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CMS RVU26D · Effective 2026-10-01

77427 in Merced

Office / nonfacility

$200.40

Base rate per service

Facility setting

$200.40

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Radiation oncology

About 77427: Radiation treatment management, five fractions

Radiation oncologist management of fractionated external beam therapy is reported in five-treatment units, with an additional unit when three or four fractions remain.

This code covers a radiation oncologist's ongoing oversight of fractionated external beam therapy, such as a multiweek course for breast, prostate, lung, or head and neck cancer. Management includes reviewing verification images and dosimetry, checking dose delivery and treatment parameters, assessing patient setup, and evaluating treatment response and side effects. The service is provided in hospital outpatient departments and freestanding radiation oncology centers.

Report one unit for each five delivered treatment fractions, regardless of calendar days. Distinct twice-daily treatment sessions count separately. At the end of a course, three or four fractions beyond the last full group of five support another unit; one or two do not. Use 77431 instead when the entire course consists of only one or two fractions. Documentation should support the oncologist's patient evaluation and review of treatment images, dosimetry, and delivery. Medicare treats 77427 as professional-only work: do not append modifier 26. Technical delivery and imaging are reported with separate codes when performed.

CMS billing rules for 77427

Professional and technical components
Professional-component-only code: interpretation and report; a separate code covers the technical portion.

Where the value comes from

  • Work RVU3.37 · 58%
  • Practice expense (office) RVU2.22 · 38%
  • Malpractice RVU0.26 · 4%

858.3K

Medicare services in 2024 · #158 by national volume

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.

77427 compared with similar codes

Office rates for Merced, from the same CMS release.

77431

Radiation management

One or two treatments

$109.51

77431 is reported for an entire course of only one or two fractions; 77427 applies to courses of three or more fractions, using five-treatment units and the end-of-course remainder rule.

77435

SBRT management

Per treatment course

$655.12

77435 manages a stereotactic body radiation therapy course of up to five fractions. Do not report 77427 for management of the same SBRT course.

77432

Stereotactic management

Cranial, single-session course

$433.13

77432 manages a single-session cranial stereotactic radiosurgery course; 77427 covers fractionated radiation treatment management.

77469

IORT management

During surgery

No office rate

77469 covers physician management of radiation delivered during surgery; 77427 covers management across a fractionated treatment course.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 77427 is $201.26—$0.86 higher than the $200.40 rate in Merced. Both use the same code, release and participation basis.

77427 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $200.40

  2. $0.86 higher than Merced

  3. Chico

    $200.40

    The same base rate than Merced

  4. El Centro

    $200.44

    $0.04 higher than Merced

  5. Fresno

    $200.40

    The same base rate than Merced

  6. The same base rate than Merced

  7. $10.26 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 77427 ranges from $180.73 in Arkansas to $252.60 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Madera

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Modesto

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Napa

    California · 77427

    Office

    $221.79

    Facility

    $221.79

    $21.39 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 77427

    Office

    $208.77

    Facility

    $208.77

    $8.37 higher than Merced for the office setting.

  • Redding

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 77427

    Office

    $203.26

    Facility

    $203.26

    $2.86 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 77427

    Office

    $207.50

    Facility

    $207.50

    $7.10 higher than Merced for the office setting.

  • Salinas

    California · 77427

    Office

    $206.65

    Facility

    $206.65

    $6.25 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 77427

    Office

    $209.33

    Facility

    $209.33

    $8.93 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 77427

    Office

    $231.79

    Facility

    $231.79

    $31.39 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 77427

    Office

    $231.50

    Facility

    $231.50

    $31.10 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 77427

    Office

    $236.52

    Facility

    $236.52

    $36.12 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 77427

    Office

    $235.31

    Facility

    $235.31

    $34.91 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 77427

    Office

    $203.59

    Facility

    $203.59

    $3.19 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 77427

    Office

    $209.67

    Facility

    $209.67

    $9.27 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 77427

    Office

    $206.83

    Facility

    $206.83

    $6.43 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 77427

    Office

    $211.65

    Facility

    $211.65

    $11.25 higher than Merced for the office setting.

  • Stockton

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 77427

    Office

    $221.37

    Facility

    $221.37

    $20.97 higher than Merced for the office setting.

