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CPT code 77778: Interstitial brachytherapy, complex source application2026 Medicare rate & RVUs in Idaho

Reports complex placement of radioactive sources within tumor tissue for interstitial brachytherapy, rather than treatment delivered through a cavity or surface applicator.

CMS RVU26DEffective Oct 1, 2026One payment locality3.3K Medicare services in 2024

In Idaho, Medicare pays $873.07 for 77778 in the office.

$873.07Office (non-facility)
Not available in this settingHospital or facility
−6.4%vs the national office rate ($932.89)

Check a contract rate as a % of Medicare · 77778 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 77778 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 77778 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 77778 covers

This service covers complex interstitial brachytherapy, in which radioactive sources are placed directly within or alongside tumor tissue. A radiation oncologist, often working with a procedural specialist, may perform the application in an operating room or procedure suite. Prostate seed implantation is a familiar example; interstitial techniques may also be used for selected tumors at other sites. This approach differs from delivering radiation through a cavity applicator or across the skin surface.

Report the code when the documented service is a complex interstitial source application. The record should support the interstitial approach, treated site, source placement, and complexity. CMS identifies professional and technical components: modifier 26 represents the professional interpretation, modifier TC the equipment and staff, and no modifier the global service. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

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 Idaho compares for 77778

Across 109 of 109 payment localities, the office rate for 77778 runs from $835.46 in Arkansas to $1,233.96 in San Benito County, CA. Idaho pays $873.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

77778 in Idaho vs other payment areas
  1. Idaho · this page$873.07
  2. Los Angeles, CA · California$1,053.65+$180.58
  3. Washington, DC area · District of Columbia$1,062.32+$189.25
  4. Miami, FL · Florida$986.25+$113.18
  5. Chicago, IL · Illinois$961.39+$88.32
  6. Manhattan, NY · New York$1,063.64+$190.57
  7. Alaska · Alaska$1,108.63+$235.56

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

Every other payment area

77778 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$846.44—
ArkansasArkansas$835.46—
ArizonaArizona$910.79—
Bakersfield, CACalifornia$991.65—
Chico, CACalifornia$989.76—
El Centro, CACalifornia$989.85—
Fresno, CACalifornia$989.76—
Hanford, CACalifornia$989.76—

77778 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.

$835.46

$1,111.86

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

View every state and territory as a table
77778 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,108.631
AL$846.441
AR$835.461
AZ$910.791
CA$989.76–$1,233.9629
CO$972.621
CT$990.821
DC$1,062.321
DE$924.951
FL$914.29–$986.253
GA$868.42–$947.432
GU$1,011.461
HI$1,011.461
IA$868.551
ID$873.071
IL$888.32–$965.794
IN$877.701
KS$863.561
KY$861.541
LA$859.80–$898.232
MA$967.13–$1,064.642
MD$941.81–$1,062.323
ME$875.75–$920.572
MI$880.50–$923.252
MN$938.431
MO$845.62–$902.733
MS$840.761
MT$932.851
NC$884.241
ND$922.171
NE$873.241
NH$956.421
NJ$1,003.94–$1,052.762
NM$884.311
NV$930.501
NY$896.08–$1,085.515
OH$878.311
OK$861.571
OR$925.01–$1,002.662
PA$880.32–$967.302
PR$939.531
RI$957.131
SC$882.381
SD$920.911
TN$867.301
TX$875.00–$967.888
UT$893.311
VA$916.89–$1,062.322
VI$939.531
VT$917.691
WA$965.63–$1,086.652
WI$893.991
WV$858.271
WY$928.201

See 77778 in every payment locality

How the 77778 rate is calculated

Each of 77778’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 · 77778

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.56

8.56 RVUs× 1.000 GPCI

Practice expense18.83

18.83 RVUs× 1.000 GPCI

Malpractice0.54

0.54 RVUs× 1.000 GPCI

Adjusted RVUs

27.9300

Conversion factor

$33.4009

Medicare rate

$932.89

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

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,169

Code
77778
Physician work
8.56
Practice expense
18.83
Malpractice
0.54

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 77778 in Idaho
ComponentRVULocality factorAdjusted
Physician work8.56× 1.0008.5600
Practice expense18.83× 0.92017.3236
Malpractice0.54× 0.4730.2554
Total RVUs26.1390
Conversion factor× 33.4009

Office rate, Idaho$873.07

Office: (8.56 × 1 + 18.83 × 0.92 + 0.54 × 0.473) × $33.4009 = $873.07

Open 77778 in the RVU calculator

Payment rules and modifiers for 77778

The CMS indicators that decide how 77778 is paid alongside other services.

CMS payment indicators · 77778

Interstitial brachytherapy, complex source application

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
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

77778 without 26 · national office

$932.89

Interstitial brachytherapy, complex source application

77778-26 · Professional component

$459.93

Pays only the interpretation and report.

When to use modifier 26

Codes related to 77778

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

Codes related to 77778
CodeHow it relatesOffice range, Idaho
Used instead
77761Intracavitary brachytherapy, simple applicationFor simple intracavitary radiation source application rather than complex interstitial placement.$396.84
77763Brachytherapy application, complex intracavitary placementFor complex intracavitary application using a cavity applicator.$743.82
77770HDR brachytherapy, single channel, per fractionFor high-dose-rate remote afterloading when that delivery method is performed.$324.56
77772HDR brachytherapy, more than 12 channelsFor complex high-dose-rate remote afterloading rather than this source application.$849.92

How 77778 has changed in Idaho

77778 · Office / nonfacility

$873.07

Effective 2026-10-01

The base rate is $30.61 higher than on 2025-10-01, moving from $842.46 to $873.07 (3.6%).

