$416.67
77285 represents intermediate simulation complexity. Choose it instead of 77280 when the documented field-setting work supports that level.
On this page
CMS RVU26D · Effective 2026-10-01
77280 Radiation simulation Medicare reimbursement rates in Ohio
Reports simple radiation treatment simulation to reproduce patient positioning and establish treatment-field geometry before external-beam therapy. Compare 77280 office and facility rates across CMS payment localities in Ohio.
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 77280 in Ohio?
Ohio 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
$248.20
1 of 1 localities have a supported rate.
Payment area: Ohio
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 77280: Simple radiation treatment simulation
Reports simple radiation treatment simulation to reproduce patient positioning and establish treatment-field geometry before external-beam therapy.
The radiation oncology team uses a simulator or treatment imaging system to reproduce the patient’s treatment position and establish basic beam geometry for a simple field setup. The radiation oncologist directs and interprets the simulation; radiation therapists commonly assist with positioning and image acquisition in a radiation oncology department. The service supports accurate setup before treatment begins or when a new setup is needed.
Select 77280 when the documented field-setting work meets the simple level; use 77285 or 77290 when the simulation complexity supports those levels. Documentation should identify the treatment site, patient position, field geometry, simulation images, and physician involvement. CMS recognizes modifier 26 for the professional component and modifier TC for the technical component; reporting without either modifier represents the global service.
CMS billing rules for 77280
- 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 RVU0.68 · 8%
- Practice expense (office) RVU7.35 · 91%
- Malpractice RVU0.04 · 0%
534K
Medicare services in 2024 · #220 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.
77280 compared with similar codes
Office rates for Ohio, from the same CMS release.
$407.88
77290 represents complex simulation work, rather than the simple setup reported with 77280. The documentation should support the higher complexity.
$67.65
77261 describes simple radiation treatment planning, not simulator-based field setup. Report it for distinct planning work rather than as a substitute for 77280.
Compare 77280 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
Ohio →
Office / nonfacility
$248.20
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 77280 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
9,029
- Code
- 77280
- Physician work
- 0.68
- Practice expense
- 7.35
- Malpractice
- 0.04
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.68 | × 1.000 | 0.6800 |
| Practice expense | 7.35 | × 0.913 | 6.7105 |
| Malpractice | 0.04 | × 1.008 | 0.0403 |
| Total RVUs | 7.4309 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$248.20
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.68 | 1 |
| Practice expense | 7.35 | 0.913 |
| Malpractice | 0.04 | 1.008 |
(0.68 × 1 + 7.35 × 0.913 + 0.04 × 1.008) × $33.4009 = $248.20
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.
77280 billing questions
How does 77280 differ from 77285 or 77290?
The distinction is the complexity of the simulation and field-setting work. Report 77280 for a simple setup; use 77285 or 77290 when the documented work meets an intermediate or complex level.
Is 77280 the same service as radiation treatment planning?
No. This code represents simulation and field setup; codes 77261–77263 describe treatment-planning levels. A planning service is distinct from simply establishing the simulation setup.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional component, including interpretation, or TC for the technical component, including equipment and staff. Without either modifier, the code represents the global service.
Does 77280 represent each image or each radiation fraction?
It reports the simple simulation service, not each treatment fraction. Document the simulation and field-setting work performed rather than treating routine treatment delivery as another simulation.
What documentation supports reporting 77280?
Record the treatment site, patient positioning, field geometry, simulation imaging, and the radiation oncologist’s direction or interpretation. The record should support a simple—not intermediate or complex—simulation level.
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.
9,02677261,,Ther radiology tx plng smpl,A,,1.27,0.75,,0.75,,0.07,2.09,2.09,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02777262,,Ther radiology tx plng intrm,A,,1.95,1.14,,1.14,,0.12,3.21,3.21,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02877263,,Ther radiology tx plng cplx,A,,3.06,1.74,,1.74,,0.24,5.04,5.04,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,02977280,,Ther rad simulaj field smpl,A,,0.68,7.35,,7.35,NA,0.04,8.07,8.07,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,03077280,26,Ther rad simulaj field smpl,A,,0.68,0.40,,0.40,,0.03,1.11,1.11,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,03177280,TC,Ther rad simulaj field smpl,A,,0.00,6.95,,6.95,NA,0.01,6.96,6.96,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,03277285,,Ther rad simulaj field intrm,A,,1.02,12.48,,12.48,NA,0.06,13.56,13.56,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703