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CMS RVU26D · Effective 2026-10-01

77469 IORT management Medicare reimbursement rates in Texas

Reports physician management of intraoperative radiation treatment delivered during surgery, distinct from the separate code for delivering the radiation beam. Compare 77469 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 77469 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

No supported rate

Facility setting

$259.69–$273.11

8 of 8 localities have a supported rate.

Lowest: Beaumont

Highest: Houston

A spread of $13.42 per service.

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 77469 in your payment locality →

Where 77469 pays more and less in Texas

Radiation oncology

About 77469: Intraoperative radiation treatment management

Reports physician management of intraoperative radiation treatment delivered during surgery, distinct from the separate code for delivering the radiation beam.

This service represents the radiation oncologist’s management of radiation delivered in the operating room during a surgical procedure. Intraoperative radiation therapy may be used to treat a tumor bed or other selected target while the area is exposed during surgery. The radiation oncologist coordinates and manages the treatment in the operative setting with the surgical team; this is different from the technical act of delivering the beam.

Report 77469 for the management service when intraoperative radiation treatment is performed, and distinguish it from the modality-specific delivery service, such as intraoperative x-ray or electron treatment. Documentation should identify the operative treatment, the physician’s management work, and the relationship to the surgical procedure and radiation delivery. The code is not the selection for routine fraction-based radiation management or for stereotactic treatment management; those services have their own codes. CMS fee schedule data assigns work and practice expense values to this service.

Where the value comes from

  • Work RVU5.61 · 70%
  • Practice expense (office) RVU1.93 · 24%
  • Malpractice RVU0.44 · 6%

354

Medicare services in 2024 · #3848 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.

77469 compared with similar codes

Office rates for Texas, from the same CMS release.

77424

Io rad tx delivery by x-ray

No office rate

77424 represents intraoperative radiation delivery by x-ray. Use 77469 for the physician’s management service, not as a substitute for the delivery code.

77425

Io rad tx deliver by elctrns

No office rate

77425 represents intraoperative radiation delivery by electrons. It identifies the delivery modality, while 77469 represents management.

77427

Radiation treatment management

Per five treatment fractions

$188.11–$199.04

77427 is radiation treatment management counted in groups of five treatments. 77469 is specific to management of treatment delivered during surgery.

77470

Special radiation

Additional treatment complexity

$137.93–$149.09

77470 represents a special radiation treatment procedure, whereas 77469 specifically identifies management of intraoperative radiation treatment.

Compare 77469 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

77469 office and facility rates by payment locality
Payment localityOfficeFacility
Austin

Office

Unavailable

Facility

$268.98
Beaumont

Office

Unavailable

Facility

$259.69
Brazoria

Office

Unavailable

Facility

$264.22
Dallas

Office

Unavailable

Facility

$265.88
Fort Worth

Office

Unavailable

Facility

$265.43
Galveston

Office

Unavailable

Facility

$265.06
Houston

Office

Unavailable

Facility

$273.11
Rest Of Texas

Office

Unavailable

Facility

$261.83

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77469 billing questions

Is 77469 the code for delivering the intraoperative radiation beam?

No. It reports the physician’s management of intraoperative radiation treatment. The x-ray or electron delivery is represented by its modality-specific delivery code when applicable.

Can 77469 be reported with an intraoperative radiation delivery code?

They describe different services: physician management and radiation delivery. The record should support the management work separately from the delivery.

How is 77469 different from 77427?

77469 is specific to management of radiation treatment delivered during surgery. 77427 describes management for a course of radiation treatment counted in groups of five treatments.

What documentation supports 77469?

Document the intraoperative radiation treatment, the physician’s management involvement, and how the service relates to the operative treatment and beam delivery.

Does 77469 identify x-ray or electron treatment?

No. The management code does not specify the delivery modality. The applicable delivery code distinguishes intraoperative x-ray treatment from electron treatment.

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 77469PPRRVU2026_Oct_nonQPP.csv, line 9,116 (RVU26D)