CPT code 77768: Skin brachytherapy, surface field over 2 cm2026 Medicare rate & RVUs
Reports one fraction of high-dose-rate radionuclide brachytherapy delivered to skin through a surface applicator for a treated area greater than 2 cm.
Medicare pays $369.08 for 77768 nationally in the office. Local office rates run $322.00–$513.09.
Medicare rate · 77768
Skin brachytherapy, surface field over 2 cm
- Work RVUs
- 1.37
- Total RVUs
- 11.05
- Global days
- XXX
National rate · 2026
$369.08
Office setting, before claim adjustments.
See every locality for 77768 →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 77768 covers
Code 77768 represents a single fraction of high-dose-rate brachytherapy delivered to a skin lesion or lesions using a surface applicator, for a treated area greater than 2 cm in diameter. Radiation oncologists commonly use this approach for selected superficial skin cancers, such as basal cell carcinoma, when treatment is delivered with a high-dose-rate radionuclide source. The service includes the surface applicator and basic dosimetry; it is distinct from placing a source within a body cavity or tissue.
Report the code for each fraction that meets the size criterion, using the documented treatment field or applicator dimensions to support selection over 77767. The record should identify the treated site, fraction delivered, applicator or treatment dimensions, and dosimetry. CMS allows separate professional and technical component billing: modifier 26 identifies the professional component, modifier TC the technical component, and no modifier reports the global service. Basic dosimetry is included in the service.
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 77768 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
$322.00 to $513.09
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $327.32 | Unavailable |
| Alaska | $410.74 | Unavailable |
| Arizona | $358.57 | Unavailable |
| Arkansas | $322.00 | Unavailable |
| Atlanta, GA | $375.19 | Unavailable |
| Austin, TX | $387.18 | Unavailable |
| Bakersfield, CA | $398.87 | Unavailable |
| Baltimore area, MD | $394.13 | Unavailable |
| Beaumont, TX | $340.06 | Unavailable |
| Brazoria, TX | $365.62 | Unavailable |
| Chicago, IL | $376.62 | Unavailable |
| Chico, CA | $398.47 | Unavailable |
| Colorado | $389.09 | Unavailable |
| Connecticut | $395.47 | Unavailable |
| Dallas, TX | $367.60 | Unavailable |
| Delaware | $365.04 | Unavailable |
| Detroit, MI | $360.89 | Unavailable |
| East St. Louis, IL | $347.96 | Unavailable |
| El Centro, CA | $398.49 | Unavailable |
| Fort Lauderdale, FL | $376.74 | Unavailable |
| Fort Worth, TX | $364.47 | Unavailable |
| Fresno, CA | $398.47 | Unavailable |
| Galveston, TX | $366.47 | Unavailable |
| Hanford, CA | $398.47 | Unavailable |
| Hawaii, Guam, HI | $410.95 | Unavailable |
| Houston, TX | $368.85 | Unavailable |
| Idaho | $341.27 | Unavailable |
| Indiana | $343.56 | Unavailable |
| Iowa | $339.35 | Unavailable |
| Kansas | $336.30 | Unavailable |
| Kentucky | $333.30 | Unavailable |
| King County, WA | $442.98 | Unavailable |
| Los Angeles, CA | $427.87 | Unavailable |
| Madera, CA | $398.47 | Unavailable |
| Manhattan, NY | $426.23 | Unavailable |
