuba City, CACalifornia | $655.12 | $655.12 |
| ColoradoColorado | $653.55 | $653.55 |
| ConnecticutConnecticut | $672.74 | $672.74 |
| DelawareDelaware | $637.44 | $637.44 |
| Fort Lauderdale, FLFlorida | $669.04 | $669.04 |
| Rest of FloridaFlorida | $646.89 | $646.89 |
| Atlanta, GAGeorgia | $652.22 | $652.22 |
| Rest of GeorgiaGeorgia | $622.99 | $622.99 |
| Hawaii, Guam, HIHawaii | $659.06 | $659.06 |
| IowaIowa | $603.72 | $603.72 |
| IdahoIdaho | $607.17 | $607.17 |
| East St. Louis, ILIllinois | $654.53 | $654.53 |
| Rest of IllinoisIllinois | $639.10 | $639.10 |
| Suburban Chicago, ILIllinois | $673.78 | $673.78 |
| IndianaIndiana | $609.14 | $609.14 |
| KansasKansas | $604.54 | $604.54 |
| KentuckyKentucky | $613.81 | $613.81 |
| New Orleans, LALouisiana | $632.25 | $632.25 |
| Rest of LouisianaLouisiana | $614.23 | $614.23 |
| Metropolitan Boston, MAMassachusetts | $697.24 | $697.24 |
| Rest of MassachusettsMassachusetts | $653.12 | $653.12 |
| Baltimore area, MDMaryland | $671.12 | $671.12 |
| Rest of MarylandMaryland | $645.33 | $645.33 |
| Rest of MaineMaine | $611.75 | $611.75 |
| Southern Maine, MEMaine | $627.94 | $627.94 |
| Detroit, MIMichigan | $654.53 | $654.53 |
| Rest of MichiganMichigan | $625.76 | $625.76 |
| MinnesotaMinnesota | $626.16 | $626.16 |
| Metropolitan Kansas City, MOMissouri | $626.92 | $626.92 |
| Metropolitan St. Louis, MOMissouri | $630.60 | $630.60 |
| Rest of MissouriMissouri | $609.57 | $609.57 |
| MississippiMississippi | $602.12 | $602.12 |
| MontanaMontana | $641.24 | $641.24 |
| North CarolinaNorth Carolina | $615.19 | $615.19 |
| North DakotaNorth Dakota | $623.04 | $623.04 |
| NebraskaNebraska | $604.93 | $604.93 |
| New HampshireNew Hampshire | $646.65 | $646.65 |
| Northern New JerseyNew Jersey | $703.59 | $703.59 |
| Rest of New JerseyNew Jersey | $680.35 | $680.35 |
| New MexicoNew Mexico | $628.87 | $628.87 |
| NevadaNevada | $636.39 | $636.39 |
| NYC suburbs and Long Island, NYNew York | $734.72 | $734.72 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $686.43 | $686.43 |
| Queens, NYNew York | $720.40 | $720.40 |
| Rest of New YorkNew York | $620.96 | $620.96 |
| OhioOhio | $622.04 | $622.04 |
| OklahomaOklahoma | $610.46 | $610.46 |
| Portland, OROregon | $664.49 | $664.49 |
| Rest of OregonOregon | $631.27 | $631.27 |
| Metropolitan Philadelphia, PAPennsylvania | $663.37 | $663.37 |
| Rest of PennsylvaniaPennsylvania | $621.23 | $621.23 |
| Puerto RicoPuerto Rico | $643.30 | $643.30 |
| Rhode IslandRhode Island | $652.72 | $652.72 |
| South CarolinaSouth Carolina | $619.65 | $619.65 |
| South DakotaSouth Dakota | $620.89 | $620.89 |
| TennesseeTennessee | $606.67 | $606.67 |
| Austin, TXTexas | $651.57 | $651.57 |
| Beaumont, TXTexas | $618.94 | $618.94 |
| Brazoria, TXTexas | $635.61 | $635.61 |
| Dallas, TXTexas | $639.52 | $639.52 |
| Fort Worth, TXTexas | $637.67 | $637.67 |
| Galveston, TXTexas | $637.53 | $637.53 |
| Houston, TXTexas | $654.37 | $654.37 |
| Rest of TexasTexas | $626.89 | $626.89 |
| UtahUtah | $624.72 | $624.72 |
| Virgin Islands, VIUnited States Virgin Islands | $643.30 | $643.30 |
| VermontVermont | $623.88 | $623.88 |
| Rest of WashingtonWashington | $650.86 | $650.86 |
| King County, WAWashington | $705.87 | $705.87 |
| WisconsinWisconsin | $610.62 | $610.62 |
| West VirginiaWest Virginia | $625.18 | $625.18 |
| WyomingWyoming | $633.31 | $633.31 |
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.
The exact Virginia 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
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.57 | × 1.000 | 11.5700 |
| Practice expense | 6.71 | × 0.983 | 6.5959 |
| Malpractice | 0.92 | × 0.706 | 0.6495 |
| Total RVUs | 18.8154 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$628.45
Office: (11.57 × 1 + 6.71 × 0.983 + 0.92 × 0.706) × $33.4009 = $628.45
Facility: (11.57 × 1 + 6.71 × 0.983 + 0.92 × 0.706) × $33.4009 = $628.45
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. |
How 77435 has changed in Virginia
77435 · Office / nonfacility
$628.45
Effective 2026-10-01
The base rate is $8.96 higher than on 2025-10-01, moving from $619.49 to $628.45 (1.4%).
