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CMS RVU26D · Effective 2026-10-01

79200 Radiopharmaceutical therapy Medicare reimbursement rates in New Jersey

Report this service for therapeutic administration of a radiopharmaceutical into an artery, rather than by oral, intravenous, or intracavitary route. Compare 79200 office and facility rates across CMS payment localities in New Jersey.

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 79200 in New Jersey?

New Jersey 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

$139.25–$145.05

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $5.80 per service.

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.

Find 79200 in your payment locality →

Radiopharmaceutical therapy

About 79200: Intra-arterial radiopharmaceutical therapy

Report this service for therapeutic administration of a radiopharmaceutical into an artery, rather than by oral, intravenous, or intracavitary route.

This service represents therapeutic delivery of a radioactive drug directly into an artery. It is associated with targeted treatment in which the agent is administered through an arterial route; nuclear medicine physicians and physicians performing image-guided arterial procedures may be involved. The code identifies the administration route, not simply the presence of a radioactive substance or a diagnostic nuclear medicine study.

Choose the code when the documented therapeutic administration is intra-arterial, and retain the treatment record showing the radiopharmaceutical and route. CMS identifies separately billable professional and technical components: modifier 26 represents the professional interpretation, modifier TC represents equipment and staff, and reporting without either modifier represents the global service. The CMS file lists both modifiers as separately priced. Do not select this code for oral, intravenous, intracavitary, or intra-arterial particulate administration when a more specific route or technique code describes the service.

CMS billing rules for 79200

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 RVU1.94 · 50%
  • Practice expense (office) RVU1.92 · 49%
  • Malpractice RVU0.05 · 1%

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.

79200 compared with similar codes

Office rates for New Jersey, from the same CMS release.

79445

Nuclear rx intra-arterial

No office rate

Both describe intra-arterial radiopharmaceutical therapy, but 79445 specifies particulate administration. Select based on the documented treatment technique.

79101

Radiopharmaceutical therapy

Intravenous route

$152.81–$159.36

79101 applies to therapeutic administration through a vein; this code applies when the radiopharmaceutical is administered into an artery.

Compare 79200 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

Office and facility base rates · shared scale starting at $0

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79200 billing questions

How is this code distinguished from 79445?

This code represents intra-arterial radiopharmaceutical therapy generally. Use 79445 when the documented therapy is specifically by intra-arterial particulate administration.

Can the professional and technical portions be billed separately?

Yes. CMS lists modifier 26 for the professional interpretation and modifier TC for the technical portion, which includes equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports the intra-arterial route?

The treatment record should identify the radiopharmaceutical and document that it was administered into an artery for therapy. A diagnostic study showing arterial anatomy alone does not establish this service.

Should this code be used for intravenous radiopharmaceutical therapy?

No. For therapeutic administration by the intravenous route, 79101 is the route-specific alternative.

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.

RVUs for 79200PPRRVU2026_Oct_nonQPP.csv, line 9,567 (RVU26D)