Billing code 77263: Treatment planningMedicare rate & RVUs
Reports a radiation oncologist’s complex treatment-planning work, including decisions about treatment approach, target coverage, and dose delivery for a radiation course.
Medicare pays $168.34 for 77263 nationally in the office and $168.34 in a hospital or facility. Local office rates run $156.26–$219.62.
Medicare rate · 77263
Treatment planning
Swap in your local Medicare rate.
- Work RVUs
- 3.06
- Total RVUs
- 5.04
- Global days
- XXX
National rate · 2026
$168.34
Office setting, before claim adjustments.
See every locality for 77263 → · 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.
On this page 10 sections
What 77263 covers
A radiation oncologist uses this service to develop a complex external-beam radiation treatment plan. The work can include reviewing the patient’s clinical history and diagnostic studies, defining the treatment target, selecting the treatment approach, and determining how dose will be delivered across the planned course. It is reported when the physician’s planning work is complex, such as when multiple treatment areas, modalities, or demanding dose and field-shaping decisions require substantial analysis. Complexity is supported by the documented planning work, not by the diagnosis or body site alone.
Report 77263 for the physician’s planning service, not for each radiation fraction delivered. The record should describe the treatment approach and the specific factors that make the planning complex, such as the areas treated, modalities considered, and dose or field decisions. CMS identifies this as a professional-component-only code for interpretation and report; a separate code covers the technical portion. Simulation and three-dimensional planning are distinct services and should be reported separately when performed and supported by their own documentation.
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 77263 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
$156.26 to $219.62
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $157.60 | $157.60 |
| Alaska* | $219.62 | $219.62 |
| Arizona | $165.38 | $165.38 |
| Arkansas | $156.26 | $156.26 |
| Atlanta | $171.19 | $171.19 |
| Austin | $171.00 | $171.00 |
| Bakersfield | $172.73 | $172.73 |
| Baltimore/Surr. Cntys | $176.12 | $176.12 |
| Beaumont | $162.54 | $162.54 |
| Brazoria | $166.87 | $166.87 |
| Chicago | $179.73 | $179.73 |
| Chico | $171.94 | $171.94 |
| Colorado | $171.53 | $171.53 |
| Connecticut | $176.54 | $176.54 |
| Dallas | $167.89 | $167.89 |
| Dc + Md/Va Suburbs | $185.11 | $185.11 |
| Delaware | $167.34 | $167.34 |
| Detroit | $171.81 | $171.81 |
| East St. Louis | $171.82 | $171.82 |
| El Centro | $171.98 | $171.98 |
| Fort Lauderdale | $175.57 | $175.57 |
| Fort Worth | $167.41 | $167.41 |
| Fresno | $171.94 | $171.94 |
| Galveston | $167.37 | $167.37 |
| Hanford-Corcoran | $171.94 | $171.94 |
| Hawaii, Guam | $172.93 | $172.93 |
| Houston | $171.77 | $171.77 |
| Idaho | $159.47 | $159.47 |
| Indiana | $159.98 | $159.98 |
| Iowa | $158.57 | $158.57 |
| Kansas | $158.79 | $158.79 |
| Kentucky | $161.21 | $161.21 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $180.47 | $180.47 |
