CPT 77435Radiology

Sbrt management

CPT 77435 covers the professional management services for Stereotactic Body Radiation Therapy (SBRT), an advanced, highly precise radiation treatment that targets tumors with intense radiation doses in fewer sessions than traditional radiation therapy.

Showing rates for

National Average

Base Medicare rate

$629.46

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

11.87

PE RVU (NF)

6.67

MP RVU

0.92

Total RVU

19.46

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

NCCI bundling edits

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Billing tips

Bill 77435 once per treatment session, not per fraction. For a 5-fraction SBRT course, bill 77435 five times over the treatment course.
Impact: Prevents underbilling - a complete 5-fraction SBRT course generates $3,147.30 in professional management fees (5 × $629.46)
Verify SBRT technical delivery codes (77432-77434) are billed separately and not bundled with 77435. The management code is distinct from technical delivery.
Impact: Ensures full reimbursement of both professional management ($629.46 per session) and technical delivery components (varies by complexity)
Document daily image guidance review, treatment plan verification, and patient assessment for each fraction billed. CMS requires evidence of physician supervision per session.
Impact: Prevents denials and audit recoupments which could result in loss of $629.46 per session deemed inadequately documented
Bill on the actual date of treatment delivery, not the planning date. 77435 is for treatment management, while planning services are captured under 77295 or 77301.
Impact: Correct date of service coding prevents processing delays and denials; ensures timely payment of $629.46 per treatment session
For multi-site SBRT (e.g., separate lung lesions), append modifier 59 or XS to the second course of 77435 when treating distinct anatomical sites concurrently.
Impact: Allows additional reimbursement of $629.46 per session for second site; without modifier, second site is typically bundled/denied
Ensure diagnosis coding specifies tumor location and histology with maximum specificity. Generic cancer codes increase audit risk and potential denials for SBRT appropriateness.

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 77435 in 2025?

The 2025 Medicare national average reimbursement for CPT 77435 is $629.46 for both facility and non-facility settings. This rate is based on 19.46 total RVUs (11.87 work RVU + 6.67 PE RVU + 0.92 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

How many times can you bill CPT 77435 for a single SBRT treatment course?

CPT 77435 is billed once per treatment session (fraction). For a typical SBRT course of 3-5 fractions, you would bill 77435 three to five times total, once for each date of treatment delivery. Each session represents a separate billable service at $629.46 per session.

What is the difference between CPT 77435 and 77432-77434?

CPT 77435 is the professional management/supervision code for SBRT treatment delivery, while 77432-77434 represent the technical delivery codes based on complexity (simple, intermediate, complex). Code 77435 captures physician oversight work, whereas 77432-77434 capture the actual radiation delivery technical components.

Do you need modifier 26 when billing CPT 77435?

No, modifier 26 is not typically needed for CPT 77435. This code represents professional services only and has identical facility and non-facility rates ($629.46), indicating it is inherently a professional component service. The code does not have a separately billable technical component.

What documentation is required to support billing CPT 77435?

Documentation must include the radiation oncologist's signature for each treatment date, daily image guidance review notes, verification of treatment parameters, patient assessment, confirmation of positioning/immobilization, and quality assurance documentation. Each billed session requires evidence of physician supervision and clinical decision-making specific to that treatment date.

Can CPT 77435 be billed with other radiation therapy management codes?

No, CPT 77435 should not be billed with other radiation treatment management codes (77427, 77431) for the same treatment course. SBRT management (77435) is mutually exclusive with conventional radiation management codes. However, it can be billed with planning codes (77295, 77301) and delivery codes (77432-77434) when performed on different dates.

What are the work RVUs for CPT code 77435?

CPT 77435 has 11.87 work RVUs in 2025, reflecting the significant physician work involved in SBRT treatment supervision. The total RVU value is 19.46, which includes 11.87 work RVU, 6.67 practice expense RVU, and 0.92 malpractice RVU.