Billing code 77293: Radiation simulationMedicare rate & RVUs
Reports respiratory-motion imaging, such as 4D CT or gated acquisition, used to account for tumor movement when planning radiation treatment delivery.
Medicare pays $401.81 for 77293 nationally in the office. Local office rates run $353.19–$554.76.
Medicare rate · 77293
Radiation simulation
- Work RVUs
- 1.95
- Total RVUs
- 12.03
- Global days
- ZZZ
National rate · 2026
$401.81
Office setting, before claim adjustments.
See every locality for 77293 →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 77293 covers
This add-on captures simulation work to assess how breathing moves a target and to support planning for motion-managed radiation delivery. A radiation oncology team may use 4D CT or gated image acquisition for tumors that move with respiration, such as lung or upper-abdominal targets. The radiation oncologist uses the resulting motion information in treatment planning; technical staff perform the imaging and related acquisition work.
Report 77293 with an eligible primary planning procedure, commonly 77295 for a 3D radiotherapy plan or 77301 for an IMRT plan. Documentation should identify the respiratory-motion assessment and the imaging or acquisition performed to guide motion management. CMS treats the code as an add-on paid within the primary procedure’s global period. It has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no modifier represents the global 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 77293 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
$353.19 to $554.76
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $358.70 | Unavailable |
| Alaska* | $454.55 | Unavailable |
| Arizona | $391.00 | Unavailable |
| Arkansas | $353.19 | Unavailable |
| Atlanta | $408.01 | Unavailable |
| Austin | $420.90 | Unavailable |
| Bakersfield | $433.75 | Unavailable |
| Baltimore/Surr. Cntys | $427.98 | Unavailable |
| Beaumont | $371.57 | Unavailable |
| Brazoria | $398.60 | Unavailable |
| Chicago | $408.26 | Unavailable |
| Chico | $433.37 | Unavailable |
| Colorado | $423.20 | Unavailable |
| Connecticut | $429.48 | Unavailable |
| Dallas | $400.59 | Unavailable |
| Dc + Md/Va Suburbs | $465.04 | Unavailable |
| Delaware | $397.80 | Unavailable |
| Detroit | $392.44 | Unavailable |
| East St. Louis | $378.53 | Unavailable |
| El Centro | $433.39 | Unavailable |
| Fort Lauderdale | $408.85 | Unavailable |
| Fort Worth | $397.30 | Unavailable |
| Fresno | $433.37 | Unavailable |
| Galveston | $399.43 | Unavailable |
| Hanford-Corcoran | $433.37 | Unavailable |
| Hawaii, Guam | $446.07 | Unavailable |
| Houston | $401.26 | Unavailable |
| Idaho | $373.39 | Unavailable |
| Indiana | $375.76 | Unavailable |
| Iowa | $371.46 | Unavailable |
| Kansas | $368.16 | Unavailable |
| Kentucky | $364.53 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $464.36 | Unavailable |
| Madera | $433.37 | Unavailable |
| Manhattan | $461.94 | Unavailable |
| Merced | $433.37 | Unavailable |
| Metropolitan Boston | $468.78 | Unavailable |
| Metropolitan Kansas City | $381.40 | Unavailable |
| Metropolitan Philadelphia | $417.30 | Unavailable |
| Metropolitan St. Louis | $385.82 | Unavailable |
| Miami | $420.59 | Unavailable |
| Minnesota | $409.13 | Unavailable |
| Mississippi | $354.61 | Unavailable |
| Modesto | $433.37 | Unavailable |
| Montana** | $401.81 | Unavailable |
| Napa | $510.28 | Unavailable |
| Nebraska | $374.07 | Unavailable |
| Nevada** | $401.59 | Unavailable |
| New Hampshire | $415.06 | Unavailable |
| New Mexico | $374.82 | Unavailable |
| New Orleans | $382.60 | Unavailable |
| North Carolina | $378.27 | Unavailable |
| North Dakota** | $399.83 | Unavailable |
| Northern Nj | $459.48 | Unavailable |
| Nyc Suburbs/Long Island | $471.85 | Unavailable |
| Ohio | $372.84 | Unavailable |
| Oklahoma | $365.40 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $463.05 | Unavailable |
| Portland | $439.00 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $437.11 | Unavailable |
| Puerto Rico | $405.43 | Unavailable |
| Queens | $468.13 | Unavailable |
| Redding | $433.37 | Unavailable |
| Rest Of California | $433.37 | Unavailable |
| Rest Of Florida | $388.83 | Unavailable |
| Rest Of Georgia | $366.45 | Unavailable |
| Rest Of Illinois | $374.69 | Unavailable |
| Rest Of Louisiana | $363.34 | Unavailable |
| Rest Of Maine | $373.88 | Unavailable |
| Rest Of Maryland | $406.19 | Unavailable |
| Rest Of Massachusetts | $419.84 | Unavailable |
| Rest Of Michigan | $373.24 | Unavailable |
| Rest Of Missouri | $355.72 | Unavailable |
| Rest Of New Jersey | $435.41 | Unavailable |
| Rest Of New York | $384.15 | Unavailable |
| Rest Of Oregon | $399.49 | Unavailable |
| Rest Of Pennsylvania | $374.30 | Unavailable |
| Rest Of Texas | $384.49 | Unavailable |
| Rest Of Washington | $419.53 | Unavailable |
| Rhode Island | $413.69 | Unavailable |
| Riverside-San Bernardino-Ontario | $434.49 | Unavailable |
| Sacramento-Roseville-Folsom | $456.94 | Unavailable |
| Salinas | $455.28 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $467.57 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $542.86 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $542.75 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $554.76 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $554.30 | Unavailable |
| San Luis Obispo-Paso Robles | $447.70 | Unavailable |
| Santa Cruz-Watsonville | $473.30 | Unavailable |
| Santa Maria-Santa Barbara | $457.42 | Unavailable |
| Santa Rosa-Petaluma | $478.22 | Unavailable |
| Seattle (King Cnty) | $480.13 | Unavailable |
| South Carolina | $375.98 | Unavailable |
| South Dakota** | $399.60 | Unavailable |
| Southern Maine | $397.58 | Unavailable |
| Stockton | $433.37 | Unavailable |
| Suburban Chicago | $413.85 | Unavailable |
| Tennessee | $369.93 | Unavailable |
| Utah | $381.47 | Unavailable |
| Vallejo | $510.11 | Unavailable |
| Vermont | $396.83 | Unavailable |
| Virgin Islands | $405.43 | Unavailable |
| Virginia | $395.16 | Unavailable |
| Visalia | $433.37 | Unavailable |
| West Virginia | $359.58 | Unavailable |
| Wisconsin | $385.50 | Unavailable |
| Wyoming** | $400.94 | Unavailable |
| Yuba City | $433.37 | Unavailable |
77293 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.
