Billing code 77470: Special radiationMedicare rate & RVUs

Reports additional work for an unusual or complex radiation treatment circumstance, such as total body irradiation or radiation delivered with concurrent chemotherapy.

CMS RVU26DEffective Oct 1, 2026109 payment localities83.5K Medicare services in 2024

Medicare pays $144.96 for 77470 nationally in the office. Local office rates run $132.70–$184.05.

Medicare rate · 77470

Special radiation

Swap in your local Medicare rate.

Work RVUs
1.98
Total RVUs
4.34
Global days
XXX

National rate · 2026

$144.96

Office setting, before claim adjustments.

See every locality for 77470 → · 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
  1. Medicare rate
  2. What 77470 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 77470 covers

A radiation oncologist reports this service when a treatment circumstance requires substantial work beyond the usual radiation planning and treatment process. Examples include total body irradiation, hemibody irradiation, hyperthermia combined with radiation, or coordinating radiation with concurrent chemotherapy. The added work may involve specialized preparation, coordination, or treatment considerations; the specific circumstance and work performed should be evident in the record.

Report 77470 for the additional special-treatment work, not as a substitute for applicable radiation delivery or management services. Documentation should explain why the case required extra effort and describe the work attributable to that circumstance. CMS identifies professional and technical components: modifier 26 represents the professional interpretation, modifier TC represents equipment and staff, and an unmodified claim represents the global service. The CMS file lists both modifiers as separately priced.

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 77470 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

$132.70 to $184.05

$132.70$158.38$184.05
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

77470 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$134.07Unavailable
Alaska*$181.43Unavailable
Arizona$142.14Unavailable
Arkansas$132.70Unavailable
Atlanta$147.04Unavailable
Austin$149.09Unavailable
Bakersfield$152.16Unavailable
Baltimore/Surr. Cntys$152.32Unavailable
Beaumont$137.93Unavailable
Brazoria$144.07Unavailable

77470 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.

$132.70

$181.43

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

View every state and territory as a table
77470 office rate range by state
State / territoryOffice rate rangeLocalities
AK$181.431
AL$134.071
AR$132.701
AZ$142.141
CA$151.78–$184.0529
CO$149.851
CT$152.801
DC$162.351
DE$144.051
FL$143.32–$153.163
GA$137.45–$147.042
GU$153.901
HI$153.901
IA$136.531
ID$137.161
IL$140.27–$150.134
IN$137.731
KS$136.061
KY$136.301
LA$136.14–$140.962
MA$149.34–$161.952
MD$146.25–$162.353
ME$137.66–$143.052
MI$138.82–$144.612
MN$144.801
MO$134.46–$141.343
MS$133.601
MT$144.951
NC$138.701
ND$142.981
NE$137.071
NH$147.641
NJ$154.87–$161.432
NM$139.371
NV$144.481
NY$140.19–$166.325
OH$138.421
OK$136.141
OR$143.67–$153.542
PA$138.59–$149.892
PR$145.741
RI$148.351
SC$138.721
SD$142.741
TN$136.541
TX$137.93–$149.098
UT$140.091
VA$142.69–$162.352
VI$145.741
VT$142.561
WA$149.02–$164.792
WI$139.481
WV$136.511
WY$144.091

How the 77470 rate is calculated

Each of 77470’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 · 77470

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.98Practice expense 2.26Malpractice 0.10

4.3400 adjusted RVUs×$33.4009 conversion factor=$144.96

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 77470

The CMS indicators that decide how 77470 is paid alongside other services.

CMS payment indicators · 77470

Special radiation

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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

77470 without 26 · national office

$144.96

Special radiation

77470-26 · Professional component

$106.21

Pays only the interpretation and report.

When to use modifier 26

77470 compared with similar codes

Compare codes

77470 vs 77402 vs 77427 vs 77432 vs 77435: national Medicare rates

Swap in your local Medicare rate.

  • 77470
    Special radiation · 1.98 wRVU
    $144.96
  • 77402
    Radiation delivery · 0 wRVU
    $82.17−$62.79
  • 77427
    Radiation treatment management · 3.37 wRVU
    $195.40+$50.44
  • 77432
    Stereotactic management · 7.72 wRVU
    $424.19+$279.23
  • 77435
    SBRT management · 11.57 wRVU
    $641.30+$496.34

How to choose

77402Radiation delivery
77402 represents level 1 radiation treatment delivery. Use 77470 for additional work associated with a special treatment circumstance, not for routine delivery.
77427Radiation treatment management
77427 represents radiation treatment management in five-treatment increments. 77470 represents additional work for special treatment circumstances.
77432Stereotactic management
77432 describes stereotactic radiation treatment. 77470 captures extra work for a special treatment circumstance and is not a stereotactic treatment code.
77435SBRT management
77435 describes management of stereotactic body radiation therapy. 77470 is distinguished by additional special-treatment work rather than SBRT management.

77470 billing questions

How is 77470 different from a radiation delivery code?

77470 represents additional work tied to a special treatment circumstance. Codes such as 77402, 77407, and 77412 describe radiation treatment delivery at different levels.

Can 77470 be reported with radiation delivery?

It may be reported with the applicable delivery service when the record supports additional special-treatment work. It does not replace the code for treatment delivery.

What documentation supports 77470?

Document the unusual treatment circumstance, why it required work beyond the usual process, and the additional work performed. Naming a complex diagnosis alone does not explain the service.

When should modifier 26 or TC be used?

CMS identifies modifier 26 for the professional interpretation and modifier TC for equipment and staff. Without either modifier, the claim represents the global service.

Is 77470 the code for routine radiation treatment management?

No. Routine management is represented by applicable management services, such as 77427 for radiation treatment management reported in five-treatment increments. 77470 addresses added work for a special treatment circumstance.

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 77470PPRRVU2026_Oct_nonQPP.csv, line 9,117 (RVU26D)

Open CMS sourceHow we calculate rates

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