Billing code 77431: Radiation managementMedicare rate & RVUs
Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval.
Medicare pays $106.55 for 77431 nationally in the office and $106.55 in a hospital or facility. Local office rates run $98.21–$136.64.
Medicare rate · 77431
Radiation management
Swap in your local Medicare rate.
- Work RVUs
- 1.76
- Total RVUs
- 3.19
- Global days
- XXX
National rate · 2026
$106.55
Office setting, before claim adjustments.
See every locality for 77431 → · 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 77431 covers
Code 77431 represents the radiation oncologist’s management of a course with only one or two treatments. The physician’s work includes evaluating the patient during treatment and reviewing the treatment plan and relevant treatment information, such as dosimetry and imaging, to manage the course. It is distinct from coding the radiation delivery itself, which describes the technical treatment service. Radiation oncologists typically provide this management in a hospital or freestanding radiation therapy department.
Select 77431 when the course has one or two treatments; do not use it for a routine five-treatment management interval. The record should support the number of treatments and the physician’s management work. CMS identifies 77431 as a professional-component-only code for interpretation and report, with a separate code covering the technical portion. Report the professional service as represented by this code; do not treat it as a split professional-and-technical code.
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 77431 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
$98.21 to $136.64
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $99.13 | $99.13 |
| Alaska* | $136.64 | $136.64 |
| Arizona | $104.54 | $104.54 |
| Arkansas | $98.21 | $98.21 |
| Atlanta | $108.35 | $108.35 |
| Austin | $108.63 | $108.63 |
| Bakersfield | $109.97 | $109.97 |
| Baltimore/Surr. Cntys | $111.74 | $111.74 |
| Beaumont | $102.34 | $102.34 |
| Brazoria | $105.60 | $105.60 |
| Chicago | $113.23 | $113.23 |
| Chico | $109.51 | $109.51 |
| Colorado | $108.99 | $108.99 |
| Connecticut | $112.02 | $112.02 |
| Dallas | $106.24 | $106.24 |
| Dc + Md/Va Suburbs | $117.92 | $117.92 |
| Delaware | $105.85 | $105.85 |
| Detroit | $108.25 | $108.25 |
| East St. Louis | $107.84 | $107.84 |
| El Centro | $109.54 | $109.54 |
| Fort Lauderdale | $110.89 | $110.89 |
| Fort Worth | $105.87 | $105.87 |
| Fresno | $109.51 | $109.51 |
| Galveston | $105.91 | $105.91 |
| Hanford-Corcoran | $109.51 | $109.51 |
| Hawaii, Guam | $110.48 | $110.48 |
| Houston | $108.48 | $108.48 |
| Idaho | $100.64 | $100.64 |
| Indiana | $101.00 | $101.00 |
| Iowa | $100.07 | $100.07 |
| Kansas | $100.09 | $100.09 |
| Kentucky | $101.37 | $101.37 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $115.27 | $115.27 |
| Madera | $109.51 | $109.51 |
| Manhattan | $120.03 | $120.03 |
| Merced | $109.51 | $109.51 |
| Metropolitan Boston | $116.80 | $116.80 |
| Metropolitan Kansas City | $103.81 | $103.81 |
| Metropolitan Philadelphia | $110.28 | $110.28 |
| Metropolitan St. Louis | $104.49 | $104.49 |
| Miami | $115.47 | $115.47 |
| Minnesota | $104.51 | $104.51 |
| Mississippi | $99.34 | $99.34 |
| Modesto | $109.51 | $109.51 |
| Montana** | $106.54 | $106.54 |
| Napa | $121.65 | $121.65 |
| Nebraska | $100.32 | $100.32 |
| Nevada** | $105.81 | $105.81 |
| New Hampshire | $107.73 | $107.73 |
| New Mexico | $103.91 | $103.91 |
| New Orleans | $104.64 | $104.64 |
| North Carolina | $101.97 | $101.97 |
| North Dakota** | $103.77 | $103.77 |
| Northern Nj | $117.46 | $117.46 |
| Nyc Suburbs/Long Island | $122.46 | $122.46 |
| Ohio | $102.84 | $102.84 |
| Oklahoma | $100.90 | $100.90 |
| Oxnard-Thousand Oaks-Ventura | $114.27 | $114.27 |
| Portland | $111.08 | $111.08 |
| Poughkpsie/N Nyc Suburbs | $114.27 | $114.27 |
| Puerto Rico | $106.95 | $106.95 |
| Queens | $120.22 | $120.22 |
| Redding | $109.51 | $109.51 |
| Rest Of California | $109.51 | $109.51 |
| Rest Of Florida | $107.01 | $107.01 |
| Rest Of Georgia | $102.79 | $102.79 |
| Rest Of Illinois | $105.43 | $105.43 |
| Rest Of Louisiana | $101.40 | $101.40 |
| Rest Of Maine | $101.33 | $101.33 |
| Rest Of Maryland | $107.27 | $107.27 |
| Rest Of Massachusetts | $108.82 | $108.82 |
| Rest Of Michigan | $103.40 | $103.40 |
| Rest Of Missouri | $100.48 | $100.48 |
| Rest Of New Jersey | $113.32 | $113.32 |
| Rest Of New York | $103.01 | $103.01 |
| Rest Of Oregon | $104.99 | $104.99 |
| Rest Of Pennsylvania | $102.76 | $102.76 |
| Rest Of Texas | $103.90 | $103.90 |
| Rest Of Washington | $108.48 | $108.48 |
| Rhode Island | $108.58 | $108.58 |
| Riverside-San Bernardino-Ontario | $111.06 | $111.06 |
| Sacramento-Roseville-Folsom | $113.52 | $113.52 |
| Salinas | $113.05 | $113.05 |
| San Diego-Chula Vista-Carlsbad | $114.62 | $114.62 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $127.27 | $127.27 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $127.11 | $127.11 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $129.89 | $129.89 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $129.24 | $129.24 |
| San Luis Obispo-Paso Robles | $111.37 | $111.37 |
| Santa Cruz-Watsonville | $114.88 | $114.88 |
| Santa Maria-Santa Barbara | $113.18 | $113.18 |
| Santa Rosa-Petaluma | $115.97 | $115.97 |
| Seattle (King Cnty) | $118.41 | $118.41 |
| South Carolina | $102.57 | $102.57 |
| South Dakota** | $103.44 | $103.44 |
| Southern Maine | $104.44 | $104.44 |
| Stockton | $109.51 | $109.51 |
| Suburban Chicago | $111.73 | $111.73 |
| Tennessee | $100.46 | $100.46 |
| Utah | $103.49 | $103.49 |
| Vallejo | $121.42 | $121.42 |
| Vermont | $103.81 | $103.81 |
| Virgin Islands | $106.95 | $106.95 |
| Virginia | $104.44 | $104.44 |
| Visalia | $109.51 | $109.51 |
| West Virginia | $102.92 | $102.92 |
| Wisconsin | $101.50 | $101.50 |
| Wyoming** | $105.33 | $105.33 |
| Yuba City | $109.51 | $109.51 |
77431 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.
