Billing code 79200: Radiopharmaceutical therapyMedicare rate & RVUs

Medicare pays $130.60 for 79200 nationally in the office. Local office rates run $120.75–$166.41.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 79200 covers

This service represents therapeutic delivery of a radioactive drug directly into an artery. It is associated with targeted treatment in which the agent is administered through an arterial route; nuclear medicine physicians and physicians performing image-guided arterial procedures may be involved. The code identifies the administration route, not simply the presence of a radioactive substance or a diagnostic nuclear medicine study.

Choose the code when the documented therapeutic administration is intra-arterial, and retain the treatment record showing the radiopharmaceutical and route. CMS identifies separately billable professional and technical components: modifier 26 represents the professional interpretation, modifier TC represents equipment and staff, and reporting without either modifier represents the global service. The CMS file lists both modifiers as separately priced. Do not select this code for oral, intravenous, intracavitary, or intra-arterial particulate administration when a more specific route or technique code describes the 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 79200 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

79200 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 79200 rate is calculated

Each of 79200’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.

Payment rules and modifiers for 79200

The CMS indicators that decide how 79200 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

79200 compared with similar codes

How to choose

79445Nuclear rx intra-arterial

Both describe intra-arterial radiopharmaceutical therapy, but 79445 specifies particulate administration. Select based on the documented treatment technique.

79101Radiopharmaceutical therapy

79101 applies to therapeutic administration through a vein; this code applies when the radiopharmaceutical is administered into an artery.

Codes related to 79200

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates