$107.60–$129.03
Choose 77438 for orthovoltage energy above 150 kV through 500 kV; choose 77437 for superficial treatment at 150 kV or less.
On this page
CMS RVU26D · Effective 2026-10-01
77438 Superficial radiation Medicare reimbursement rates in Virginia
Reports each fraction of superficial radiation delivered with orthovoltage equipment operating above 150 kV through 500 kV, commonly for selected skin lesions. Compare 77438 office and facility rates across CMS payment localities in Virginia.
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 77438 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$108.58–$130.21
2 of 2 localities have a supported rate.
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 therapy
About 77438: Orthovoltage superficial radiation treatment delivery
Reports each fraction of superficial radiation delivered with orthovoltage equipment operating above 150 kV through 500 kV, commonly for selected skin lesions.
This service covers delivery of a superficial radiation treatment fraction using orthovoltage equipment in the range above 150 kV through 500 kV. Radiation oncologists prescribe and oversee treatment, while radiation therapists typically operate the equipment in a radiation oncology center. It is used for selected cutaneous lesions, including some nonmelanoma skin cancers, when the treatment plan calls for orthovoltage energy.
Report the code for each qualifying treatment fraction, not for treatment planning or image guidance alone. The treatment record should support the target site, prescribed energy, and delivery of the fraction. CMS classifies this as a technical-component-only service; a separate code covers interpretation. The physician’s documentation and the treatment record should distinguish the delivered orthovoltage treatment from lower-energy superficial treatment and from other radiation delivery methods.
CMS billing rules for 77438
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU3.30 · 100%
- Malpractice RVU0.01 · 0%
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.
77438 compared with similar codes
Office rates for Virginia, from the same CMS release.
$80.58–$96.75
77402 represents level 1 radiation treatment delivery; 77438 is specifically for superficial orthovoltage delivery in its stated energy range.
$15.93–$17.64
77439 is for ultrasound guidance used to place a superficial radiation applicator, not for delivery of the treatment fraction.
Compare 77438 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$130.21
Facility
Unavailable
Virginia →
Office / nonfacility
$108.58
Facility
Unavailable
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77438 billing questions
How does this differ from 77437?
This code is for orthovoltage treatment above 150 kV through 500 kV. Code 77437 is the sibling for superficial treatment at 150 kV or less.
Is the code reported per fraction?
Yes. Report it for each qualifying orthovoltage treatment fraction delivered, rather than for the overall course of treatment.
Does this code include interpretation?
No. CMS identifies 77438 as technical-component-only, with interpretation covered by a separate code.
What documentation supports reporting 77438?
The treatment record should identify the treated site, the orthovoltage energy used, and the delivered fraction. The treatment plan should support the selected modality and energy range.
When might 77439 be reported with this service?
Code 77439 describes ultrasound image guidance for placement of a superficial radiation therapy applicator. It may be reported with 77438 when that image-guidance service is performed.
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.
9,10977436,26,Surf radj ther tx planning,A,,0.77,0.45,,0.45,,0.03,1.25,1.25,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11077436,TC,Surf radj ther tx planning,A,,0.00,1.09,,1.09,NA,0.01,1.10,1.10,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11177437,,Surf radj ther supfc<=150kv,A,,0.00,3.27,,3.27,NA,0.01,3.28,3.28,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11277438,,Surf rad thr orthvlt>150-500,A,,0.00,3.30,,3.30,NA,0.01,3.31,3.31,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11377439,,Surf rad thr img gdn us plmt,A,,0.30,0.18,,0.18,NA,0.00,0.48,0.48,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11477439,26,Surf rad thr img gdn us plmt,A,,0.30,0.18,,0.18,,0.00,0.48,0.48,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,11577439,TC,Surf rad thr img gdn us plmt,B,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00