$98.21
$136.64
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 | $136.64 | 1 |
| AL | $99.13 | 1 |
| AR | $98.21 | 1 |
| AZ | $104.54 | 1 |
| CA | $109.51–$129.89 | 29 |
| CO | $108.99 | 1 |
| CT | $112.02 | 1 |
| DC | $117.92 | 1 |
| DE | $105.85 | 1 |
| FL | $107.01–$115.47 | 3 |
| GA | $102.79–$108.35 | 2 |
| GU | $110.48 | 1 |
| HI | $110.48 | 1 |
| IA | $100.07 | 1 |
| ID | $100.64 | 1 |
| IL | $105.43–$113.23 | 4 |
| IN | $101.00 | 1 |
| KS | $100.09 | 1 |
| KY | $101.37 | 1 |
| LA | $101.40–$104.64 | 2 |
| MA | $108.82–$116.80 | 2 |
| MD | $107.27–$117.92 | 3 |
| ME | $101.33–$104.44 | 2 |
| MI | $103.40–$108.25 | 2 |
| MN | $104.51 | 1 |
| MO | $100.48–$104.49 | 3 |
| MS | $99.34 | 1 |
| MT | $106.54 | 1 |
| NC | $101.97 | 1 |
| ND | $103.77 | 1 |
| NE | $100.32 | 1 |
| NH | $107.73 | 1 |
| NJ | $113.32–$117.46 | 2 |
| NM | $103.91 | 1 |
| NV | $105.81 | 1 |
| NY | $103.01–$122.46 | 5 |
| OH | $102.84 | 1 |
| OK | $100.90 | 1 |
| OR | $104.99–$111.08 | 2 |
| PA | $102.76–$110.28 | 2 |
| PR | $106.95 | 1 |
| RI | $108.58 | 1 |
| SC | $102.57 | 1 |
| SD | $103.44 | 1 |
| TN | $100.46 | 1 |
| TX | $102.34–$108.63 | 8 |
| UT | $103.49 | 1 |
| VA | $104.44–$117.92 | 2 |
| VI | $106.95 | 1 |
| VT | $103.81 | 1 |
| WA | $108.48–$118.41 | 2 |
| WI | $101.50 | 1 |
| WV | $102.92 | 1 |
| WY | $105.33 | 1 |
How the 77431 rate is calculated
Each of 77431’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 · 77431
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.76Practice expense 1.29Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77431
The CMS indicators that decide how 77431 is paid alongside other services.
CMS payment indicators · 77431
Radiation management
| 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. |
77431 compared with similar codes
Compare codes
77431 vs 77427 vs 77432 vs 77435 vs 77402: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77427Radiation treatment management
- 77431 applies to a course with one or two treatments; 77427 covers a five-treatment management interval.
- 77432Stereotactic management
- Use 77432 for management of a single-session stereotactic cranial radiation course, rather than a one- or two-treatment course coded under 77431.
- 77435SBRT management
- 77435 is the management code for a stereotactic body radiation therapy course; 77431 is for a course limited to one or two treatments.
- 77402Radiation delivery
- 77402 describes radiation delivery, while 77431 reports physician management of a short treatment course.
77431 billing questions
When should 77431 be selected instead of 77427?
Use 77431 for management of a course with only one or two treatments. Code 77427 represents the usual five-treatment management interval.
Can radiation delivery be reported separately?
Yes. The management service is distinct from the technical radiation delivery service, which is represented by a separate code when supported.
Should modifier 26 or TC be appended?
No. CMS identifies 77431 as professional-component-only, covering interpretation and report; it is not a code split into professional and technical portions.
What documentation supports reporting 77431?
Document the course’s one- or two-treatment count and the radiation oncologist’s management work, including review of relevant treatment information.
Is 77431 the management code for stereotactic treatment?
Not when a more specific stereotactic management code describes the service. Codes 77432 and 77435 address stereotactic treatment circumstances.
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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