| Marin County, CA | $501.86 | Unavailable |
| Merced, CA | $398.47 | Unavailable |
| Metropolitan Boston, MA | $432.36 | Unavailable |
| Metropolitan Kansas City, MO | $349.52 | Unavailable |
| Metropolitan Philadelphia, PA | $383.82 | Unavailable |
| Metropolitan St. Louis, MO | $353.78 | Unavailable |
| Miami, FL | $388.80 | Unavailable |
| Minnesota | $375.27 | Unavailable |
| Mississippi | $323.61 | Unavailable |
| Modesto, CA | $398.47 | Unavailable |
| Montana | $369.07 | Unavailable |
| Napa, CA | $471.26 | Unavailable |
| Nebraska | $341.82 | Unavailable |
| Nevada | $368.67 | Unavailable |
| New Hampshire | $381.62 | Unavailable |
| New Mexico | $343.48 | Unavailable |
| New Orleans, LA | $350.85 | Unavailable |
| North Carolina | $346.14 | Unavailable |
| North Dakota | $366.50 | Unavailable |
| Northern New Jersey | $423.29 | Unavailable |
| NYC suburbs and Long Island, NY | $436.02 | Unavailable |
| Ohio | $341.36 | Unavailable |
| Oklahoma | $333.98 | Unavailable |
| Oxnard, CA | $426.78 | Unavailable |
| Portland, OR | $404.11 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $402.35 | Unavailable |
| Puerto Rico | $372.52 | Unavailable |
| Queens, NY | $431.98 | Unavailable |
| Redding, CA | $398.47 | Unavailable |
| Rest of California | $398.47 | Unavailable |
| Rest of Florida | $357.23 | Unavailable |
| Rest of Georgia | $335.46 | Unavailable |
| Rest of Illinois | $343.77 | Unavailable |
| Rest of Louisiana | $332.22 | Unavailable |
| Rest of Maine | $341.92 | Unavailable |
| Rest of Maryland | $373.01 | Unavailable |
| Rest of Massachusetts | $385.84 | Unavailable |
| Rest of Michigan | $341.89 | Unavailable |
| Rest of Missouri | $324.95 | Unavailable |
| Rest of New Jersey | $400.68 | Unavailable |
| Rest of New York | $351.84 | Unavailable |
| Rest of Oregon | $366.51 | Unavailable |
| Rest of Pennsylvania | $342.68 | Unavailable |
| Rest of Texas | $352.39 | Unavailable |
| Rest of Washington | $385.54 | Unavailable |
| Rhode Island | $380.01 | Unavailable |
| Riverside, CA | $399.89 | Unavailable |
| Sacramento, CA | $420.71 | Unavailable |
| Salinas, CA | $419.20 | Unavailable |
| San Benito County, CA | $513.09 | Unavailable |
| San Diego, CA | $430.98 | Unavailable |
| San Francisco, CA | $501.71 | Unavailable |
| San Luis Obispo, CA | $412.18 | Unavailable |
| Santa Clara County, CA | $512.48 | Unavailable |
| Santa Cruz, CA | $436.61 | Unavailable |
| Santa Maria, CA | $421.30 | Unavailable |
| Santa Rosa, CA | $441.17 | Unavailable |
| South Carolina | $344.19 | Unavailable |
| South Dakota | $366.20 | Unavailable |
| Southern Maine, ME | $364.61 | Unavailable |
| Stockton, CA | $398.47 | Unavailable |
| Suburban Chicago, IL | $381.36 | Unavailable |
| Tennessee | $338.04 | Unavailable |
| Utah | $349.50 | Unavailable |
| Vallejo, CA | $471.05 | Unavailable |
| Vermont | $363.75 | Unavailable |
| Virgin Islands, VI | $372.52 | Unavailable |
| Virginia | $362.38 | Unavailable |
| Visalia, CA | $398.47 | Unavailable |
| Washington, DC area | $428.82 | Unavailable |
| West Virginia | $329.17 | Unavailable |
| Wisconsin | $352.68 | Unavailable |
| Wyoming | $367.95 | Unavailable |
| Yuba City, CA | $398.47 | Unavailable |
77768 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.