| Madera | $171.94 | $171.94 |
| Manhattan | $188.99 | $188.99 |
| Merced | $171.94 | $171.94 |
| Metropolitan Boston | $182.92 | $182.92 |
| Metropolitan Kansas City | $164.61 | $164.61 |
| Metropolitan Philadelphia | $174.11 | $174.11 |
| Metropolitan St. Louis | $165.57 | $165.57 |
| Miami | $182.98 | $182.98 |
| Minnesota | $164.38 | $164.38 |
| Mississippi | $158.17 | $158.17 |
| Modesto | $171.94 | $171.94 |
| Montana** | $168.32 | $168.32 |
| Napa | $189.32 | $189.32 |
| Nebraska | $158.88 | $158.88 |
| Nevada** | $167.06 | $167.06 |
| New Hampshire | $169.72 | $169.72 |
| New Mexico | $165.13 | $165.13 |
| New Orleans | $166.00 | $166.00 |
| North Carolina | $161.55 | $161.55 |
| North Dakota** | $163.58 | $163.58 |
| Northern Nj | $184.62 | $184.62 |
| Nyc Suburbs/Long Island | $192.74 | $192.74 |
| Ohio | $163.35 | $163.35 |
| Oklahoma | $160.33 | $160.33 |
| Oxnard-Thousand Oaks-Ventura | $178.76 | $178.76 |
| Portland | $174.37 | $174.37 |
| Poughkpsie/N Nyc Suburbs | $180.14 | $180.14 |
| Puerto Rico | $168.86 | $168.86 |
| Queens | $189.00 | $189.00 |
| Redding | $171.94 | $171.94 |
| Rest Of California | $171.94 | $171.94 |
| Rest Of Florida | $169.82 | $169.82 |
| Rest Of Georgia | $163.60 | $163.60 |
| Rest Of Illinois | $167.80 | $167.80 |
| Rest Of Louisiana | $161.32 | $161.32 |
| Rest Of Maine | $160.66 | $160.66 |
| Rest Of Maryland | $169.40 | $169.40 |
| Rest Of Massachusetts | $171.43 | $171.43 |
| Rest Of Michigan | $164.32 | $164.32 |
| Rest Of Missouri | $160.11 | $160.11 |
| Rest Of New Jersey | $178.55 | $178.55 |
| Rest Of New York | $163.05 | $163.05 |
| Rest Of Oregon | $165.73 | $165.73 |
| Rest Of Pennsylvania | $163.13 | $163.13 |
| Rest Of Texas | $164.60 | $164.60 |
| Rest Of Washington | $170.83 | $170.83 |
| Rhode Island | $171.33 | $171.33 |
| Riverside-San Bernardino-Ontario | $174.58 | $174.58 |
| Sacramento-Roseville-Folsom | $177.77 | $177.77 |
| Salinas | $177.03 | $177.03 |
| San Diego-Chula Vista-Carlsbad | $179.13 | $179.13 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $197.54 | $197.54 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $197.27 | $197.27 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $201.55 | $201.55 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $200.44 | $200.44 |
| San Luis Obispo-Paso Robles | $174.44 | $174.44 |
| Santa Cruz-Watsonville | $179.26 | $179.26 |
| Santa Maria-Santa Barbara | $177.13 | $177.13 |
| Santa Rosa-Petaluma | $180.94 | $180.94 |
| Seattle (King Cnty) | $185.18 | $185.18 |
| South Carolina | $162.72 | $162.72 |
| South Dakota** | $163.02 | $163.02 |
| Southern Maine | $164.86 | $164.86 |
| Stockton | $171.94 | $171.94 |
| Suburban Chicago | $176.81 | $176.81 |
| Tennessee | $159.34 | $159.34 |
| Utah | $164.04 | $164.04 |
| Vallejo | $188.92 | $188.92 |
| Vermont | $163.80 | $163.80 |
| Virgin Islands | $168.86 | $168.86 |
| Virginia | $165.00 | $165.00 |
| Visalia | $171.94 | $171.94 |
| West Virginia | $164.18 | $164.18 |
| Wisconsin | $160.35 | $160.35 |
| Wyoming** | $166.26 | $166.26 |
| Yuba City | $171.94 | $171.94 |
77263 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.
