Billing code 77470: Special radiationMedicare rate & RVUs in Illinois
Reports additional work for an unusual or complex radiation treatment circumstance, such as total body irradiation or radiation delivered with concurrent chemotherapy.
Medicare pays $140.27–$150.13 for 77470 in the office in Illinois, from Rest Of Illinois to Chicago. 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 77470 covers
A radiation oncologist reports this service when a treatment circumstance requires substantial work beyond the usual radiation planning and treatment process. Examples include total body irradiation, hemibody irradiation, hyperthermia combined with radiation, or coordinating radiation with concurrent chemotherapy. The added work may involve specialized preparation, coordination, or treatment considerations; the specific circumstance and work performed should be evident in the record.
Report 77470 for the additional special-treatment work, not as a substitute for applicable radiation delivery or management services. Documentation should explain why the case required extra effort and describe the work attributable to that circumstance. CMS identifies professional and technical components: modifier 26 represents the professional interpretation, modifier TC represents equipment and staff, and an unmodified claim represents the global service. The CMS file lists both modifiers as separately priced.
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 77470 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$140.27 to $150.13
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $150.13 | Unavailable |
| East St. Louis | $142.31 | Unavailable |
| Rest Of Illinois | $140.27 | Unavailable |
| Suburban Chicago | $150.04 | Unavailable |
How the 77470 rate is calculated
Each of 77470’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 · 77470
RVUs × geographic indexes × conversion factor
Work1.98
1.98 RVUs× 1.000 GPCI
Practice expense2.26
2.26 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
4.3400
Conversion factor
$33.4009
Medicare rate
$144.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 77470
The CMS indicators that decide how 77470 is paid alongside other services.
CMS payment indicators · 77470
Special radiation
| 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
77470 without 26 · national office
$144.96
Special radiation
77470-26 · Professional component
$106.21
Pays only the interpretation and report.
77470 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 77402Radiation delivery
- 77402 represents level 1 radiation treatment delivery. Use 77470 for additional work associated with a special treatment circumstance, not for routine delivery.
- 77427Radiation treatment management
- 77427 represents radiation treatment management in five-treatment increments. 77470 represents additional work for special treatment circumstances.
- 77432Stereotactic management
- 77432 describes stereotactic radiation treatment. 77470 captures extra work for a special treatment circumstance and is not a stereotactic treatment code.
- 77435SBRT management
- 77435 describes management of stereotactic body radiation therapy. 77470 is distinguished by additional special-treatment work rather than SBRT management.
77470 billing questions
How is 77470 different from a radiation delivery code?
77470 represents additional work tied to a special treatment circumstance. Codes such as 77402, 77407, and 77412 describe radiation treatment delivery at different levels.
Can 77470 be reported with radiation delivery?
It may be reported with the applicable delivery service when the record supports additional special-treatment work. It does not replace the code for treatment delivery.
What documentation supports 77470?
Document the unusual treatment circumstance, why it required work beyond the usual process, and the additional work performed. Naming a complex diagnosis alone does not explain the service.
When should modifier 26 or TC be used?
CMS identifies modifier 26 for the professional interpretation and modifier TC for equipment and staff. Without either modifier, the claim represents the global service.
Is 77470 the code for routine radiation treatment management?
No. Routine management is represented by applicable management services, such as 77427 for radiation treatment management reported in five-treatment increments. 77470 addresses added work for a special treatment circumstance.
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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