CPT 77401Radiology

Radiation tx delivery supfc

CPT 77401 covers the delivery of superficial radiation therapy, a treatment that uses low-energy X-rays to treat skin cancers and other surface-level conditions. The radiation only penetrates a few millimeters into tissue, making it ideal for treating lesions on or near the skin surface.

Showing rates for

National Average

Base Medicare rate

$39.79

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

Work RVU

PE RVU (NF)

1.22

MP RVU

0.01

Total RVU

1.23

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Bill 77401 per treatment session, not per treatment field or port, regardless of number of superficial areas treated during single session
Impact: Prevents overbilling denials and audit flags; code represents entire superficial delivery session valued at $39.79
Ensure treatment date matches medical record documentation exactly; radiation oncology is highly audited for date-of-service accuracy
Impact: Prevents 30-40% of common denials related to documentation mismatch in serial treatment billing
Verify energy level documentation shows ≤200 kV; higher energies require different CPT codes (77402-77416)
Impact: Incorrect code selection for orthovoltage or higher energies results in underpayment of $50-300 per fraction
Bundle all superficial treatments delivered on same day into single 77401 charge unless treating truly distinct, separate anatomic sites with modifier 59
Impact: Proper bundling prevents payer downcoding and recoupment averaging $39.79 per inappropriate duplicate charge
Track and bill separately for treatment devices, simulation (77280-77295), and treatment management (77427-77499); these are not included in 77401
Impact: Captures additional $100-500 per treatment course that is frequently missed when only delivery code is billed
Document radiation therapist credentials and physician supervision clearly in treatment record to satisfy state and federal requirements
Impact: Protects against retrospective denials and reduces audit vulnerability for entire treatment course

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 77401 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 77401 is $39.79 for both facility and non-facility settings. This rate is based on 1.23 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary by geographic locality adjustments.

How many times can you bill CPT 77401 for a single patient?

You can bill 77401 once per treatment session delivered. Typical treatment courses involve 10-30 fractions delivered over several weeks, so the code would be billed separately for each day treatment is delivered. You cannot bill multiple units on the same date unless treating truly distinct anatomic sites with appropriate modifier 59 documentation.

What is the difference between CPT 77401 and 77402?

CPT 77401 is for superficial radiation therapy using energy up to 200 kV, penetrating only a few millimeters. CPT 77402 covers orthovoltage radiation (200-1000 kV) which penetrates several centimeters deeper. The choice depends on tumor depth and energy level used, with 77402 receiving higher reimbursement for the more complex delivery.

Can CPT 77401 be billed with a consultation code on the same day?

Yes, but the consultation or E/M service must be separately identifiable and documented as distinct from the treatment delivery. Append modifier 25 to the E/M code. The consultation typically occurs on a different date during initial planning; billing both on treatment delivery dates requires clear documentation of a separate medical decision-making process.

What diagnosis codes are typically used with CPT 77401?

Common ICD-10 codes include C44.x (malignant neoplasm of skin - various sites), D04.x (carcinoma in situ of skin), and L91.0 (keloid scar). Non-melanoma skin cancers (basal cell and squamous cell carcinomas) are the most frequent diagnoses. Medical necessity must clearly support why superficial radiation is appropriate for the specific diagnosis and anatomic location.

Does CPT 77401 include treatment planning and setup?

No, CPT 77401 covers only the delivery of radiation treatment. Treatment planning (77261-77263, 77280-77295), simulation, treatment devices, and clinical treatment management (77427-77499) are billed separately. Failing to bill these additional services results in significant lost revenue for the complete treatment course.

What are the RVU values for CPT 77401 in 2025?

For 2025, CPT 77401 has 0.00 Work RVU, 1.22 Practice Expense RVU (both facility and non-facility), 0.01 Malpractice RVU, totaling 1.23 total RVUs. The zero work RVU reflects that this is primarily a technical service typically performed by radiation therapists under physician supervision rather than direct physician work.