$156.26
$219.62
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 | $219.62 | 1 |
| AL | $157.60 | 1 |
| AR | $156.26 | 1 |
| AZ | $165.38 | 1 |
| CA | $171.94–$201.55 | 29 |
| CO | $171.53 | 1 |
| CT | $176.54 | 1 |
| DC | $185.11 | 1 |
| DE | $167.34 | 1 |
| FL | $169.82–$182.98 | 3 |
| GA | $163.60–$171.19 | 2 |
| GU | $172.93 | 1 |
| HI | $172.93 | 1 |
| IA | $158.57 | 1 |
| ID | $159.47 | 1 |
| IL | $167.80–$179.73 | 4 |
| IN | $159.98 | 1 |
| KS | $158.79 | 1 |
| KY | $161.21 | 1 |
| LA | $161.32–$166.00 | 2 |
| MA | $171.43–$182.92 | 2 |
| MD | $169.40–$185.11 | 3 |
| ME | $160.66–$164.86 | 2 |
| MI | $164.32–$171.81 | 2 |
| MN | $164.38 | 1 |
| MO | $160.11–$165.57 | 3 |
| MS | $158.17 | 1 |
| MT | $168.32 | 1 |
| NC | $161.55 | 1 |
| ND | $163.58 | 1 |
| NE | $158.88 | 1 |
| NH | $169.72 | 1 |
| NJ | $178.55–$184.62 | 2 |
| NM | $165.13 | 1 |
| NV | $167.06 | 1 |
| NY | $163.05–$192.74 | 5 |
| OH | $163.35 | 1 |
| OK | $160.33 | 1 |
| OR | $165.73–$174.37 | 2 |
| PA | $163.13–$174.11 | 2 |
| PR | $168.86 | 1 |
| RI | $171.33 | 1 |
| SC | $162.72 | 1 |
| SD | $163.02 | 1 |
| TN | $159.34 | 1 |
| TX | $162.54–$171.77 | 8 |
| UT | $164.04 | 1 |
| VA | $165.00–$185.11 | 2 |
| VI | $168.86 | 1 |
| VT | $163.80 | 1 |
| WA | $170.83–$185.18 | 2 |
| WI | $160.35 | 1 |
| WV | $164.18 | 1 |
| WY | $166.26 | 1 |
How the 77263 rate is calculated
Each of 77263’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 · 77263
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.06Practice expense 1.74Malpractice 0.24
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77263
The CMS indicators that decide how 77263 is paid alongside other services.
CMS payment indicators · 77263
Treatment planning
| 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 | 2 | Professional component only. |
77263 compared with similar codes
Compare codes
77263 vs 77261 vs 77262 vs 77290 vs 77295: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77261Radiation planning
- 77261 is for simple treatment planning. Choose 77263 only when the documented planning decisions and work support the complex level.
- 77262Radiation planning
- 77262 represents intermediate planning; 77263 represents complex planning. The record should explain the planning demands supporting the higher level.
- 77290Radiation simulation
- 77290 reports radiation simulation, which establishes treatment setup and geometry. 77263 reports the physician’s complex treatment-planning work.
- 77295Radiotherapy plan
- 77295 reports a three-dimensional radiotherapy plan. It is distinct from the complex treatment-planning service reported with 77263.
77263 billing questions
How does 77263 differ from 77261 and 77262?
These codes represent different levels of treatment-planning complexity. Use 77263 when the documented planning work is complex rather than simple or intermediate; the diagnosis or treatment site alone does not establish the level.
Is 77263 the same service as radiation simulation?
No. Treatment planning determines the approach and dose strategy; simulation establishes treatment geometry and setup. Report simulation separately when performed and documented.
Does 77263 include a three-dimensional radiotherapy plan?
The planning service and a three-dimensional radiotherapy plan are distinct. When a separate 3D plan is performed and documented, code 77295 may also be reported.
Should 77263 be billed for every treatment fraction?
No. It reports planning work, not each delivered fraction. Documentation should support the complex planning service for the radiation course.
How should the professional and technical work be reported?
CMS identifies 77263 as professional-component-only for interpretation and report. A separate code covers the technical portion; the record should support the physician’s planning work.
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
Fee sheets
Put 77263 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →