Billing code 79005: Radiopharmaceutical therapyMedicare rate & RVUs in Vermont
Report this service for therapeutic administration of a radioactive pharmaceutical by mouth, such as radioactive iodine treatment for thyroid disease.
Medicare pays $130.08 for 79005 in the office in Vermont (Vermont). 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 79005 covers
This service covers therapeutic administration of a radioactive pharmaceutical by mouth. A familiar example is oral radioactive iodine treatment for hyperthyroidism or thyroid cancer. It is typically performed in a nuclear medicine department by a nuclear medicine physician or other qualified clinician, with staff and facilities prepared to handle the therapeutic dose. The route is the key distinction: the radioactive agent is swallowed rather than administered intravenously or into a body cavity.
Select this code when the documented treatment is delivered orally, not simply because a radioactive agent was ordered or dispensed. The record should support the treatment indication, agent and dose, oral route, date of administration, and responsible provider. CMS identifies separately priced professional and technical components: modifier 26 represents the professional interpretation, while modifier TC represents equipment and staff; billing without either modifier represents the global service. Use the component that matches the service furnished and billed.
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.
79005 in Vermont
| Payment locality | Office | Facility |
|---|---|---|
| Vermont | $130.08 | Unavailable |
How the 79005 rate is calculated
Each of 79005’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 · 79005
RVUs × geographic indexes × conversion factor
Work1.76
1.76 RVUs× 1.000 GPCI
Practice expense2.11
2.11 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
3.9600
Conversion factor
$33.4009
Medicare rate
$132.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 79005
The CMS indicators that decide how 79005 is paid alongside other services.
CMS payment indicators · 79005
Radiopharmaceutical therapy
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
79005 without 26 · national office
$132.27
Radiopharmaceutical therapy
79005-26 · Professional component
$81.50
Pays only the interpretation and report.
79005 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 79101Radiopharmaceutical therapy
- Choose 79005 when the therapeutic agent is given by mouth; choose 79101 when it is administered intravenously.
- 79200Radiopharmaceutical therapy
- 79005 describes oral administration, while 79200 is for delivery of radiopharmaceutical therapy into a body cavity.
- 79440Joint radiotherapy
- Use 79005 for an oral dose and 79440 for radiopharmaceutical therapy administered into a joint.
79005 billing questions
How is this code distinguished from 79101?
The route of administration separates them. Use this code for a therapeutic radioactive pharmaceutical given orally; 79101 is for intravenous administration.
Which modifiers identify the components?
Modifier 26 identifies the professional component, and modifier TC identifies the technical component. Without either modifier, the claim represents the global service.
What documentation supports reporting this code?
Document the treatment indication, radioactive agent and dose, oral route, date administered, and responsible provider.
Does this code describe diagnostic imaging?
It describes therapeutic oral administration, such as radioactive iodine treatment, rather than an imaging examination. Any separately reported service needs its own supporting documentation and applicable code.
Can this code be used when the radioactive agent is injected?
No. This code identifies oral administration; select the route-specific therapy code when the agent is delivered by another route.
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
Show the CMS file lines behind this rate
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