CPT code 77768: Skin brachytherapy, surface field over 2 cm2026 Medicare rate & RVUs in South Dakota
Reports one fraction of high-dose-rate radionuclide brachytherapy delivered to skin through a surface applicator for a treated area greater than 2 cm.
In South Dakota, Medicare pays $366.20 for 77768 in the office.
Check a contract rate as a % of Medicare · 77768 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 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.
How South Dakota compares for 77768
Across 109 of 109 payment localities, the office rate for 77768 runs from $322.00 in Arkansas to $513.09 in San Benito County, CA. South Dakota pays $366.20. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$366.20
- Los Angeles, CA · California$427.87+$61.67
- Washington, DC area · District of Columbia$428.82+$62.62
- Miami, FL · Florida$388.80+$22.60
- Chicago, IL · Illinois$376.62+$10.42
- Manhattan, NY · New York$426.23+$60.03
- Alaska · Alaska$410.74+$44.54
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $327.32 | — |
| ArkansasArkansas | $322.00 | — |
| ArizonaArizona | $358.57 | — |
| Bakersfield, CACalifornia | $398.87 | — |
| Chico, CACalifornia | $398.47 | — |
| El Centro, CACalifornia | $398.49 | — |
| Fresno, CACalifornia | $398.47 | — |
| Hanford, CACalifornia | $398.47 | — |
| Madera, CACalifornia | $398.47 | — |
| Merced, CACalifornia | $398.47 | — |
| Modesto, CACalifornia | $398.47 | — |
| Napa, CACalifornia | $471.26 | — |
| Oxnard, CACalifornia | $426.78 | — |
| Redding, CACalifornia | $398.47 | — |
| Rest of CaliforniaCalifornia | $398.47 | — |
| Riverside, CACalifornia | $399.89 | — |
| Sacramento, CACalifornia | $420.71 | — |
| Salinas, CACalifornia | $419.20 | — |
| San Diego, CACalifornia | $430.98 | — |
| Marin County, CACalifornia | $501.86 | — |
| San Francisco, CACalifornia | $501.71 | — |
| San Benito County, CACalifornia | $513.09 | — |
| Santa Clara County, CACalifornia | $512.48 | — |
| San Luis Obispo, CACalifornia | $412.18 | — |
| Santa Cruz, CACalifornia | $436.61 | — |
| Santa Maria, CACalifornia | $421.30 | — |
| Santa Rosa, CACalifornia | $441.17 | — |
| Stockton, CACalifornia | $398.47 | — |
| Vallejo, CACalifornia | $471.05 | — |
| Visalia, CACalifornia | $398.47 | — |
| Yuba City, CACalifornia | $398.47 | — |
| ColoradoColorado | $389.09 | — |
| ConnecticutConnecticut | $395.47 | — |
| DelawareDelaware | $365.04 | — |
| Fort Lauderdale, FLFlorida | $376.74 | — |
| Rest of FloridaFlorida | $357.23 | — |
| Atlanta, GAGeorgia | $375.19 | — |
| Rest of GeorgiaGeorgia | $335.46 | — |
| Hawaii, Guam, HIHawaii | $410.95 | — |
| IowaIowa | $339.35 | — |
| IdahoIdaho | $341.27 | — |
| East St. Louis, ILIllinois | $347.96 | — |
| Rest of IllinoisIllinois | $343.77 | — |
| Suburban Chicago, ILIllinois | $381.36 | — |
| IndianaIndiana | $343.56 | — |
| KansasKansas | $336.30 | — |
| KentuckyKentucky | $333.30 | — |
| New Orleans, LALouisiana | $350.85 | — |
| Rest of LouisianaLouisiana | $332.22 | — |
| Metropolitan Boston, MAMassachusetts | $432.36 | — |
| Rest of MassachusettsMassachusetts | $385.84 | — |
| Baltimore area, MDMaryland | $394.13 | — |
| Rest of MarylandMaryland | $373.01 | — |
| Rest of MaineMaine | $341.92 | — |
| Southern Maine, MEMaine | $364.61 | — |
| Detroit, MIMichigan | $360.89 | — |
| Rest of MichiganMichigan | $341.89 | — |
| MinnesotaMinnesota | $375.27 | — |
| Metropolitan Kansas City, MOMissouri | $349.52 | — |
| Metropolitan St. Louis, MOMissouri | $353.78 | — |
| Rest of MissouriMissouri | $324.95 | — |
| MississippiMississippi | $323.61 | — |
| MontanaMontana | $369.07 | — |
| North CarolinaNorth Carolina | $346.14 | — |
| North DakotaNorth Dakota | $366.50 | — |
| NebraskaNebraska | $341.82 | — |
| New HampshireNew Hampshire | $381.62 | — |
| Northern New JerseyNew Jersey | $423.29 | — |
| Rest of New JerseyNew Jersey | $400.68 | — |
| New MexicoNew Mexico | $343.48 | — |
| NevadaNevada | $368.67 | — |
| NYC suburbs and Long Island, NYNew York | $436.02 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $402.35 | — |
| Queens, NYNew York | $431.98 | — |
| Rest of New YorkNew York | $351.84 | — |
| OhioOhio | $341.36 | — |
| OklahomaOklahoma | $333.98 | — |
| Portland, OROregon | $404.11 | — |
| Rest of OregonOregon | $366.51 | — |
| Metropolitan Philadelphia, PAPennsylvania | $383.82 | — |
| Rest of PennsylvaniaPennsylvania | $342.68 | — |
| Puerto RicoPuerto Rico | $372.52 | — |
| Rhode IslandRhode Island | $380.01 | — |
| South CarolinaSouth Carolina | $344.19 | — |
| TennesseeTennessee | $338.04 | — |
| Austin, TXTexas | $387.18 | — |
| Beaumont, TXTexas | $340.06 | — |
| Brazoria, TXTexas | $365.62 | — |
| Dallas, TXTexas | $367.60 | — |
| Fort Worth, TXTexas | $364.47 | — |
| Galveston, TXTexas | $366.47 | — |
| Houston, TXTexas | $368.85 | — |
| Rest of TexasTexas | $352.39 | — |
| UtahUtah | $349.50 | — |
| VirginiaVirginia | $362.38 | — |
| Virgin Islands, VIUnited States Virgin Islands | $372.52 | — |
| VermontVermont | $363.75 | — |
| Rest of WashingtonWashington | $385.54 | — |
| King County, WAWashington | $442.98 | — |
| WisconsinWisconsin | $352.68 | — |
| West VirginiaWest Virginia | $329.17 | — |
| WyomingWyoming | $367.95 | — |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,157
- Code
- 77768
- Physician work
- 1.37
- Practice expense
- 9.55
- Malpractice
- 0.13
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 9.55 | × 1.000 | 9.5500 |
| Malpractice | 0.13 | × 0.336 | 0.0437 |
| Total RVUs | 10.9637 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$366.20
Office: (1.37 × 1 + 9.55 × 1 + 0.13 × 0.336) × $33.4009 = $366.20
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.
How 77768 has changed in South Dakota
77768 · Office / nonfacility
$366.20
Effective 2026-10-01
The base rate is $11.17 higher than on 2025-10-01, moving from $355.03 to $366.20 (3.1%).
