Billing code 77438: Superficial radiationMedicare rate & RVUs in Ohio
Reports each fraction of superficial radiation delivered with orthovoltage equipment operating above 150 kV through 500 kV, commonly for selected skin lesions.
Medicare pays $100.97 for 77438 in the office in Ohio (Ohio). 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 77438 covers
This service covers delivery of a superficial radiation treatment fraction using orthovoltage equipment in the range above 150 kV through 500 kV. Radiation oncologists prescribe and oversee treatment, while radiation therapists typically operate the equipment in a radiation oncology center. It is used for selected cutaneous lesions, including some nonmelanoma skin cancers, when the treatment plan calls for orthovoltage energy.
Report the code for each qualifying treatment fraction, not for treatment planning or image guidance alone. The treatment record should support the target site, prescribed energy, and delivery of the fraction. CMS classifies this as a technical-component-only service; a separate code covers interpretation. The physician’s documentation and the treatment record should distinguish the delivered orthovoltage treatment from lower-energy superficial treatment and from other radiation delivery methods.
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.
77438 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $100.97 | Unavailable |
How the 77438 rate is calculated
Each of 77438’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 · 77438
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.30Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77438
The CMS indicators that decide how 77438 is paid alongside other services.
CMS payment indicators · 77438
Superficial 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 | 3 | Technical component only. |
77438 compared with similar codes
Compare codes
77438 vs 77437 vs 77402 vs 77439: national Medicare rates
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How to choose
- 77437Superficial radiation
- Choose 77438 for orthovoltage energy above 150 kV through 500 kV; choose 77437 for superficial treatment at 150 kV or less.
- 77402Radiation delivery
- 77402 represents level 1 radiation treatment delivery; 77438 is specifically for superficial orthovoltage delivery in its stated energy range.
- 77439Radiation image guidance
- 77439 is for ultrasound guidance used to place a superficial radiation applicator, not for delivery of the treatment fraction.
77438 billing questions
How does this differ from 77437?
This code is for orthovoltage treatment above 150 kV through 500 kV. Code 77437 is the sibling for superficial treatment at 150 kV or less.
Is the code reported per fraction?
Yes. Report it for each qualifying orthovoltage treatment fraction delivered, rather than for the overall course of treatment.
Does this code include interpretation?
No. CMS identifies 77438 as technical-component-only, with interpretation covered by a separate code.
What documentation supports reporting 77438?
The treatment record should identify the treated site, the orthovoltage energy used, and the delivered fraction. The treatment plan should support the selected modality and energy range.
When might 77439 be reported with this service?
Code 77439 describes ultrasound image guidance for placement of a superficial radiation therapy applicator. It may be reported with 77438 when that image-guidance service is performed.
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
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