CPT 77772Radiology

Hdr rdncl ntrstl/icav brchtx

CPT 77772 covers high dose rate (HDR) brachytherapy, a procedure where radiation is delivered directly inside or very close to a tumor through catheters or needles for a brief, intense treatment session.

Showing rates for

National Average

Base Medicare rate

$887.91

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

5.4

PE RVU (NF)

21.66

MP RVU

0.39

Total RVU

27.45

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

NCCI bundling edits

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Billing tips

Bill each HDR fraction separately with 77772 for every treatment delivery session, not per applicator insertion
Impact: Prevents underbilling; typical patient receives 3-5 fractions worth $2,663.73-$4,439.55 total
Verify applicator placement codes (57155, 58346) are billed separately on placement date, not bundled with delivery
Impact: Recovers additional $300-$800 per treatment course depending on applicator type and placement complexity
Ensure clinical brachytherapy planning (77316-77318) is billed on simulation date prior to first fraction delivery
Impact: Captures planning reimbursement of $200-$500 that is frequently missed when focus is only on delivery codes
Document physicist presence during each treatment delivery in medical record with time stamps and verification signatures
Impact: Prevents denials for lack of required supervision; physicist presence is bundled into the 21.66 PE RVUs
Use date of service as actual treatment delivery date, not applicator insertion or removal date
Impact: Ensures proper claims sequencing and prevents date-based denials or duplicate rejections
For multi-day implants, verify daily fractions are medically necessary per treatment plan before billing each 77772
Impact: Prevents medical necessity denials; Medicare requires treatment plan documentation supporting each fraction billed

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 77772 in 2025?

The 2025 Medicare national average reimbursement for CPT 77772 is $887.91 for both facility and non-facility settings, based on 27.45 total RVUs and the 32.3465 conversion factor.

How many times can CPT 77772 be billed for a single patient?

CPT 77772 should be billed once per HDR brachytherapy fraction delivered. Typical treatment courses involve 2-5 fractions depending on tumor site and protocol, so each fraction delivery is billed separately with appropriate documentation of medical necessity.

Can CPT 77772 be billed on the same day as applicator insertion codes?

Yes, but requires modifier 59 or XU to indicate distinct procedural services. The applicator insertion (such as 57155 or 58346) and treatment delivery (77772) are separately reportable when performed on the same day with proper documentation of separate sessions.

What documentation is required to bill CPT 77772?

Required documentation includes a signed treatment plan with prescribed fractionation, physicist supervision verification, treatment delivery record with dose/dwell times, pre-treatment position verification imaging, and physician attestation of treatment completion and patient tolerance.

What is the difference between CPT 77772 and 77771?

CPT 77771 is for intermediate/simple HDR brachytherapy (1-4 channels/needles) while 77772 is for intermediate/complex cases (5-10 channels). The code selection depends on the number of catheters or needles used for treatment delivery, with 77772 representing more complex treatments.

Is physicist supervision included in CPT 77772 reimbursement?

Yes, qualified medical physicist presence during treatment delivery is bundled into the 21.66 practice expense RVUs for CPT 77772. The physicist's supervision cannot be billed separately but must be documented in the medical record to support the code.

Can CPT 77772 be billed for both gynecologic and prostate brachytherapy?

Yes, CPT 77772 covers HDR brachytherapy delivery for any anatomic site including gynecologic (cervix, endometrium, vagina), prostate, breast, and other tumor locations, as long as the treatment meets HDR criteria (>12 Gy/hour) and uses interstitial or intracavitary approach.