Billing code 77789: Surface brachytherapyMedicare rate & RVUs
Reports low-dose-rate brachytherapy when a radionuclide source is applied at a superficial treatment site rather than inserted into tissue or a cavity.
Medicare pays $132.94 for 77789 nationally in the office. Local office rates run $118.61–$177.27.
Medicare rate · 77789
Surface brachytherapy
Swap in your local Medicare rate.
- Work RVUs
- 1.11
- Total RVUs
- 3.98
- Global days
- 000
National rate · 2026
$132.94
Office setting, before claim adjustments.
See every locality for 77789 → · 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 77789 covers
This service covers applying a low-dose-rate radionuclide source at a superficial treatment site using a surface applicator. A radiation oncologist typically directs the treatment, with radiation therapy staff assisting in a hospital or radiation oncology setting. The source is positioned against the target rather than placed into an interstitial tract or body cavity, distinguishing this approach from interstitial and intracavitary brachytherapy.
Select the code for the surface application method, and document the treatment site, source or applicator placement, and the physician’s work. CMS allows billing for the global service or separately for the professional interpretation with modifier 26 and the technical portion with modifier TC. Same-day preoperative and postoperative care is included in the 0-day global period. Modifier 50 is inappropriate. An assistant at surgery is paid only when medical necessity is documented; 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.
Where 77789 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
$118.61 to $177.27
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $120.23 | Unavailable |
| Alaska* | $156.50 | Unavailable |
| Arizona | $129.70 | Unavailable |
| Arkansas | $118.61 | Unavailable |
| Atlanta | $135.01 | Unavailable |
| Austin | $138.17 | Unavailable |
| Bakersfield | $141.70 | Unavailable |
| Baltimore/Surr. Cntys | $140.91 | Unavailable |
| Beaumont | $124.35 | Unavailable |
| Brazoria | $131.88 | Unavailable |
| Chicago | $136.69 | Unavailable |
| Chico | $141.46 | Unavailable |
| Colorado | $138.85 | Unavailable |
| Connecticut | $141.37 | Unavailable |
| Dallas | $132.56 | Unavailable |
| Dc + Md/Va Suburbs | $151.85 | Unavailable |
| Delaware | $131.76 | Unavailable |
| Detroit | $131.27 | Unavailable |
| East St. Louis | $127.82 | Unavailable |
| El Centro | $141.47 | Unavailable |
| Fort Lauderdale | $136.04 | Unavailable |
| Fort Worth | $131.66 | Unavailable |
| Fresno | $141.46 | Unavailable |
| Galveston | $132.18 | Unavailable |
| Hanford-Corcoran | $141.46 | Unavailable |
| Hawaii, Guam | $144.76 | Unavailable |
| Houston | $133.46 | Unavailable |
| Idaho | $124.22 | Unavailable |
| Indiana | $124.91 | Unavailable |
| Iowa | $123.58 | Unavailable |
| Kansas | $122.80 | Unavailable |
| Kentucky | $122.36 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $150.78 | Unavailable |
| Madera | $141.46 | Unavailable |
| Manhattan | $151.83 | Unavailable |
| Merced | $141.46 | Unavailable |
| Metropolitan Boston | $152.34 | Unavailable |
| Metropolitan Kansas City | $127.18 | Unavailable |
| Metropolitan Philadelphia | $137.89 | Unavailable |
| Metropolitan St. Louis | $128.45 | Unavailable |
| Miami | $140.34 | Unavailable |
| Minnesota | $134.00 | Unavailable |
| Mississippi | $119.33 | Unavailable |
| Modesto | $141.46 | Unavailable |
| Montana** | $132.93 | Unavailable |
| Napa | $163.86 | Unavailable |
| Nebraska | $124.28 | Unavailable |
| Nevada** | $132.64 | Unavailable |
| New Hampshire | $136.48 | Unavailable |
| New Mexico | $125.64 | Unavailable |
| New Orleans | $127.74 | Unavailable |
| North Carolina | $125.83 | Unavailable |
| North Dakota** | $131.55 | Unavailable |
| Northern Nj | $150.39 | Unavailable |
| Nyc Suburbs/Long Island | $154.99 | Unavailable |
| Ohio | $124.82 | Unavailable |
| Oklahoma | $122.41 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $150.11 | Unavailable |
| Portland | $143.31 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $143.98 | Unavailable |
| Puerto Rico | $133.93 | Unavailable |
| Queens | $153.36 | Unavailable |
| Redding | $141.46 | Unavailable |
| Rest Of California | $141.46 | Unavailable |
| Rest Of Florida | $130.00 | Unavailable |
| Rest Of Georgia | $123.28 | Unavailable |
| Rest Of Illinois | $126.12 | Unavailable |
| Rest Of Louisiana | $122.08 | Unavailable |
| Rest Of Maine | $124.57 | Unavailable |
| Rest Of Maryland | $134.24 | Unavailable |
| Rest Of Massachusetts | $138.01 | Unavailable |
| Rest Of Michigan | $125.10 | Unavailable |
| Rest Of Missouri | $119.97 | Unavailable |
| Rest Of New Jersey | $143.25 | Unavailable |
| Rest Of New York | $127.57 | Unavailable |
| Rest Of Oregon | $131.87 | Unavailable |
| Rest Of Pennsylvania | $125.14 | Unavailable |
| Rest Of Texas | $127.94 | Unavailable |
