CPT code 77470: Special radiation, additional treatment complexity2026 Medicare rate & RVUs in South Dakota
Reports additional work for an unusual or complex radiation treatment circumstance, such as total body irradiation or radiation delivered with concurrent chemotherapy.
In South Dakota, Medicare pays $142.74 for 77470 in the office.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $142.74. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$142.74
- Los Angeles, CA · California$160.36+$17.62
- Washington, DC area · District of Columbia$162.35+$19.61
- Miami, FL · Florida$153.16+$10.42
- Chicago, IL · Illinois$150.13+$7.39
- Manhattan, NY · New York$163.38+$20.64
- Alaska · Alaska$181.43+$38.69
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $151.78 | — |
| Merced, CACalifornia | $151.78 | — |
| Modesto, CACalifornia | $151.78 | — |
| Napa, CACalifornia | $171.49 | — |
| Oxnard, CACalifornia | $159.29 | — |
| Redding, CACalifornia | $151.78 | — |
| Rest of CaliforniaCalifornia | $151.78 | — |
| Riverside, CACalifornia | $152.91 | — |
| Sacramento, CACalifornia | $158.10 | — |
| Salinas, CACalifornia | $157.46 | — |
| San Diego, CACalifornia | $160.21 | — |
| Marin County, CACalifornia | $180.38 | — |
| San Francisco, CACalifornia | $180.27 | — |
| San Benito County, CACalifornia | $184.05 | — |
| Santa Clara County, CACalifornia | $183.59 | — |
| San Luis Obispo, CACalifornia | $155.03 | — |
| Santa Cruz, CACalifornia | $161.03 | — |
| Santa Maria, CACalifornia | $157.79 | — |
| Santa Rosa, CACalifornia | $162.60 | — |
| Stockton, CACalifornia | $151.78 | — |
| Vallejo, CACalifornia | $171.32 | — |
| Visalia, CACalifornia | $151.78 | — |
| Yuba City, CACalifornia | $151.78 | — |
| ColoradoColorado | $149.85 | — |
| ConnecticutConnecticut | $152.80 | — |
| DelawareDelaware | $144.05 | — |
| Fort Lauderdale, FLFlorida | $148.64 | — |
| Rest of FloridaFlorida | $143.32 | — |
| Atlanta, GAGeorgia | $147.04 | — |
| Rest of GeorgiaGeorgia | $137.45 | — |
| Hawaii, Guam, HIHawaii | $153.90 | — |
| IowaIowa | $136.53 | — |
| IdahoIdaho | $137.16 | — |
| East St. Louis, ILIllinois | $142.31 | — |
| Rest of IllinoisIllinois | $140.27 | — |
| Suburban Chicago, ILIllinois | $150.04 | — |
| IndianaIndiana | $137.73 | — |
| KansasKansas | $136.06 | — |
| KentuckyKentucky | $136.30 | — |
| New Orleans, LALouisiana | $140.96 | — |
| Rest of LouisianaLouisiana | $136.14 | — |
| Metropolitan Boston, MAMassachusetts | $161.95 | — |
| Rest of MassachusettsMassachusetts | $149.34 | — |
| Baltimore area, MDMaryland | $152.32 | — |
| Rest of MarylandMaryland | $146.25 | — |
| Rest of MaineMaine | $137.66 | — |
| Southern Maine, MEMaine | $143.05 | — |
| Detroit, MIMichigan | $144.61 | — |
| Rest of MichiganMichigan | $138.82 | — |
| MinnesotaMinnesota | $144.80 | — |
| Metropolitan Kansas City, MOMissouri | $140.28 | — |
| Metropolitan St. Louis, MOMissouri | $141.34 | — |
| Rest of MissouriMissouri | $134.46 | — |
| MississippiMississippi | $133.60 | — |
| MontanaMontana | $144.95 | — |
| North CarolinaNorth Carolina | $138.70 | — |
| North DakotaNorth Dakota | $142.98 | — |
| NebraskaNebraska | $137.07 | — |
| New HampshireNew Hampshire | $147.64 | — |
| Northern New JerseyNew Jersey | $161.43 | — |
| Rest of New JerseyNew Jersey | $154.87 | — |
| New MexicoNew Mexico | $139.37 | — |
| NevadaNevada | $144.48 | — |
| NYC suburbs and Long Island, NYNew York | $166.32 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $155.81 | — |
| Queens, NYNew York | $164.41 | — |
| Rest of New YorkNew York | $140.19 | — |
| OhioOhio | $138.42 | — |
| OklahomaOklahoma | $136.14 | — |
| Portland, OROregon | $153.54 | — |
| Rest of OregonOregon | $143.67 | — |
| Metropolitan Philadelphia, PAPennsylvania | $149.89 | — |
| Rest of PennsylvaniaPennsylvania | $138.59 | — |
| Puerto RicoPuerto Rico | $145.74 | — |
| Rhode IslandRhode Island | $148.35 | — |
| South CarolinaSouth Carolina | $138.72 | — |
| TennesseeTennessee | $136.54 | — |
| Austin, TXTexas | $149.09 | — |
| Beaumont, TXTexas | $137.93 | — |
| Brazoria, TXTexas | $144.07 | — |
| Dallas, TXTexas | $144.78 | — |
| Fort Worth, TXTexas | $144.07 | — |
| Galveston, TXTexas | $144.39 | — |
| Houston, TXTexas | $146.22 | — |
| Rest of TexasTexas | $140.79 | — |
| UtahUtah | $140.09 | — |
| VirginiaVirginia | $142.69 | — |
| Virgin Islands, VIUnited States Virgin Islands | $145.74 | — |
| VermontVermont | $142.56 | — |
| Rest of WashingtonWashington | $149.02 | — |
| King County, WAWashington | $164.79 | — |
| WisconsinWisconsin | $139.48 | — |
| West VirginiaWest Virginia | $136.51 | — |
| WyomingWyoming | $144.09 | — |
77470 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.
