Radiation physics consult
CPT code 77370 covers a radiation physics consultation, where a qualified medical physicist evaluates and advises on the technical aspects of radiation treatment to ensure it's safe and effective for the patient.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Document the specific clinical question or complex issue that necessitated the physics consultation separate from routine treatment planning physics
Impact: Prevents denials for lack of medical necessity; protects full $145.56 reimbursement which is otherwise frequently denied as inclusive to treatment planning
Bill only once per treatment course unless documentation clearly supports a new clinical issue requiring separate consultation
Impact: Avoid audit triggers and recoupment; inappropriate multiple billings can result in loss of $145.56 per denied claim plus potential fraud investigation
Ensure the consulting physicist's written report is signed, dated, and separately identifiable in the medical record from routine physics documentation
Impact: Essential for audit defense; absence of distinct consultation report is the leading cause of denials resulting in 100% payment loss
Verify the qualified medical physicist's credentials are current and on file, including board certification and state licensure where required
Impact: Credential deficiencies can result in denial of all claims and potential recoupment; affects all $145.56 payments retroactively
Consider unbundling risks when billing with treatment planning codes 77295, 77300, or 77301 on the same date of service
Impact: High bundling risk without modifier 59/XU; can result in denial and loss of the $145.56 payment
Track RVU productivity using the 4.5 total RVUs for physician compensation and physics staffing models
Impact: Accurate RVU tracking supports appropriate physicist compensation at approximately $32.35 per work RVU using the 2025 conversion factor
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