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
$355.03changed to$366.20
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.40 changed to 1.37
- Practice expense RVU 9.53 changed to 9.55
- Malpractice RVU 0.12 changed to 0.13
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$363.16changed to$355.03
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.46 changed to 9.53
- Malpractice RVU 0.13 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$357.23changed to$363.16
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$365.55changed to$357.23
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.34 changed to 9.46
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$365.15changed to$365.55
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.11 changed to 9.34
- Malpractice RVU 0.12 changed to 0.13
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$370.03changed to$365.15
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.17 changed to 9.11
- Malpractice RVU 0.10 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$364.16changed to$370.03
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.65 changed to 9.17
- Malpractice RVU 0.11 changed to 0.10
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$363.01changed to$364.16
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.63 changed to 8.65
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$364.42changed to$363.01
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.68 changed to 8.63
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$356.86changed to$364.42
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.50 changed to 8.68
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$353.89changed to$356.86
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.44 changed to 8.50
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$353.89
Held through RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $366.20 | Not available in this setting | RVU26D |
| 2026-07-01 | $366.20 | Not available in this setting | RVU26C |
| 2026-04-01 | $366.20 | Not available in this setting | RVU26B |
| 2026-01-01 | $366.20 | Not available in this setting | RVU26A |
| 2025-10-01 | $355.03 | Not available in this setting | RVU25D |
| 2025-07-01 | $355.03 | Not available in this setting | RVU25C |
| 2025-04-01 | $355.03 | Not available in this setting | RVU25B |
| 2025-01-01 | $355.03 | Not available in this setting | RVU25A |
| 2024-10-01 | $363.16 | Not available in this setting | RVU24D |
| 2024-07-01 | $363.16 | Not available in this setting | RVU24C |
| 2024-04-01 | $363.16 | Not available in this setting | RVU24B |
| 2024-03-09 | $363.16 | Not available in this setting | RVU24AR |
| 2024-01-01 | $357.23 | Not available in this setting | RVU24A |
| 2023-10-01 | $365.55 | Not available in this setting | RVU23D |
| 2023-07-01 | $365.55 | Not available in this setting | RVU23C |
| 2023-04-01 | $365.55 | Not available in this setting | RVU23B |
| 2023-01-01 | $365.55 | Not available in this setting | RVU23A |
| 2022-10-01 | $365.15 | Not available in this setting | RVU22D |
| 2022-07-01 | $365.15 | Not available in this setting | RVU22C |
| 2022-04-01 | $365.15 | Not available in this setting | RVU22B |
| 2022-01-01 | $365.15 | Not available in this setting | RVU22A |
| 2021-10-01 | $370.03 | Not available in this setting | RVU21D |
| 2021-07-01 | $370.03 | Not available in this setting | RVU21C |
| 2021-04-01 | $370.03 | Not available in this setting | RVU21B |
| 2021-01-01 | $370.03 | Not available in this setting | RVU21A |
| 2020-10-01 | $364.16 | Not available in this setting | RVU20D |
| 2020-07-01 | $364.16 | Not available in this setting | RVU20C |
| 2020-04-01 | $364.16 | Not available in this setting | RVU20B |
| 2020-01-01 | $364.16 | Not available in this setting | RVU20A |
| 2019-10-01 | $363.01 | Not available in this setting | RVU19D |
| 2019-07-01 | $363.01 | Not available in this setting | RVU19C |
| 2019-04-01 | $363.01 | Not available in this setting | RVU19B |
| 2019-01-01 | $363.01 | Not available in this setting | RVU19A |
| 2018-10-01 | $364.42 | Not available in this setting | RVU18D |
| 2018-07-01 | $364.42 | Not available in this setting | RVU18C |
| 2018-04-01 | $364.42 | Not available in this setting | RVU18B |
| 2018-01-01 | $364.42 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $356.86 | Not available in this setting | RVU17D |
| 2017-07-01 | $356.86 | Not available in this setting | RVU17C |
| 2017-04-01 | $356.86 | Not available in this setting | RVU17B |
| 2017-01-01 | $356.86 | Not available in this setting | RVU17A |
| 2016-10-01 | $353.89 | Not available in this setting | RVU16D |
| 2016-07-01 | $353.89 | Not available in this setting | RVU16C |
| 2016-04-01 | $353.89 | Not available in this setting | RVU16B |
| 2016-01-01 | $353.89 | Not available in this setting | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | 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
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
Show the CMS file lines behind this rate
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