| Rest Of Washington | $137.82 | Unavailable |
| Rhode Island | $136.47 | Unavailable |
| Riverside-San Bernardino-Ontario | $142.24 | Unavailable |
| Sacramento-Roseville-Folsom | $148.43 | Unavailable |
| Salinas | $147.87 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $151.31 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $173.54 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $173.46 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $177.27 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $176.94 | Unavailable |
| San Luis Obispo-Paso Robles | $145.48 | Unavailable |
| Santa Cruz-Watsonville | $152.74 | Unavailable |
| Santa Maria-Santa Barbara | $148.41 | Unavailable |
| Santa Rosa-Petaluma | $154.29 | Unavailable |
| Seattle (King Cnty) | $155.59 | Unavailable |
| South Carolina | $125.48 | Unavailable |
| South Dakota** | $131.38 | Unavailable |
| Southern Maine | $131.23 | Unavailable |
| Stockton | $141.46 | Unavailable |
| Suburban Chicago | $137.53 | Unavailable |
| Tennessee | $123.34 | Unavailable |
| Utah | $127.09 | Unavailable |
| Vallejo | $163.75 | Unavailable |
| Vermont | $130.85 | Unavailable |
| Virgin Islands | $133.93 | Unavailable |
| Virginia | $130.66 | Unavailable |
| Visalia | $141.46 | Unavailable |
| West Virginia | $121.69 | Unavailable |
| Wisconsin | $127.39 | Unavailable |
| Wyoming** | $132.33 | Unavailable |
| Yuba City | $141.46 | Unavailable |
77789 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.
$118.61
$159.37
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 | $156.50 | 1 |
| AL | $120.23 | 1 |
| AR | $118.61 | 1 |
| AZ | $129.70 | 1 |
| CA | $141.46–$177.27 | 29 |
| CO | $138.85 | 1 |
| CT | $141.37 | 1 |
| DC | $151.85 | 1 |
| DE | $131.76 | 1 |
| FL | $130.00–$140.34 | 3 |
| GA | $123.28–$135.01 | 2 |
| GU | $144.76 | 1 |
| HI | $144.76 | 1 |
| IA | $123.58 | 1 |
| ID | $124.22 | 1 |
| IL | $126.12–$137.53 | 4 |
| IN | $124.91 | 1 |
| KS | $122.80 | 1 |
| KY | $122.36 | 1 |
| LA | $122.08–$127.74 | 2 |
| MA | $138.01–$152.34 | 2 |
| MD | $134.24–$151.85 | 3 |
| ME | $124.57–$131.23 | 2 |
| MI | $125.10–$131.27 | 2 |
| MN | $134.00 | 1 |
| MO | $119.97–$128.45 | 3 |
| MS | $119.33 | 1 |
| MT | $132.93 | 1 |
| NC | $125.83 | 1 |
| ND | $131.55 | 1 |
| NE | $124.28 | 1 |
| NH | $136.48 | 1 |
| NJ | $143.25–$150.39 | 2 |
| NM | $125.64 | 1 |
| NV | $132.64 | 1 |
| NY | $127.57–$154.99 | 5 |
| OH | $124.82 | 1 |
| OK | $122.41 | 1 |
| OR | $131.87–$143.31 | 2 |
| PA | $125.14–$137.89 | 2 |
| PR | $133.93 | 1 |
| RI | $136.47 | 1 |
| SC | $125.48 | 1 |
| SD | $131.38 | 1 |
| TN | $123.34 | 1 |
| TX | $124.35–$138.17 | 8 |
| UT | $127.09 | 1 |
| VA | $130.66–$151.85 | 2 |
| VI | $133.93 | 1 |
| VT | $130.85 | 1 |
| WA | $137.82–$155.59 | 2 |
| WI | $127.39 | 1 |
| WV | $121.69 | 1 |
| WY | $132.33 | 1 |
How the 77789 rate is calculated
Each of 77789’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 · 77789
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.11Practice expense 2.80Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77789
The CMS indicators that decide how 77789 is paid alongside other services.
CMS payment indicators · 77789
Surface brachytherapy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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
77789 without 26 · national office
$132.94
Surface brachytherapy
77789-26 · Professional component
$59.79
Pays only the interpretation and report.
77789 compared with similar codes
Compare codes
77789 vs 77767 vs 77768 vs 77761: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77767Skin brachytherapy
- 77767 describes high-dose-rate skin surface brachytherapy using one channel. Choose 77789 for low-dose-rate surface source application.
- 77768Skin brachytherapy
- 77768 describes high-dose-rate skin surface brachytherapy using multiple channels. It is not the low-dose-rate surface application reported with 77789.
- 77761Intracavitary brachytherapy
- 77761 applies when a source is placed inside a body cavity for a simple intracavitary treatment; 77789 is for a surface application.
77789 billing questions
How does this differ from the high-dose-rate skin surface codes?
This code is for low-dose-rate surface application. Codes 77767 and 77768 describe high-dose-rate skin surface brachytherapy and are selected according to channel count.
When would an intracavitary code be more appropriate?
Use an intracavitary code when the source is placed within a body cavity, rather than applied at the surface. Codes 77761–77763 distinguish intracavitary applications by complexity.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion; billing without either modifier represents the global service.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the service.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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
Fee sheets
Put 77789 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 →