Billing code 79403: Nuclear therapyMedicare rate & RVUs

Medicare pays $156.65 for 79403 nationally in the office. Local office rates run $144.07–$199.49.

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

What 79403 covers

This service covers therapeutic administration of a radiopharmaceutical for a hematopoietic tumor or marrow disorder. A nuclear medicine physician typically directs the treatment, with administration performed in a hospital or other setting equipped to handle therapeutic radiopharmaceuticals. Phosphorus-32 treatment for selected myeloproliferative diseases is a representative clinical application. The treatment is distinct from radioisotope therapy directed at thyroid disease or delivered into a joint or artery.

Select the code based on the hematopoietic treatment indication, not simply because a radiopharmaceutical was administered. The record should identify the target disease, prescribed radiopharmaceutical, and administration. CMS recognizes professional and technical components: modifier 26 reports the interpretation, modifier TC reports the equipment and staff portion, and an unmodified claim represents the global service. The CMS fee schedule separately prices 26 and TC. The code includes the radiopharmaceutical supply as part of the therapy service; document the administered agent and treatment.

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 79403 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

79403 rates by state

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

How the 79403 rate is calculated

Each of 79403’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 79403

The CMS indicators that decide how 79403 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

79403 compared with similar codes

How to choose

79440Joint radiotherapy

79403 concerns treatment directed at hematopoietic disease; 79440 describes radiopharmaceutical therapy administered into a joint.

79445Nuclear rx intra-arterial

79403 identifies hematopoietic treatment, while 79445 describes therapy delivered by intra-arterial particulate administration.

79005Radiopharmaceutical therapy

Use 79005 for radiopharmaceutical therapy directed at thyroid carcinoma; use 79403 for a hematopoietic tumor or marrow disease.

Codes related to 79403

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