  • Visalia

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 77427

    Office

    $200.40

    Facility

    $200.40

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 77427

    Office

    $215.65

    Facility

    $215.65

    $15.25 higher than Merced for the office setting.

  • Miami

    Florida · 77427

    Office

    $211.71

    Facility

    $211.71

    $11.31 higher than Merced for the office setting.

  • Chicago

    Illinois · 77427

    Office

    $207.80

    Facility

    $207.80

    $7.40 higher than Merced for the office setting.

  • Manhattan

    New York · 77427

    Office

    $219.70

    Facility

    $219.70

    $19.30 higher than Merced for the office setting.

  • Alaska*

    Alaska · 77427

    Office

    $252.60

    Facility

    $252.60

    $52.20 higher than Merced for the office setting.

  • Alabama

    Alabama · 77427

    Office

    $182.36

    Facility

    $182.36

    $18.04 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 77427

    Office

    $180.73

    Facility

    $180.73

    $19.67 lower than Merced for the office setting.

  • Arizona

    Arizona · 77427

    Office

    $191.85

    Facility

    $191.85

    $8.55 lower than Merced for the office setting.

  • Colorado

    Colorado · 77427

    Office

    $199.59

    Facility

    $199.59

    $0.81 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 77427

    Office

    $205.18

    Facility

    $205.18

    $4.78 higher than Merced for the office setting.

  • Delaware

    Delaware · 77427

    Office

    $194.19

    Facility

    $194.19

    $6.21 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 77427

    Office

    $203.38

    Facility

    $203.38

    $2.98 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 77427

    Office

    $196.50

    Facility

    $196.50

    $3.90 lower than Merced for the office setting.

  • Atlanta

    Georgia · 77427

    Office

    $198.66

    Facility

    $198.66

    $1.74 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 77427

    Office

    $189.05

    Facility

    $189.05

    $11.35 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 77427

    Office

    $201.90

    Facility

    $201.90

    $1.50 higher than Merced for the office setting.

  • Iowa

    Iowa · 77427

    Office

    $183.86

    Facility

    $183.86

    $16.54 lower than Merced for the office setting.

  • Idaho

    Idaho · 77427

    Office

    $184.89

    Facility

    $184.89

    $15.51 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 77427

    Office

    $198.27

    Facility

    $198.27

    $2.13 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 77427

    Office

    $193.83

    Facility

    $193.83

    $6.57 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 77427

    Office

    $204.89

    Facility

    $204.89

    $4.49 higher than Merced for the office setting.

  • Indiana

    Indiana · 77427

    Office

    $185.52

    Facility

    $185.52

    $14.88 lower than Merced for the office setting.

  • Kansas

    Kansas · 77427

    Office

    $183.97

    Facility

    $183.97

    $16.43 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 77427

    Office

    $186.43

    Facility

    $186.43

    $13.97 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 77427

    Office

    $192.20

    Facility

    $192.20

    $8.20 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 77427

    Office

    $186.50

    Facility

    $186.50

    $13.90 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 77427

    Office

    $213.44

    Facility

    $213.44

    $13.04 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 77427

    Office

    $199.36

    Facility

    $199.36

    $1.04 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 77427

    Office

    $204.67

    Facility

    $204.67

    $4.27 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 77427

    Office

    $196.70

    Facility

    $196.70

    $3.70 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 77427

    Office

    $186.18

    Facility

    $186.18

    $14.22 lower than Merced for the office setting.

  • Southern Maine

    Maine · 77427

    Office

    $191.52

    Facility

    $191.52

    $8.88 lower than Merced for the office setting.

  • Detroit

    Michigan · 77427

    Office

    $198.76

    Facility

    $198.76

    $1.64 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 77427

    Office

    $190.06

    Facility

    $190.06

    $10.34 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 77427

    Office

    $191.43

    Facility

    $191.43

    $8.97 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 77427

    Office

    $190.67

    Facility

    $190.67

    $9.73 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 77427

    Office

    $191.85

    Facility

    $191.85

    $8.55 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 77427

    Office

    $184.94

    Facility

    $184.94

    $15.46 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 77427

    Office

    $182.82

    Facility

    $182.82

    $17.58 lower than Merced for the office setting.