$353.19
$494.07
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 | $454.55 | 1 |
| AL | $358.70 | 1 |
| AR | $353.19 | 1 |
| AZ | $391.00 | 1 |
| CA | $433.37–$554.76 | 29 |
| CO | $423.20 | 1 |
| CT | $429.48 | 1 |
| DC | $465.04 | 1 |
| DE | $397.80 | 1 |
| FL | $388.83–$420.59 | 3 |
| GA | $366.45–$408.01 | 2 |
| GU | $446.07 | 1 |
| HI | $446.07 | 1 |
| IA | $371.46 | 1 |
| ID | $373.39 | 1 |
| IL | $374.69–$413.85 | 4 |
| IN | $375.76 | 1 |
| KS | $368.16 | 1 |
| KY | $364.53 | 1 |
| LA | $363.34–$382.60 | 2 |
| MA | $419.84–$468.78 | 2 |
| MD | $406.19–$465.04 | 3 |
| ME | $373.88–$397.58 | 2 |
| MI | $373.24–$392.44 | 2 |
| MN | $409.13 | 1 |
| MO | $355.72–$385.82 | 3 |
| MS | $354.61 | 1 |
| MT | $401.81 | 1 |
| NC | $378.27 | 1 |
| ND | $399.83 | 1 |
| NE | $374.07 | 1 |
| NH | $415.06 | 1 |
| NJ | $435.41–$459.48 | 2 |
| NM | $374.82 | 1 |
| NV | $401.59 | 1 |
| NY | $384.15–$471.85 | 5 |
| OH | $372.84 | 1 |
| OK | $365.40 | 1 |
| OR | $399.49–$439.00 | 2 |
| PA | $374.30–$417.30 | 2 |
| PR | $405.43 | 1 |
| RI | $413.69 | 1 |
| SC | $375.98 | 1 |
| SD | $399.60 | 1 |
| TN | $369.93 | 1 |
| TX | $371.57–$420.90 | 8 |
| UT | $381.47 | 1 |
| VA | $395.16–$465.04 | 2 |
| VI | $405.43 | 1 |
| VT | $396.83 | 1 |
| WA | $419.53–$480.13 | 2 |
| WI | $385.50 | 1 |
| WV | $359.58 | 1 |
| WY | $400.94 | 1 |
How the 77293 rate is calculated
Each of 77293’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 · 77293
RVUs × geographic indexes × conversion factor
Work1.95
1.95 RVUs× 1.000 GPCI
Practice expense9.98
9.98 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
12.0300
Conversion factor
$33.4009
Medicare rate
$401.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77293
The CMS indicators that decide how 77293 is paid alongside other services.
CMS payment indicators · 77293
Radiation simulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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
77293 without 26 · national office
$401.81
Radiation simulation
77293-26 · Professional component
$104.21
Pays only the interpretation and report.
77293 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77290Radiation simulation
- 77290 describes complex radiation treatment simulation. Use 77293 for the additional respiratory-motion assessment used to plan motion-managed delivery.
- 77295Radiotherapy plan
- 77295 represents a 3D radiotherapy plan; 77293 captures respiratory-motion simulation work reported as an add-on to an eligible planning procedure.
- 77301IMRT planning
- 77301 is the IMRT planning service. 77293 describes respiratory-motion simulation and may be paired with the IMRT plan when appropriate.
77293 billing questions
When is 77293 appropriate instead of 77290?
Use 77293 for simulation work that evaluates respiratory motion to plan motion-managed treatment delivery. Code 77290 describes complex radiation treatment simulation, not the respiratory-motion management service itself.
Which primary planning codes can be reported with 77293?
Common pairings include 77295 for a 3D radiotherapy plan and 77301 for an IMRT plan. Report 77293 as an add-on with an eligible primary procedure.
Can the professional and technical components be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 77293?
Document the respiratory-motion assessment, the imaging or acquisition method, and how the resulting information supports motion-management treatment planning. The record should support the paired primary planning procedure as well.
How does the add-on status affect payment?
77293 must be billed with a primary procedure and is paid within that procedure’s global period. It is not reported as a stand-alone service.
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 77293 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 →