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CPT code 77470: Special radiation, additional treatment complexity2026 Medicare rate & RVUs in Iowa

Reports additional work for an unusual or complex radiation treatment circumstance, such as total body irradiation or radiation delivered with concurrent chemotherapy.

CMS RVU26DEffective Oct 1, 2026One payment locality83.5K Medicare services in 2024

In Iowa, Medicare pays $136.53 for 77470 in the office.

$136.53Office (non-facility)
Not available in this settingHospital or facility
−5.8%vs the national office rate ($144.96)

Check a contract rate as a % of Medicare · 77470 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 77470 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 77470 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 77470 covers

A radiation oncologist reports this service when a treatment circumstance requires substantial work beyond the usual radiation planning and treatment process. Examples include total body irradiation, hemibody irradiation, hyperthermia combined with radiation, or coordinating radiation with concurrent chemotherapy. The added work may involve specialized preparation, coordination, or treatment considerations; the specific circumstance and work performed should be evident in the record.

Report 77470 for the additional special-treatment work, not as a substitute for applicable radiation delivery or management services. Documentation should explain why the case required extra effort and describe the work attributable to that circumstance. CMS identifies professional and technical components: modifier 26 represents the professional interpretation, modifier TC represents equipment and staff, and an unmodified claim represents the global service. CMS lists both modifiers as separately priced.

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 Iowa compares for 77470

Across 109 of 109 payment localities, the office rate for 77470 runs from $132.70 in Arkansas to $184.05 in San Benito County, CA. Iowa pays $136.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

77470 in Iowa vs other payment areas
  1. Iowa · this page$136.53
  2. Los Angeles, CA · California$160.36+$23.83
  3. Washington, DC area · District of Columbia$162.35+$25.82
  4. Miami, FL · Florida$153.16+$16.63
  5. Chicago, IL · Illinois$150.13+$13.60
  6. Manhattan, NY · New York$163.38+$26.85
  7. Alaska · Alaska$181.43+$44.90

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

Every other payment area

77470 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$134.07—
ArkansasArkansas$132.70—
ArizonaArizona$142.14—
Bakersfield, CACalifornia$152.16—
Chico, CACalifornia$151.78—
El Centro, CACalifornia$151.80—
Fresno, CACalifornia$151.78—
Hanford, CACalifornia$151.78—

77470 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.

$132.70

$181.43

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
77470 office rate range by state
State / territoryOffice rate rangeLocalities
AK$181.431
AL$134.071
AR$132.701
AZ$142.141
CA$151.78–$184.0529
CO$149.851
CT$152.801
DC$162.351
DE$144.051
FL$143.32–$153.163
GA$137.45–$147.042
GU$153.901
HI$153.901
IA$136.531
ID$137.161
IL$140.27–$150.134
IN$137.731
KS$136.061
KY$136.301
LA$136.14–$140.962
MA$149.34–$161.952
MD$146.25–$162.353
ME$137.66–$143.052
MI$138.82–$144.612
MN$144.801
MO$134.46–$141.343
MS$133.601
MT$144.951
NC$138.701
ND$142.981
NE$137.071
NH$147.641
NJ$154.87–$161.432
NM$139.371
NV$144.481
NY$140.19–$166.325
OH$138.421
OK$136.141
OR$143.67–$153.542
PA$138.59–$149.892
PR$145.741
RI$148.351
SC$138.721
SD$142.741
TN$136.541
TX$137.93–$149.098
UT$140.091
VA$142.69–$162.352
VI$145.741
VT$142.561
WA$149.02–$164.792
WI$139.481
WV$136.511
WY$144.091

See 77470 in every payment locality

How the 77470 rate is calculated

Each of 77470’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 · 77470

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.98

1.98 RVUs× 1.000 GPCI

Practice expense2.26

2.26 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

4.3400

Conversion factor

$33.4009

Medicare rate

$144.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,117

Code
77470
Physician work
1.98
Practice expense
2.26
Malpractice
0.10

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 77470 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.98× 1.0001.9800
Practice expense2.26× 0.9152.0679
Malpractice0.10× 0.3970.0397
Total RVUs4.0876
Conversion factor× 33.4009

Office rate, Iowa$136.53

Office: (1.98 × 1 + 2.26 × 0.915 + 0.1 × 0.397) × $33.4009 = $136.53

Open 77470 in the RVU calculator

Payment rules and modifiers for 77470

The CMS indicators that decide how 77470 is paid alongside other services.

CMS payment indicators · 77470

Special radiation, additional treatment complexity

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/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

77470 without 26 · national office

$144.96

Special radiation, additional treatment complexity

77470-26 · Professional component

$106.21

Pays only the interpretation and report.

When to use modifier 26

Codes related to 77470

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

Codes related to 77470
CodeHow it relatesOffice range, Iowa
Often billed with
77402Radiation delivery, level 1Level 1 radiation delivery may accompany separately documented special-treatment work.$74.84
77407Radiation delivery, level 2Level 2 radiation delivery may accompany separately documented special-treatment work.$282.58
77412Radiation delivery, complex treatmentLevel 3 radiation delivery may accompany separately documented special-treatment work.$404.65

How 77470 has changed in Iowa

77470 · Office / nonfacility

$136.53

Effective 2026-10-01

The base rate is $2.35 higher than on 2025-10-01, moving from $134.18 to $136.53 (1.8%).