  • Montana**

    Montana · 77427

    Office

    $195.38

    Facility

    $195.38

    $5.02 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 77427

    Office

    $187.29

    Facility

    $187.29

    $13.11 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 77427

    Office

    $190.24

    Facility

    $190.24

    $10.16 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 77427

    Office

    $184.28

    Facility

    $184.28

    $16.12 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 77427

    Office

    $197.35

    Facility

    $197.35

    $3.05 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 77427

    Office

    $214.94

    Facility

    $214.94

    $14.54 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 77427

    Office

    $207.56

    Facility

    $207.56

    $7.16 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 77427

    Office

    $190.99

    Facility

    $190.99

    $9.41 lower than Merced for the office setting.

  • Nevada**

    Nevada · 77427

    Office

    $194.02

    Facility

    $194.02

    $6.38 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 77427

    Office

    $224.06

    Facility

    $224.06

    $23.66 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 77427

    Office

    $209.33

    Facility

    $209.33

    $8.93 higher than Merced for the office setting.

  • Queens

    New York · 77427

    Office

    $219.93

    Facility

    $219.93

    $19.53 higher than Merced for the office setting.

  • Rest Of New York

    New York · 77427

    Office

    $189.11

    Facility

    $189.11

    $11.29 lower than Merced for the office setting.

  • Ohio

    Ohio · 77427

    Office

    $189.01

    Facility

    $189.01

    $11.39 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 77427

    Office

    $185.52

    Facility

    $185.52

    $14.88 lower than Merced for the office setting.

  • Portland

    Oregon · 77427

    Office

    $203.20

    Facility

    $203.20

    $2.80 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 77427

    Office

    $192.52

    Facility

    $192.52

    $7.88 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 77427

    Office

    $202.14

    Facility

    $202.14

    $1.74 higher than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 77427

    Office

    $188.84

    Facility

    $188.84

    $11.56 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 77427

    Office

    $196.08

    Facility

    $196.08

    $4.32 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 77427

    Office

    $199.04

    Facility

    $199.04

    $1.36 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 77427

    Office

    $188.46

    Facility

    $188.46

    $11.94 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 77427

    Office

    $189.63

    Facility

    $189.63

    $10.77 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 77427

    Office

    $184.63

    Facility

    $184.63

    $15.77 lower than Merced for the office setting.

  • Austin

    Texas · 77427

    Office

    $198.93

    Facility

    $198.93

    $1.47 lower than Merced for the office setting.

  • Beaumont

    Texas · 77427

    Office

    $188.11

    Facility

    $188.11

    $12.29 lower than Merced for the office setting.

  • Brazoria

    Texas · 77427

    Office

    $193.72

    Facility

    $193.72

    $6.68 lower than Merced for the office setting.

  • Dallas

    Texas · 77427

    Office

    $194.88

    Facility

    $194.88

    $5.52 lower than Merced for the office setting.

  • Fort Worth

    Texas · 77427

    Office

    $194.25

    Facility

    $194.25

    $6.15 lower than Merced for the office setting.

  • Galveston

    Texas · 77427

    Office

    $194.28

    Facility

    $194.28

    $6.12 lower than Merced for the office setting.

  • Houston

    Texas · 77427

    Office

    $199.04

    Facility

    $199.04

    $1.36 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 77427

    Office

    $190.77

    Facility

    $190.77

    $9.63 lower than Merced for the office setting.

  • Utah

    Utah · 77427

    Office

    $190.06

    Facility

    $190.06

    $10.34 lower than Merced for the office setting.

  • Virginia

    Virginia · 77427

    Office

    $191.58

    Facility

    $191.58

    $8.82 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 77427

    Office

    $196.08

    Facility

    $196.08

    $4.32 lower than Merced for the office setting.

  • Vermont

    Vermont · 77427

    Office

    $190.36

    Facility

    $190.36

    $10.04 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 77427

    Office

    $198.71

    Facility

    $198.71

    $1.69 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 77427

    Office

    $216.27

    Facility

    $216.27

    $15.87 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 77427

    Office

    $186.27

    Facility

    $186.27

    $14.13 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 77427

    Office

    $189.42

    Facility

    $189.42

    $10.98 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 77427

    Office

    $193.14

    Facility

    $193.14

    $7.26 lower than Merced for the office setting.