$132.70
$181.43
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 | $181.43 | 1 |
| AL | $134.07 | 1 |
| AR | $132.70 | 1 |
| AZ | $142.14 | 1 |
| CA | $151.78–$184.05 | 29 |
| CO | $149.85 | 1 |
| CT | $152.80 | 1 |
| DC | $162.35 | 1 |
| DE | $144.05 | 1 |
| FL | $143.32–$153.16 | 3 |
| GA | $137.45–$147.04 | 2 |
| GU | $153.90 | 1 |
| HI | $153.90 | 1 |
| IA | $136.53 | 1 |
| ID | $137.16 | 1 |
| IL | $140.27–$150.13 | 4 |
| IN | $137.73 | 1 |
| KS | $136.06 | 1 |
| KY | $136.30 | 1 |
| LA | $136.14–$140.96 | 2 |
| MA | $149.34–$161.95 | 2 |
| MD | $146.25–$162.35 | 3 |
| ME | $137.66–$143.05 | 2 |
| MI | $138.82–$144.61 | 2 |
| MN | $144.80 | 1 |
| MO | $134.46–$141.34 | 3 |
| MS | $133.60 | 1 |
| MT | $144.95 | 1 |
| NC | $138.70 | 1 |
| ND | $142.98 | 1 |
| NE | $137.07 | 1 |
| NH | $147.64 | 1 |
| NJ | $154.87–$161.43 | 2 |
| NM | $139.37 | 1 |
| NV | $144.48 | 1 |
| NY | $140.19–$166.32 | 5 |
| OH | $138.42 | 1 |
| OK | $136.14 | 1 |
| OR | $143.67–$153.54 | 2 |
| PA | $138.59–$149.89 | 2 |
| PR | $145.74 | 1 |
| RI | $148.35 | 1 |
| SC | $138.72 | 1 |
| SD | $142.74 | 1 |
| TN | $136.54 | 1 |
| TX | $137.93–$149.09 | 8 |
| UT | $140.09 | 1 |
| VA | $142.69–$162.35 | 2 |
| VI | $145.74 | 1 |
| VT | $142.56 | 1 |
| WA | $149.02–$164.79 | 2 |
| WI | $139.48 | 1 |
| WV | $136.51 | 1 |
| WY | $144.09 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.98 | × 1.000 | 1.9800 |
| Practice expense | 2.26 | × 1.000 | 2.2600 |
| Malpractice | 0.10 | × 0.336 | 0.0336 |
| Total RVUs | 4.2736 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$142.74
Office: (1.98 × 1 + 2.26 × 1 + 0.1 × 0.336) × $33.4009 = $142.74
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
| 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 | 1 | Diagnostic 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.
How 77470 has changed in South Dakota
77470 · Office / nonfacility
$142.74
Effective 2026-10-01
The base rate is $2.41 higher than on 2025-10-01, moving from $140.33 to $142.74 (1.7%).
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
$140.33changed to$142.74
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$139.54changed to$140.33
- 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.
March 9, 2024
RVU24AR
$137.26changed to$139.54
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$138.05changed to$137.26
- 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
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$135.47changed to$138.05
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$132.41changed to$135.47
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.73 changed to 1.85
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$134.50changed to$132.41
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.66 changed to 1.73
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$132.94changed to$134.50
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.62 changed to 1.66
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$137.84changed to$132.94
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.76 changed to 1.62
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$144.61changed to$137.84
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.96 changed to 1.76
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$155.53changed to$144.61
- 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
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$154.08changed to$155.53
- 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.