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
$619.49changed to$628.45
- 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 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$627.45changed to$619.49
- 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.
March 9, 2024
RVU24AR
$617.21changed to$627.45
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$639.40changed to$617.21
- 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 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$644.66changed to$639.40
- 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
- Practice expense GPCI 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$642.81changed to$644.66
- 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.
January 1, 2021
RVU21A
$657.80changed to$642.81
- 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
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$649.29changed to$657.80
- 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
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$643.23changed to$649.29
- 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.
January 1, 2018
RVU18AR1
$635.18changed to$643.23
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 5.17 changed to 5.30
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$629.16changed to$635.18
- 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
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$626.09changed to$629.16
- 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.
July 1, 2015
RVU15C
$622.97changed to$626.09
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$622.66changed to$622.97
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.95 changed to 0.93
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$592.68changed to$622.66
- 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
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $592.68
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $628.45 | $628.45 | RVU26D |
| 2026-07-01 | $628.45 | $628.45 | RVU26C |
| 2026-04-01 | $628.45 | $628.45 | RVU26B |
| 2026-01-01 | $628.45 | $628.45 | RVU26A |
| 2025-10-01 | $619.49 | $619.49 | RVU25D |
| 2025-07-01 | $619.49 | $619.49 | RVU25C |
| 2025-04-01 | $619.49 | $619.49 | RVU25B |
| 2025-01-01 | $619.49 | $619.49 | RVU25A |
| 2024-10-01 | $627.45 | $627.45 | RVU24D |
| 2024-07-01 | $627.45 | $627.45 | RVU24C |
| 2024-04-01 | $627.45 | $627.45 | RVU24B |
| 2024-03-09 | $627.45 | $627.45 | RVU24AR |
| 2024-01-01 | $617.21 | $617.21 | RVU24A |
| 2023-10-01 | $639.40 | $639.40 | RVU23D |
| 2023-07-01 | $639.40 | $639.40 | RVU23C |
| 2023-04-01 | $639.40 | $639.40 | RVU23B |
| 2023-01-01 | $639.40 | $639.40 | RVU23A |
| 2022-10-01 | $644.66 | $644.66 | RVU22D |
| 2022-07-01 | $644.66 | $644.66 | RVU22C |
| 2022-04-01 | $644.66 | $644.66 | RVU22B |
| 2022-01-01 | $644.66 | $644.66 | RVU22A |
| 2021-10-01 | $642.81 | $642.81 | RVU21D |
| 2021-07-01 | $642.81 | $642.81 | RVU21C |
| 2021-04-01 | $642.81 | $642.81 | RVU21B |
| 2021-01-01 | $642.81 | $642.81 | RVU21A |
| 2020-10-01 | $657.80 | $657.80 | RVU20D |
| 2020-07-01 | $657.80 | $657.80 | RVU20C |
| 2020-04-01 | $657.80 | $657.80 | RVU20B |
| 2020-01-01 | $657.80 | $657.80 | RVU20A |
| 2019-10-01 | $649.29 | $649.29 | RVU19D |
| 2019-07-01 | $649.29 | $649.29 | RVU19C |
| 2019-04-01 | $649.29 | $649.29 | RVU19B |
| 2019-01-01 | $649.29 | $649.29 | RVU19A |
| 2018-10-01 | $643.23 | $643.23 | RVU18D |
| 2018-07-01 | $643.23 | $643.23 | RVU18C |
| 2018-04-01 | $643.23 | $643.23 | RVU18B |
| 2018-01-01 | $643.23 | $643.23 | RVU18AR1 |
| 2017-10-01 | $635.18 | $635.18 | RVU17D |
| 2017-07-01 | $635.18 | $635.18 | RVU17C |
| 2017-04-01 | $635.18 | $635.18 | RVU17B |
| 2017-01-01 | $635.18 | $635.18 | RVU17A |
| 2016-10-01 | $629.16 | $629.16 | RVU16D |
| 2016-07-01 | $629.16 | $629.16 | RVU16C |
| 2016-04-01 | $629.16 | $629.16 | RVU16B |
| 2016-01-01 | $629.16 | $629.16 | RVU16A |
| 2015-10-01 | $626.09 | $625.74 | RVU15D |
| 2015-07-01 | $626.09 | $625.74 | RVU15C |
| 2015-04-01 | $622.97 | $622.62 | RVU15B |
| 2015-01-01 | $622.97 | $622.62 | RVU15A |
| 2014-10-01 | $622.66 | $622.66 | RVU14D |
| 2014-07-01 | $622.66 | $622.66 | RVU14C |
| 2014-04-01 | $622.66 | $622.66 | RVU14B |
| 2014-01-01 | $622.66 | $622.66 | RVU14A |
| 2013-10-01 | $592.68 | $592.68 | RVU13D |
| 2013-07-01 | $592.68 | $592.68 | RVU13C |
| 2013-04-01 | $592.68 | $592.68 | RVU13B |
| 2013-01-01 | $592.68 | $592.68 | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
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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