See how rates vary across the country

77427 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$180.73

$252.60

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$252.601
AL$182.361
AR$180.731
AZ$191.851
CA$200.40–$236.5229
CO$199.591
CT$205.181
DC$215.651
DE$194.191
FL$196.50–$211.713
GA$189.05–$198.662
GU$201.901
HI$201.901
IA$183.861
ID$184.891
IL$193.83–$207.804
IN$185.521
KS$183.971
KY$186.431
LA$186.50–$192.202
MA$199.36–$213.442
MD$196.70–$215.653
ME$186.18–$191.522
MI$190.06–$198.762
MN$191.431
MO$184.94–$191.853
MS$182.821
MT$195.381
NC$187.291
ND$190.241
NE$184.281
NH$197.351
NJ$207.56–$214.942
NM$190.991
NV$194.021
NY$189.11–$224.065
OH$189.011
OK$185.521
OR$192.52–$203.202
PA$188.84–$202.142
PR$196.081
RI$199.041
SC$188.461
SD$189.631
TN$184.631
TX$188.11–$199.048
UT$190.061
VA$191.58–$215.652
VI$196.081
VT$190.361
WA$198.71–$216.272
WI$186.271
WV$189.421
WY$193.141

Explore 77427 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 77427 in Merced, the physician’s office rate is $200.40 and the facility-setting rate is $200.40: a difference of $0.00.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 77427 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$220.44

$200.40 × 110% = $220.44

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 77427 in Merced.

PPRRVU2026_Oct_nonQPP.csv

9,104

Code
77427
Physician work
3.37
Practice expense
2.22
Malpractice
0.26

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 77427 in Merced
ComponentRVULocality factorAdjusted
Physician work3.37× 1.0173.4273
Practice expense2.22× 1.0962.4331
Malpractice0.26× 0.5360.1394
Total RVUs5.9998
Conversion factor× 33.4009

Office / nonfacility rate, Merced$200.40

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 77427 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.371.017
Practice expense2.221.096
Malpractice0.260.536

(3.37 × 1.017 + 2.22 × 1.096 + 0.26 × 0.536) × $33.4009 = $200.40

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.371.017
Practice expense2.221.096
Malpractice0.260.536

(3.37 × 1.017 + 2.22 × 1.096 + 0.26 × 0.536) × $33.4009 = $200.40

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

77427 · Office / nonfacility

$200.40

Effective 2026-10-01

The base rate is $8.26 higher than on 2025-10-01, moving from $192.14 to $200.40 (4.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $192.14changed to$200.40

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.17 changed to 2.22
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $192.14

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$200.40$200.40RVU26D
2026-07-01$200.40$200.40RVU26C
2026-04-01$200.40$200.40RVU26B
2026-01-01$200.40$200.40RVU26A
2025-10-01$192.14$192.14RVU25D
2025-07-01$192.14$192.14RVU25C
2025-04-01$192.14$192.14RVU25B
2025-01-01$192.14$192.14RVU25A

77427 billing questions

How many units are reported for a 28-fraction course?

Report six units: five for the first 25 fractions and one for the remaining three. A remainder of only one or two fractions would not support another unit.

When should 77431 be used instead?

Use 77431 when the entire treatment course consists of only one or two fractions. A course of three or more fractions is managed with 77427.

Can E/M visits be billed during the treatment course?

Routine on-treatment evaluation for the condition being irradiated is included in treatment management. A separately identifiable visit for an unrelated problem may be reported when documented; append modifier 25 to the E/M code when needed to distinguish a same-day service.

Does modifier 26 need to be appended?

No. 77427 is already a professional-only code; technical delivery and imaging are reported under separate codes.

Do twice-daily treatments count as two fractions?

Yes. When treatment is delivered in two distinct sessions on the same day, each session counts toward the five-treatment unit.

Is review of port films or verification images separately billable?

The oncologist's review is part of treatment management. Port image acquisition, such as 77417, is a separate technical service.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 77427PPRRVU2026_Oct_nonQPP.csv, line 9,104 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)