$114.02
79403 concerns treatment directed at hematopoietic disease; 79440 describes radiopharmaceutical therapy administered into a joint.
On this page
CMS RVU26D · Effective 2026-10-01
79403 Nuclear therapy Medicare reimbursement rates in Utah
Report this service for therapeutic administration of a radiopharmaceutical directed at a hematopoietic tumor or marrow disease, rather than thyroid or local-site treatment. Compare 79403 office and facility rates across CMS payment localities in Utah.
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 79403 in Utah?
Utah 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
$151.54
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Nuclear medicine
About 79403: Hematopoietic tumor radiopharmaceutical therapy
Report this service for therapeutic administration of a radiopharmaceutical directed at a hematopoietic tumor or marrow disease, rather than thyroid or local-site treatment.
This service covers therapeutic administration of a radiopharmaceutical for a hematopoietic tumor or marrow disorder. A nuclear medicine physician typically directs the treatment, with administration performed in a hospital or other setting equipped to handle therapeutic radiopharmaceuticals. Phosphorus-32 treatment for selected myeloproliferative diseases is a representative clinical application. The treatment is distinct from radioisotope therapy directed at thyroid disease or delivered into a joint or artery.
Select the code based on the hematopoietic treatment indication, not simply because a radiopharmaceutical was administered. The record should identify the target disease, prescribed radiopharmaceutical, and administration. CMS recognizes professional and technical components: modifier 26 reports the interpretation, modifier TC reports the equipment and staff portion, and an unmodified claim represents the global service. The CMS fee schedule separately prices 26 and TC. The code includes the radiopharmaceutical supply as part of the therapy service; document the administered agent and treatment.
CMS billing rules for 79403
- 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 RVU2.19 · 47%
- Practice expense (office) RVU2.43 · 52%
- Malpractice RVU0.07 · 1%
24
Medicare services in 2024 · #5826 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.
79403 compared with similar codes
Office rates for Utah, from the same CMS release.
79445
No office rateNuclear rx intra-arterial
79403 identifies hematopoietic treatment, while 79445 describes therapy delivered by intra-arterial particulate administration.
$127.73
Use 79005 for radiopharmaceutical therapy directed at thyroid carcinoma; use 79403 for a hematopoietic tumor or marrow disease.
Compare 79403 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
Utah →
Office / nonfacility
$151.54
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 79403 in Utah.
PPRRVU2026_Oct_nonQPP.csv
9,573
- Code
- 79403
- Physician work
- 2.19
- Practice expense
- 2.43
- Malpractice
- 0.07
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.19 | × 1.000 | 2.1900 |
| Practice expense | 2.43 | × 0.940 | 2.2842 |
| Malpractice | 0.07 | × 0.898 | 0.0629 |
| Total RVUs | 4.5371 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$151.54
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.19 | 1 |
| Practice expense | 2.43 | 0.94 |
| Malpractice | 0.07 | 0.898 |
(2.19 × 1 + 2.43 × 0.94 + 0.07 × 0.898) × $33.4009 = $151.54
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.
79403 billing questions
How does this differ from 79440 or 79445?
Use 79403 for radiopharmaceutical therapy directed at a hematopoietic tumor or marrow disease. Codes 79440 and 79445 describe therapy delivered into a joint and an artery, respectively.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion involving equipment and staff. Billing without either modifier represents the global service.
Is the radiopharmaceutical supply separately reported?
The therapy service includes the radiopharmaceutical supply. Document the agent administered as part of the treatment record.
What documentation supports reporting 79403?
Document the hematopoietic tumor or marrow disease being treated, the therapeutic radiopharmaceutical used, and its administration. The indication should support this code rather than thyroid-directed or local-site radiopharmaceutical therapy.
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.
9,57079300,,Nuclr rx interstit colloid,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57179300,26,Nuclr rx interstit colloid,A,,1.56,0.28,,0.28,,0.02,1.86,1.86,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57279300,TC,Nuclr rx interstit colloid,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57379403,,Hematopoietic nuclear tx,A,,2.19,2.43,,2.43,NA,0.07,4.69,4.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57479403,26,Hematopoietic nuclear tx,A,,2.19,0.39,,0.39,,0.03,2.61,2.61,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57579403,TC,Hematopoietic nuclear tx,A,,0.00,2.04,,2.04,NA,0.04,2.08,2.08,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,57679440,,Nuclear rx intra-articular,A,,1.94,1.52,,1.52,NA,0.05,3.51,3.51,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985