$322.00
$455.78
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 | $410.74 | 1 |
| AL | $327.32 | 1 |
| AR | $322.00 | 1 |
| AZ | $358.57 | 1 |
| CA | $398.47–$513.09 | 29 |
| CO | $389.09 | 1 |
| CT | $395.47 | 1 |
| DC | $428.82 | 1 |
| DE | $365.04 | 1 |
| FL | $357.23–$388.80 | 3 |
| GA | $335.46–$375.19 | 2 |
| GU | $410.95 | 1 |
| HI | $410.95 | 1 |
| IA | $339.35 | 1 |
| ID | $341.27 | 1 |
| IL | $343.77–$381.36 | 4 |
| IN | $343.56 | 1 |
| KS | $336.30 | 1 |
| KY | $333.30 | 1 |
| LA | $332.22–$350.85 | 2 |
| MA | $385.84–$432.36 | 2 |
| MD | $373.01–$428.82 | 3 |
| ME | $341.92–$364.61 | 2 |
| MI | $341.89–$360.89 | 2 |
| MN | $375.27 | 1 |
| MO | $324.95–$353.78 | 3 |
| MS | $323.61 | 1 |
| MT | $369.07 | 1 |
| NC | $346.14 | 1 |
| ND | $366.50 | 1 |
| NE | $341.82 | 1 |
| NH | $381.62 | 1 |
| NJ | $400.68–$423.29 | 2 |
| NM | $343.48 | 1 |
| NV | $368.67 | 1 |
| NY | $351.84–$436.02 | 5 |
| OH | $341.36 | 1 |
| OK | $333.98 | 1 |
| OR | $366.51–$404.11 | 2 |
| PA | $342.68–$383.82 | 2 |
| PR | $372.52 | 1 |
| RI | $380.01 | 1 |
| SC | $344.19 | 1 |
| SD | $366.20 | 1 |
| TN | $338.04 | 1 |
| TX | $340.06–$387.18 | 8 |
| UT | $349.50 | 1 |
| VA | $362.38–$428.82 | 2 |
| VI | $372.52 | 1 |
| VT | $363.75 | 1 |
| WA | $385.54–$442.98 | 2 |
| WI | $352.68 | 1 |
| WV | $329.17 | 1 |
| WY | $367.95 | 1 |
How the 77768 rate is calculated
Each of 77768’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 · 77768
RVUs × geographic indexes × conversion factor
Work1.37
1.37 RVUs× 1.000 GPCI
Practice expense9.55
9.55 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
11.0500
Conversion factor
$33.4009
Medicare rate
$369.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77768
The CMS indicators that decide how 77768 is paid alongside other services.
CMS payment indicators · 77768
Skin brachytherapy, surface field over 2 cm
| 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
77768 without 26 · national office
$369.08
Skin brachytherapy, surface field over 2 cm
77768-26 · Professional component
$73.82
Pays only the interpretation and report.
77768 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77767Skin brachytherapyOne channel
- This is the closest code: both report high-dose-rate skin surface brachytherapy per fraction. Choose 77768 for a treated area greater than 2 cm in diameter and 77767 for 2 cm or less.
- 77770HDR brachytherapySingle channel, per fraction
- 77770 describes high-dose-rate brachytherapy delivered interstitially or intracavitarily. Use 77768 when the source is applied to the skin surface.
- 77789Surface brachytherapyLow-dose-rate application
- 77789 concerns surface application of a radiation source using a different brachytherapy approach; 77768 is for high-dose-rate skin surface treatment per fraction.
77768 billing questions
How does 77768 differ from 77767?
Both report high-dose-rate skin surface brachytherapy per fraction. Use 77768 when the treated surface area is greater than 2 cm in diameter; 77767 is for 2 cm or less.
Is basic dosimetry separately reportable?
Basic dosimetry is included in 77768. The treatment documentation should support the dosimetry and the delivered fraction.
Can the professional and technical components be billed separately?
Yes. Modifier 26 identifies the professional component, and modifier TC identifies the technical component. Reporting without either modifier represents the global service.
Is the code reported once for the entire treatment course?
No. The code is reported per fraction, so the record should support each fraction delivered.
What documentation supports choosing 77768?
Document the skin treatment site, fraction delivered, and treated-field or applicator dimensions showing an area greater than 2 cm in diameter.
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
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