Billing code 79403: Nuclear therapyMedicare rate & RVUs in Florida
Report this service for therapeutic administration of a radiopharmaceutical directed at a hematopoietic tumor or marrow disease, rather than thyroid or local-site treatment.
Medicare pays $154.26–$163.55 for 79403 in the office in Florida, from Rest Of Florida to Miami. 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 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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$154.26 to $163.55
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $159.59 | Unavailable |
| Miami | $163.55 | Unavailable |
| Rest Of Florida | $154.26 | Unavailable |
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.
How the rate is built · 79403
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.19Practice expense 2.43Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 79403
The CMS indicators that decide how 79403 is paid alongside other services.
CMS payment indicators · 79403
Nuclear therapy
| 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 | 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
79403 without 26 · national office
$156.65
Nuclear therapy
79403-26 · Professional component
$87.18
Pays only the interpretation and report.
79403 compared with similar codes
Compare codes
79403 vs 79440 vs 79445 vs 79005: national Medicare rates
Swap in your local Medicare rate.
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.
79403 billing questions
How does this differ from 79440 or 79445?
Use 79403 for radiopharmaceutical therapy directed at a hematopoietic tumor or marrow disease. Codes 79440 and 79445 describe therapy delivered into a joint and an artery, respectively.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion involving equipment and staff. Billing without either modifier represents the global service.
Is the radiopharmaceutical supply separately reported?
The therapy service includes the radiopharmaceutical supply. Document the agent administered as part of the treatment record.
What documentation supports reporting 79403?
Document the hematopoietic tumor or marrow disease being treated, the therapeutic radiopharmaceutical used, and its administration. The indication should support this code rather than thyroid-directed or local-site radiopharmaceutical therapy.
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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