CPT 77767Radiology

Hdr rdncl skn surf brachytx

CPT code 77767 is used for high-dose-rate (HDR) radiation treatment applied to the skin surface using temporary radioactive sources placed on or near the skin. This is a specialized form of brachytherapy where radiation is delivered directly to superficial skin lesions or tumors.

Showing rates for

National Average

Base Medicare rate

$243.25

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

1.05

PE RVU (NF)

6.39

MP RVU

0.08

Total RVU

7.52

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

NCCI bundling edits

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Billing tips

Bill 77767 per treatment session, not per lesion or applicator; multiple applicators in one session count as single unit
Impact: Prevents downcoding or bundling that could reduce reimbursement from $243.25 to zero for additional applicators
Ensure medical physicist's dosimetry calculations and treatment plan are documented in medical record before billing
Impact: Missing physics documentation is primary cause of audits; can result in 100% recoupment ($243.25 per session)
Verify prior authorization for series of treatments; many payers require pre-approval for brachytherapy courses exceeding 5 fractions
Impact: Lack of authorization can result in denial of entire treatment series, potentially thousands in lost revenue
Do not bill 77767 with treatment planning codes (77316-77318) on same date of service unless separate planning for different site
Impact: Unbundling can trigger automatic denial and potential fraud investigation; planning is separate date of service
Document source loading time, dwell time, and radiation safety procedures for each treatment session
Impact: Technical detail supports medical necessity and differentiates from lower-intensity treatments; prevents downcoding
Link appropriate ICD-10 diagnosis code with specific anatomic site and laterality for skin malignancy
Impact: Vague diagnosis codes increase denial rate by approximately 15-20% for radiation oncology procedures

Common denials

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT 77767?

The 2025 Medicare national average reimbursement rate for CPT 77767 is $243.25 for both facility and non-facility settings, based on 7.52 total RVUs and a conversion factor of 32.3465.

How many times can CPT 77767 be billed per treatment course?

CPT 77767 is billed once per treatment session/fraction. The total number of billable sessions depends on the prescribed fractionation schedule, which varies by diagnosis and treatment protocol. Each fraction requires separate documentation and is billed as a distinct service, though prior authorization may limit approved sessions.

Can CPT 77767 be billed with treatment planning codes on the same day?

Generally no. Treatment planning codes (77316-77318) are typically performed and documented on a separate date of service prior to the first treatment. Billing both on the same date often results in bundling denials unless clearly distinct services with modifier 59 and supporting documentation.

What documentation is required to bill CPT 77767 without denial risk?

Required documentation includes radiation oncologist treatment notes, medical physicist treatment planning report with dose calculations, source calibration records, applicator specifications, dwell times, radiation safety monitoring, patient tolerance documentation, and diagnosis with specific anatomic site.

Does CPT 77767 require modifier 26 or TC for split billing?

Modifier 26 (professional) or TC (technical) can be used if the service is split between physician and facility, but it is uncommon for 77767 since the facility and non-facility rates are identical at $243.25. Most commonly billed as global service without split.

What is the difference between CPT 77767 and 77768?

CPT 77767 is for high-dose-rate skin surface brachytherapy using temporary sources applied to the skin, while 77768 covers HDR brachytherapy for 1-4 intracavitary or interstitial sources placed inside body cavities or tissue. The anatomic placement distinguishes these codes.

What diagnosis codes support medical necessity for CPT 77767?

Common supporting diagnoses include C44.x codes for basal cell and squamous cell carcinomas of skin, C43.x for melanoma, D04.x for carcinoma in situ of skin, and L91.0 for keloid scars. The diagnosis must specify the exact anatomic site being treated with the surface brachytherapy.