Billing code 77431: Radiation managementMedicare rate & RVUs in Delaware
Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval.
Medicare pays $105.85 for 77431 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 77431 covers
Code 77431 represents the radiation oncologist’s management of a course with only one or two treatments. The physician’s work includes evaluating the patient during treatment and reviewing the treatment plan and relevant treatment information, such as dosimetry and imaging, to manage the course. It is distinct from coding the radiation delivery itself, which describes the technical treatment service. Radiation oncologists typically provide this management in a hospital or freestanding radiation therapy department.
Select 77431 when the course has one or two treatments; do not use it for a routine five-treatment management interval. The record should support the number of treatments and the physician’s management work. CMS identifies 77431 as a professional-component-only code for interpretation and report, with a separate code covering the technical portion. Report the professional service as represented by this code; do not treat it as a split professional-and-technical code.
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.
77431 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $105.85 | $105.85 |
How the 77431 rate is calculated
Each of 77431’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 · 77431
RVUs × geographic indexes × conversion factor
Work1.76
1.76 RVUs× 1.000 GPCI
Practice expense1.29
1.29 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
3.1900
Conversion factor
$33.4009
Medicare rate
$106.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77431
The CMS indicators that decide how 77431 is paid alongside other services.
CMS payment indicators · 77431
Radiation management
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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 | 2 | Professional component only. |
77431 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77427Radiation treatment management
- 77431 applies to a course with one or two treatments; 77427 covers a five-treatment management interval.
- 77432Stereotactic management
- Use 77432 for management of a single-session stereotactic cranial radiation course, rather than a one- or two-treatment course coded under 77431.
- 77435SBRT management
- 77435 is the management code for a stereotactic body radiation therapy course; 77431 is for a course limited to one or two treatments.
- 77402Radiation delivery
- 77402 describes radiation delivery, while 77431 reports physician management of a short treatment course.
77431 billing questions
When should 77431 be selected instead of 77427?
Use 77431 for management of a course with only one or two treatments. Code 77427 represents the usual five-treatment management interval.
Can radiation delivery be reported separately?
Yes. The management service is distinct from the technical radiation delivery service, which is represented by a separate code when supported.
Should modifier 26 or TC be appended?
No. CMS identifies 77431 as professional-component-only, covering interpretation and report; it is not a code split into professional and technical portions.
What documentation supports reporting 77431?
Document the course’s one- or two-treatment count and the radiation oncologist’s management work, including review of relevant treatment information.
Is 77431 the management code for stereotactic treatment?
Not when a more specific stereotactic management code describes the service. Codes 77432 and 77435 address stereotactic treatment circumstances.
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
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