77431 applies to a course with one or two treatments; 77427 covers a five-treatment management interval.
On this page
CMS RVU26D · Effective 2026-10-01
77431 Radiation management Medicare reimbursement rates in Maine
Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval. Compare 77431 office and facility rates across CMS payment localities in Maine.
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 77431 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$101.33–$104.44
2 of 2 localities have a supported rate.
Facility setting
$101.33–$104.44
2 of 2 localities have a 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 77431: Radiation management for one or two treatments
Reports physician management of an external-beam radiation course limited to one or two treatments, rather than the usual five-treatment management interval.
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.
CMS billing rules for 77431
- Professional and technical components
- Professional-component-only code: interpretation and report; a separate code covers the technical portion.
Where the value comes from
- Work RVU1.76 · 55%
- Practice expense (office) RVU1.29 · 40%
- Malpractice RVU0.14 · 4%
5.7K
Medicare services in 2024 · #1793 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.
77431 compared with similar codes
Office rates for Maine, from the same CMS release.
Use 77432 for management of a single-session stereotactic cranial radiation course, rather than a one- or two-treatment course coded under 77431.
77435 is the management code for a stereotactic body radiation therapy course; 77431 is for a course limited to one or two treatments.
77402 describes radiation delivery, while 77431 reports physician management of a short treatment course.
Compare 77431 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$101.33
Facility
$101.33
Southern Maine →
Office / nonfacility
$104.44
Facility
$104.44
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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 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.