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

    $134.18changed to$136.53

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.03 changed to 1.98
    • Practice expense RVU 2.27 changed to 2.26
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $133.68changed to$134.18

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.12 changed to 2.27
    • Malpractice RVU 0.11 changed to 0.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $131.50changed to$133.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $132.26changed to$131.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.00 changed to 2.12
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $129.79changed to$132.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.85 changed to 2.00
    • Malpractice RVU 0.10 changed to 0.12
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $127.07changed to$129.79

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.73 changed to 1.85

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $129.13changed to$127.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.66 changed to 1.73
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $127.64changed to$129.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.62 changed to 1.66
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $132.07changed to$127.64

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.76 changed to 1.62

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $137.95changed to$132.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.96 changed to 1.76
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $147.67changed to$137.95

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.09 changed to 2.03
    • Practice expense RVU 2.21 changed to 1.96
    • Malpractice RVU 0.11 changed to 0.10
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $146.45changed to$147.67

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.15 changed to 2.21
    • Malpractice RVU 0.12 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $145.72changed to$146.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $144.80changed to$145.72

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.13 changed to 2.15
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $140.72changed to$144.80

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.25 changed to 2.13
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $140.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$136.53Not available in this settingRVU26D
2026-07-01$136.53Not available in this settingRVU26C
2026-04-01$136.53Not available in this settingRVU26B
2026-01-01$136.53Not available in this settingRVU26A
2025-10-01$134.18Not available in this settingRVU25D
2025-07-01$134.18Not available in this settingRVU25C
2025-04-01$134.18Not available in this settingRVU25B
2025-01-01$134.18Not available in this settingRVU25A
2024-10-01$133.68Not available in this settingRVU24D
2024-07-01$133.68Not available in this settingRVU24C
2024-04-01$133.68Not available in this settingRVU24B
2024-03-09$133.68Not available in this settingRVU24AR
2024-01-01$131.50Not available in this settingRVU24A
2023-10-01$132.26Not available in this settingRVU23D
2023-07-01$132.26Not available in this settingRVU23C
2023-04-01$132.26Not available in this settingRVU23B
2023-01-01$132.26Not available in this settingRVU23A
2022-10-01$129.79Not available in this settingRVU22D
2022-07-01$129.79Not available in this settingRVU22C
2022-04-01$129.79Not available in this settingRVU22B
2022-01-01$129.79Not available in this settingRVU22A
2021-10-01$127.07Not available in this settingRVU21D
2021-07-01$127.07Not available in this settingRVU21C
2021-04-01$127.07Not available in this settingRVU21B
2021-01-01$127.07Not available in this settingRVU21A
2020-10-01$129.13Not available in this settingRVU20D
2020-07-01$129.13Not available in this settingRVU20C
2020-04-01$129.13Not available in this settingRVU20B
2020-01-01$129.13Not available in this settingRVU20A
2019-10-01$127.64Not available in this settingRVU19D
2019-07-01$127.64Not available in this settingRVU19C
2019-04-01$127.64Not available in this settingRVU19B
2019-01-01$127.64Not available in this settingRVU19A
2018-10-01$132.07Not available in this settingRVU18D
2018-07-01$132.07Not available in this settingRVU18C
2018-04-01$132.07Not available in this settingRVU18B
2018-01-01$132.07Not available in this settingRVU18AR1
2017-10-01$137.95Not available in this settingRVU17D
2017-07-01$137.95Not available in this settingRVU17C
2017-04-01$137.95Not available in this settingRVU17B
2017-01-01$137.95Not available in this settingRVU17A
2016-10-01$147.67Not available in this settingRVU16D
2016-07-01$147.67Not available in this settingRVU16C
2016-04-01$147.67Not available in this settingRVU16B
2016-01-01$147.67Not available in this settingRVU16A
2015-10-01$146.45Not available in this settingRVU15D
2015-07-01$146.45Not available in this settingRVU15C
2015-04-01$145.72Not available in this settingRVU15B
2015-01-01$145.72Not available in this settingRVU15A
2014-10-01$144.80Not available in this settingRVU14D
2014-07-01$144.80Not available in this settingRVU14C
2014-04-01$144.80Not available in this settingRVU14B
2014-01-01$144.80Not available in this settingRVU14A
2013-10-01$140.72Not available in this settingRVU13D
2013-07-01$140.72Not available in this settingRVU13C
2013-04-01$140.72Not available in this settingRVU13B
2013-01-01$140.72Not available in this settingRVU13AR

Price 77470 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

77470 billing questions

How is 77470 different from a radiation delivery code?

77470 represents additional work tied to a special treatment circumstance. Codes such as 77402, 77407, and 77412 describe radiation treatment delivery at different levels.

Can 77470 be reported with radiation delivery?

It may be reported with the applicable delivery service when the record supports additional special-treatment work. It does not replace the code for treatment delivery.

What documentation supports 77470?

Document the unusual treatment circumstance, why it required work beyond the usual process, and the additional work performed. Naming a complex diagnosis alone does not explain the service.

When should modifier 26 or TC be used?

CMS identifies modifier 26 for the professional interpretation and modifier TC for equipment and staff. Without either modifier, the claim represents the global service.

Is 77470 the code for routine radiation treatment management?

No. Routine management is represented by applicable management services, such as 77427 for radiation treatment management reported in five-treatment increments. 77470 addresses added work for a special treatment circumstance.

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 77470PPRRVU2026_Oct_nonQPP.csv, line 9,117 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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