$163.80
77263 identifies complex treatment-planning work by complexity level. Use 77295 when the service is a three-dimensional plan with modeled dose distribution.
On this page
CMS RVU26D · Effective 2026-10-01
77295 Radiotherapy plan Medicare reimbursement rates in Vermont
Report this service for a three-dimensional radiation therapy plan that models the target and nearby normal tissues to guide dose delivery. Compare 77295 office and facility rates across CMS payment localities in Vermont.
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 77295 in Vermont?
Vermont 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
$477.82
1 of 1 localities have a supported rate.
Payment area: Vermont
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 77295: Three-dimensional radiotherapy treatment planning
Report this service for a three-dimensional radiation therapy plan that models the target and nearby normal tissues to guide dose delivery.
A radiation oncology team uses imaging data to map the treatment target and surrounding structures, arrange radiation beams, and calculate how the planned dose is distributed in three dimensions. The plan may include dose-volume analysis to assess target coverage and exposure to nearby organs at risk. Radiation oncologists and medical physicists typically develop or review the plan as part of external-beam treatment planning.
Select this code when the documented work supports a three-dimensional plan, rather than a treatment-planning complexity level or a simulation service. Records should support the modeled anatomy, planned beam arrangement, dose calculations, and dose-volume analysis. CMS recognizes professional and technical components: report modifier 26 for the professional interpretation, modifier TC for the technical work and resources, or no component modifier for the global service. The professional and technical components are separately priced by CMS.
CMS billing rules for 77295
- 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 RVU4.18 · 29%
- Practice expense (office) RVU10.10 · 70%
- Malpractice RVU0.25 · 2%
101.1K
Medicare services in 2024 · #552 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.
77295 compared with similar codes
Office rates for Vermont, from the same CMS release.
$436.04
77290 covers complex treatment simulation and field setup. It does not represent development of the three-dimensional dose plan.
$1,931.98
77301 is for intensity-modulated radiotherapy planning. 77295 describes three-dimensional radiotherapy planning by a different method.
Compare 77295 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
Vermont →
Office / nonfacility
$477.82
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 77295 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
9,041
- Code
- 77295
- Physician work
- 4.18
- Practice expense
- 10.10
- Malpractice
- 0.25
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.18 | × 1.000 | 4.1800 |
| Practice expense | 10.10 | × 0.990 | 9.9990 |
| Malpractice | 0.25 | × 0.506 | 0.1265 |
| Total RVUs | 14.3055 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$477.82
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.18 | 1 |
| Practice expense | 10.1 | 0.99 |
| Malpractice | 0.25 | 0.506 |
(4.18 × 1 + 10.1 × 0.99 + 0.25 × 0.506) × $33.4009 = $477.82
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.
77295 billing questions
How is this different from 77263?
77295 represents a three-dimensional radiation plan. Code 77263 describes a treatment-planning complexity level; select based on the service documented rather than treating the codes as interchangeable.
Is this the same service as simulation under 77290?
No. Simulation establishes or verifies treatment setup and fields; 77295 covers development of the three-dimensional plan. The services may be part of the same treatment-planning process.
Which modifier should be used for a split-component claim?
Use modifier 26 for the professional interpretation or modifier TC for the technical portion. Submit without either modifier when billing the global service.
What documentation supports reporting 77295?
The record should support three-dimensional modeling of the target and surrounding anatomy, planned beam arrangement, dose calculations, and dose-volume analysis.
How does 77295 differ from an IMRT plan?
77295 describes three-dimensional radiotherapy planning. Code 77301 is used for intensity-modulated radiotherapy planning, a distinct planning method.
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.
9,03877293,,Respirator motion mgmt simul,A,,1.95,9.98,,9.98,NA,0.10,12.03,12.03,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,03977293,26,Respirator motion mgmt simul,A,,1.95,1.10,,1.10,,0.07,3.12,3.12,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,04077293,TC,Respirator motion mgmt simul,A,,0.00,8.88,,8.88,NA,0.03,8.91,8.91,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,04177295,,3-d radiotherapy plan,A,,4.18,10.10,,10.10,NA,0.25,14.53,14.53,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,04277295,26,3-d radiotherapy plan,A,,4.18,2.37,,2.37,,0.18,6.73,6.73,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,04377295,TC,3-d radiotherapy plan,A,,0.00,7.73,,7.73,NA,0.07,7.80,7.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,04477299,,Unlisted px ther rad tx plng,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817