July 1, 2015
RVU15C
$153.32changed to$154.08
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$152.81changed to$153.32
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$149.28changed to$152.81
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.25 changed to 2.13
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $149.28
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $142.74 | Not available in this setting | RVU26D |
| 2026-07-01 | $142.74 | Not available in this setting | RVU26C |
| 2026-04-01 | $142.74 | Not available in this setting | RVU26B |
| 2026-01-01 | $142.74 | Not available in this setting | RVU26A |
| 2025-10-01 | $140.33 | Not available in this setting | RVU25D |
| 2025-07-01 | $140.33 | Not available in this setting | RVU25C |
| 2025-04-01 | $140.33 | Not available in this setting | RVU25B |
| 2025-01-01 | $140.33 | Not available in this setting | RVU25A |
| 2024-10-01 | $139.54 | Not available in this setting | RVU24D |
| 2024-07-01 | $139.54 | Not available in this setting | RVU24C |
| 2024-04-01 | $139.54 | Not available in this setting | RVU24B |
| 2024-03-09 | $139.54 | Not available in this setting | RVU24AR |
| 2024-01-01 | $137.26 | Not available in this setting | RVU24A |
| 2023-10-01 | $138.05 | Not available in this setting | RVU23D |
| 2023-07-01 | $138.05 | Not available in this setting | RVU23C |
| 2023-04-01 | $138.05 | Not available in this setting | RVU23B |
| 2023-01-01 | $138.05 | Not available in this setting | RVU23A |
| 2022-10-01 | $135.47 | Not available in this setting | RVU22D |
| 2022-07-01 | $135.47 | Not available in this setting | RVU22C |
| 2022-04-01 | $135.47 | Not available in this setting | RVU22B |
| 2022-01-01 | $135.47 | Not available in this setting | RVU22A |
| 2021-10-01 | $132.41 | Not available in this setting | RVU21D |
| 2021-07-01 | $132.41 | Not available in this setting | RVU21C |
| 2021-04-01 | $132.41 | Not available in this setting | RVU21B |
| 2021-01-01 | $132.41 | Not available in this setting | RVU21A |
| 2020-10-01 | $134.50 | Not available in this setting | RVU20D |
| 2020-07-01 | $134.50 | Not available in this setting | RVU20C |
| 2020-04-01 | $134.50 | Not available in this setting | RVU20B |
| 2020-01-01 | $134.50 | Not available in this setting | RVU20A |
| 2019-10-01 | $132.94 | Not available in this setting | RVU19D |
| 2019-07-01 | $132.94 | Not available in this setting | RVU19C |
| 2019-04-01 | $132.94 | Not available in this setting | RVU19B |
| 2019-01-01 | $132.94 | Not available in this setting | RVU19A |
| 2018-10-01 | $137.84 | Not available in this setting | RVU18D |
| 2018-07-01 | $137.84 | Not available in this setting | RVU18C |
| 2018-04-01 | $137.84 | Not available in this setting | RVU18B |
| 2018-01-01 | $137.84 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $144.61 | Not available in this setting | RVU17D |
| 2017-07-01 | $144.61 | Not available in this setting | RVU17C |
| 2017-04-01 | $144.61 | Not available in this setting | RVU17B |
| 2017-01-01 | $144.61 | Not available in this setting | RVU17A |
| 2016-10-01 | $155.53 | Not available in this setting | RVU16D |
| 2016-07-01 | $155.53 | Not available in this setting | RVU16C |
| 2016-04-01 | $155.53 | Not available in this setting | RVU16B |
| 2016-01-01 | $155.53 | Not available in this setting | RVU16A |
| 2015-10-01 | $154.08 | Not available in this setting | RVU15D |
| 2015-07-01 | $154.08 | Not available in this setting | RVU15C |
| 2015-04-01 | $153.32 | Not available in this setting | RVU15B |
| 2015-01-01 | $153.32 | Not available in this setting | RVU15A |
| 2014-10-01 | $152.81 | Not available in this setting | RVU14D |
| 2014-07-01 | $152.81 | Not available in this setting | RVU14C |
| 2014-04-01 | $152.81 | Not available in this setting | RVU14B |
| 2014-01-01 | $152.81 | Not available in this setting | RVU14A |
| 2013-10-01 | $149.28 | Not available in this setting | RVU13D |
| 2013-07-01 | $149.28 | Not available in this setting | RVU13C |
| 2013-04-01 | $149.28 | Not available in this setting | RVU13B |
| 2013-01-01 | $149.28 | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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