$278.86
This is the closest code: both report high-dose-rate skin surface brachytherapy per fraction. Choose 77768 for a treated area greater than 2 cm in diameter and 77767 for 2 cm or less.
On this page
CMS RVU26D · Effective 2026-10-01
77768 Skin brachytherapy Medicare reimbursement rates in Guam
Reports one fraction of high-dose-rate radionuclide brachytherapy delivered to skin through a surface applicator for a treated area greater than 2 cm. Compare 77768 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 77768 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$410.95
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiation oncology
About 77768: High-dose-rate skin surface brachytherapy, larger field
Reports one fraction of high-dose-rate radionuclide brachytherapy delivered to skin through a surface applicator for a treated area greater than 2 cm.
Code 77768 represents a single fraction of high-dose-rate brachytherapy delivered to a skin lesion or lesions using a surface applicator, for a treated area greater than 2 cm in diameter. Radiation oncologists commonly use this approach for selected superficial skin cancers, such as basal cell carcinoma, when treatment is delivered with a high-dose-rate radionuclide source. The service includes the surface applicator and basic dosimetry; it is distinct from placing a source within a body cavity or tissue.
Report the code for each fraction that meets the size criterion, using the documented treatment field or applicator dimensions to support selection over 77767. The record should identify the treated site, fraction delivered, applicator or treatment dimensions, and dosimetry. CMS allows separate professional and technical component billing: modifier 26 identifies the professional component, modifier TC the technical component, and no modifier reports the global service. Basic dosimetry is included in the service.
CMS billing rules for 77768
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU1.37 · 12%
- Practice expense (office) RVU9.55 · 86%
- Malpractice RVU0.13 · 1%
6.5K
Medicare services in 2024 · #1707 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.
77768 compared with similar codes
Office rates for Guam, from the same CMS release.
$386.12
77770 describes high-dose-rate brachytherapy delivered interstitially or intracavitarily. Use 77768 when the source is applied to the skin surface.
$144.76
77789 concerns surface application of a radiation source using a different brachytherapy approach; 77768 is for high-dose-rate skin surface treatment per fraction.
Compare 77768 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$410.95
Facility
Unavailable
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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 77768 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
9,157
- Code
- 77768
- Physician work
- 1.37
- Practice expense
- 9.55
- Malpractice
- 0.13
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 9.55 | × 1.137 | 10.8584 |
| Malpractice | 0.13 | × 0.579 | 0.0753 |
| Total RVUs | 12.3036 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$410.95
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 9.55 | 1.137 |
| Malpractice | 0.13 | 0.579 |
(1.37 × 1 + 9.55 × 1.137 + 0.13 × 0.579) × $33.4009 = $410.95
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.
77768 billing questions
How does 77768 differ from 77767?
Both report high-dose-rate skin surface brachytherapy per fraction. Use 77768 when the treated surface area is greater than 2 cm in diameter; 77767 is for 2 cm or less.
Is basic dosimetry separately reportable?
Basic dosimetry is included in 77768. The treatment documentation should support the dosimetry and the delivered fraction.
Can the professional and technical components be billed separately?
Yes. Modifier 26 identifies the professional component, and modifier TC identifies the technical component. Reporting without either modifier represents the global service.
Is the code reported once for the entire treatment course?
No. The code is reported per fraction, so the record should support each fraction delivered.
What documentation supports choosing 77768?
Document the skin treatment site, fraction delivered, and treated-field or applicator dimensions showing an area greater than 2 cm in diameter.
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.
9,15477767,,Hdr rdncl skn surf brachytx,A,,1.02,6.40,,6.40,NA,0.09,7.51,7.51,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,15577767,26,Hdr rdncl skn surf brachytx,A,,1.02,0.58,,0.58,,0.04,1.64,1.64,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,15677767,TC,Hdr rdncl skn surf brachytx,A,,0.00,5.82,,5.82,NA,0.05,5.87,5.87,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,15777768,,Hdr rdncl skn surf brachytx,A,,1.37,9.55,,9.55,NA,0.13,11.05,11.05,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,15877768,26,Hdr rdncl skn surf brachytx,A,,1.37,0.78,,0.78,,0.06,2.21,2.21,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,15977768,TC,Hdr rdncl skn surf brachytx,A,,0.00,8.77,,8.77,NA,0.07,8.84,8.84,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,16077770,,Hdr rdncl ntrstl/icav brchtx,A,,1.90,8.43,,8.43,NA,0.13,10.46,10.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014