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

    $842.46changed to$873.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.78 changed to 8.56
    • Practice expense RVU 18.74 changed to 18.83
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $854.12changed to$842.46

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 18.32 changed to 18.74
    • Malpractice RVU 0.53 changed to 0.54

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $840.18changed to$854.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $848.30changed to$840.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 17.94 changed to 18.32
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $832.02changed to$848.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 17.18 changed to 17.94
    • Malpractice RVU 0.47 changed to 0.53
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $819.80changed to$832.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 16.56 changed to 17.18
    • Malpractice RVU 0.46 changed to 0.47

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $816.80changed to$819.80

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.33 changed to 16.56
    • Malpractice RVU 0.45 changed to 0.46
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $806.57changed to$816.80

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.80 changed to 15.33
    • Malpractice RVU 0.49 changed to 0.45
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $791.08changed to$806.57

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 14.35 changed to 14.80

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $777.56changed to$791.08

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 14.04 changed to 14.35
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $731.43changed to$777.56

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.00 changed to 8.78
    • Practice expense RVU 13.58 changed to 14.04
    • Malpractice RVU 0.46 changed to 0.49
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $821.12changed to$731.43

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 11.32 changed to 8.00
    • Practice expense RVU 12.49 changed to 13.58
    • Malpractice RVU 0.62 changed to 0.46

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $817.03changed to$821.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $815.18changed to$817.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.36 changed to 12.49
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $797.24changed to$815.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.09 changed to 12.36
    • Malpractice RVU 0.68 changed to 0.65
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $797.24

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$873.07Not available in this settingRVU26D
2026-07-01$873.07Not available in this settingRVU26C
2026-04-01$873.07Not available in this settingRVU26B
2026-01-01$873.07Not available in this settingRVU26A
2025-10-01$842.46Not available in this settingRVU25D
2025-07-01$842.46Not available in this settingRVU25C
2025-04-01$842.46Not available in this settingRVU25B
2025-01-01$842.46Not available in this settingRVU25A
2024-10-01$854.12Not available in this settingRVU24D
2024-07-01$854.12Not available in this settingRVU24C
2024-04-01$854.12Not available in this settingRVU24B
2024-03-09$854.12Not available in this settingRVU24AR
2024-01-01$840.18Not available in this settingRVU24A
2023-10-01$848.30Not available in this settingRVU23D
2023-07-01$848.30Not available in this settingRVU23C
2023-04-01$848.30Not available in this settingRVU23B
2023-01-01$848.30Not available in this settingRVU23A
2022-10-01$832.02Not available in this settingRVU22D
2022-07-01$832.02Not available in this settingRVU22C
2022-04-01$832.02Not available in this settingRVU22B
2022-01-01$832.02Not available in this settingRVU22A
2021-10-01$819.80Not available in this settingRVU21D
2021-07-01$819.80Not available in this settingRVU21C
2021-04-01$819.80Not available in this settingRVU21B
2021-01-01$819.80Not available in this settingRVU21A
2020-10-01$816.80Not available in this settingRVU20D
2020-07-01$816.80Not available in this settingRVU20C
2020-04-01$816.80Not available in this settingRVU20B
2020-01-01$816.80Not available in this settingRVU20A
2019-10-01$806.57Not available in this settingRVU19D
2019-07-01$806.57Not available in this settingRVU19C
2019-04-01$806.57Not available in this settingRVU19B
2019-01-01$806.57Not available in this settingRVU19A
2018-10-01$791.08Not available in this settingRVU18D
2018-07-01$791.08Not available in this settingRVU18C
2018-04-01$791.08Not available in this settingRVU18B
2018-01-01$791.08Not available in this settingRVU18AR1
2017-10-01$777.56Not available in this settingRVU17D
2017-07-01$777.56Not available in this settingRVU17C
2017-04-01$777.56Not available in this settingRVU17B
2017-01-01$777.56Not available in this settingRVU17A
2016-10-01$731.43Not available in this settingRVU16D
2016-07-01$731.43Not available in this settingRVU16C
2016-04-01$731.43Not available in this settingRVU16B
2016-01-01$731.43Not available in this settingRVU16A
2015-10-01$821.12Not available in this settingRVU15D
2015-07-01$821.12Not available in this settingRVU15C
2015-04-01$817.03Not available in this settingRVU15B
2015-01-01$817.03Not available in this settingRVU15A
2014-10-01$815.18Not available in this settingRVU14D
2014-07-01$815.18Not available in this settingRVU14C
2014-04-01$815.18Not available in this settingRVU14B
2014-01-01$815.18Not available in this settingRVU14A
2013-10-01$797.24Not available in this settingRVU13D
2013-07-01$797.24Not available in this settingRVU13C
2013-04-01$797.24Not available in this settingRVU13B
2013-01-01$797.24Not available in this settingRVU13AR

Price 77778 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

77778 billing questions

How does this differ from an intracavitary application?

This code is for complex placement of sources within tissue. Use an intracavitary application code when radiation is delivered through an applicator positioned in a body cavity.

Can the professional and technical components be billed separately?

Yes. CMS identifies modifier 26 for the professional interpretation and modifier TC for the technical service; reporting without a modifier represents the global service.

Is modifier 50 appropriate for bilateral treatment?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care.

When may an assistant at surgery be paid?

Assistant-at-surgery payment is allowed only when the medical necessity of the assistant is documented. Co-surgeons and team surgery are not permitted.

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 77778PPRRVU2026_Oct_nonQPP.csv, line 9,169 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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