CPT CODERadiologyStatus A

CPT Code 77301Complete Billing & Coding Guide (2026)Radiotherapy dose plan imrt

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$1960
Non-facility · National avg
Facility
$1960
Total RVU
58.69
Global
XXX
Payment
$1960
non-facility
Work RVU
7.79
physician effort
Global Period
XXX
no post-op
Bundling Edits
10
NCCI pairs

About CPT 77301

CPT 77301 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Radiotherapy dose plan imrt". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 77301 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

77301 has 10 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.

Code Properties

Global Period
XXX
Not applicable (E/M, diagnostic, etc.)
Status Indicator
A
Active. Payment under Medicare PFS.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
58.69 total RVU
7.79
50.20
Work RVU
7.79 · 13%
Physician time + skill
Practice Expense
50.20 · 86%
Office & equipment
Malpractice
0.70 · 1%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$1960.30
58.69 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$1960.30
58.69 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

Medicare Payment by State

Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.

DC
$2275
CA
$2266
WA
$2198
AK
$2189
NJ
$2187
HI
$2180
NY
$2175
MA
$2171
CT
$2100
CO
$2066
OR
$2046
MD
$2037

Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 77301. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 77301 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Radiology bundling traps usually involve component coding (TC/26 splits) plus contrast-with vs without coding pairs. CO-97 denials on 77301 often resolve once the right component modifier is appended on resubmission.

Applicable Modifiers

Modifiers commonly paired with 77301 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

26
Professional component — physician interpretation/report only (no technical component)
When to use · When the physician only interprets/reads a diagnostic test performed by another entity (e.g., reading an echo performed at a hospital).
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
76
Repeat procedure or service by same physician
When to use · When the same physician repeats the exact same procedure on the same day (e.g., repeat EKG after treatment, repeat X-ray after reduction).
77
Repeat procedure by another physician
When to use · When a different physician repeats the same procedure on the same day.
91
Repeat clinical diagnostic laboratory test on the same day for the same patient
When to use · When the same lab test is repeated on the same day for clinical reasons (not equipment malfunction).
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
AR Recovery Note

Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 77301. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
CMS LCD: Billing and Coding: Radiation Therapies
CMS LCD
C00.0See ICD-10-CM tabular index
C00.1See ICD-10-CM tabular index
C00.2See ICD-10-CM tabular index
C00.3See ICD-10-CM tabular index
C00.4See ICD-10-CM tabular index
C00.5See ICD-10-CM tabular index
C00.6See ICD-10-CM tabular index
C00.8See ICD-10-CM tabular index
C01See ICD-10-CM tabular index
C02.0See ICD-10-CM tabular index
C02.1See ICD-10-CM tabular index
C02.2See ICD-10-CM tabular index
AR Recovery Note

Imaging CO-50 denials trace to medical-policy criteria mismatches. Cardiac MRI, cardiac CT, nuclear cardiology, and advanced imaging all face strict commercial payer policies. We pre-verify the indication against the payer's policy before submission, not after the denial.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 77301 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Radiology claims. Our AAPC-certified team audits your last 90 days of 77301 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 77301

What does CPT code 77301 cover?

CPT 77301 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Radiotherapy dose plan imrt". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 77301?

The national average Medicare payment for CPT 77301 is approximately $1960.3 in a non-facility setting and $1960.3 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 58.69 with a conversion factor of $33.4009.

What is the global period for CPT 77301?

CPT 77301 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.

What codes bundle with CPT 77301?

CPT 77301 has NCCI Procedure-to-Procedure edits with 10+ codes including 0591T, 0592T, 0593T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.