$102.34–$108.63
77431 is reported for an entire course of only one or two fractions; 77427 applies to courses of three or more fractions, using five-treatment units and the end-of-course remainder rule.
On this page
CMS RVU26D · Effective 2026-10-01
77427 Radiation treatment management Medicare reimbursement rates in Texas
Radiation oncologist management of fractionated external beam therapy is reported in five-treatment units, with an additional unit when three or four fractions remain. Compare 77427 office and facility rates across CMS payment localities in Texas.
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 77427 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$188.11–$199.04
8 of 8 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.
Where 77427 pays more and less in Texas
8 payment localities
$188.11 to $199.04
Radiation oncology
About 77427: Radiation treatment management, five fractions
Radiation oncologist management of fractionated external beam therapy is reported in five-treatment units, with an additional unit when three or four fractions remain.
This code covers a radiation oncologist's ongoing oversight of fractionated external beam therapy, such as a multiweek course for breast, prostate, lung, or head and neck cancer. Management includes reviewing verification images and dosimetry, checking dose delivery and treatment parameters, assessing patient setup, and evaluating treatment response and side effects. The service is provided in hospital outpatient departments and freestanding radiation oncology centers.
Report one unit for each five delivered treatment fractions, regardless of calendar days. Distinct twice-daily treatment sessions count separately. At the end of a course, three or four fractions beyond the last full group of five support another unit; one or two do not. Use 77431 instead when the entire course consists of only one or two fractions. Documentation should support the oncologist's patient evaluation and review of treatment images, dosimetry, and delivery. Medicare treats 77427 as professional-only work: do not append modifier 26. Technical delivery and imaging are reported with separate codes when performed.
CMS billing rules for 77427
- Professional and technical components
- Professional-component-only code: interpretation and report; a separate code covers the technical portion.
Where the value comes from
- Work RVU3.37 · 58%
- Practice expense (office) RVU2.22 · 38%
- Malpractice RVU0.26 · 4%
858.3K
Medicare services in 2024 · #158 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.
77427 compared with similar codes
Office rates for Texas, from the same CMS release.
$618.94–$654.37
77435 manages a stereotactic body radiation therapy course of up to five fractions. Do not report 77427 for management of the same SBRT course.
$409.61–$432.89
77432 manages a single-session cranial stereotactic radiosurgery course; 77427 covers fractionated radiation treatment management.
No office rate
77469 covers physician management of radiation delivered during surgery; 77427 covers management across a fractionated treatment course.
Compare 77427 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $198.93 | Facility $198.93 |
| Beaumont | Office $188.11 | Facility $188.11 |
| Brazoria | Office $193.72 | Facility $193.72 |
| Dallas | Office $194.88 | Facility $194.88 |
| Fort Worth | Office $194.25 | Facility $194.25 |
| Galveston | Office $194.28 | Facility $194.28 |
| Houston | Office $199.04 | Facility $199.04 |
| Rest Of Texas | Office $190.77 | Facility $190.77 |
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77427 billing questions
How many units are reported for a 28-fraction course?
Report six units: five for the first 25 fractions and one for the remaining three. A remainder of only one or two fractions would not support another unit.
When should 77431 be used instead?
Use 77431 when the entire treatment course consists of only one or two fractions. A course of three or more fractions is managed with 77427.
Can E/M visits be billed during the treatment course?
Routine on-treatment evaluation for the condition being irradiated is included in treatment management. A separately identifiable visit for an unrelated problem may be reported when documented; append modifier 25 to the E/M code when needed to distinguish a same-day service.
Does modifier 26 need to be appended?
No. 77427 is already a professional-only code; technical delivery and imaging are reported under separate codes.
Do twice-daily treatments count as two fractions?
Yes. When treatment is delivered in two distinct sessions on the same day, each session counts toward the five-treatment unit.
Is review of port films or verification images separately billable?
The oncologist's review is part of treatment management. Port image acquisition, such as 77417, is a separate technical service.
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.
9,10177423,,Neutron beam tx complex,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10277424,,Io rad tx delivery by x-ray,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10377425,,Io rad tx deliver by elctrns,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10477427,,Radiation tx management x5,A,,3.37,2.22,,2.22,,0.26,5.85,5.85,2,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10577431,,Radiation therapy management,A,,1.76,1.29,,1.29,,0.14,3.19,3.19,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10677432,,Stereotactic radiation trmt,A,,7.72,4.37,,4.37,,0.61,12.70,12.70,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,10777435,,Sbrt management,A,,11.57,6.71,,6.71,,0.92,19.20,19.20,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00