CPT 77280 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Radiation Oncology Treatment |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 77280 by major payers:
$313.51
$296.52
$315.99
$380.69
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 77280 | ||||||
United | 77280 | $228.83 | 1760773717 - AARON FALCHOOK | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Radiation Oncology Physician (2085R0001X) |
United | 77280 | $303.29 | 1396770111 - WILLIAM POOLE | 42893917 - (MA) RADIOLOGY & IMAGING, INC. | CT | Diagnostic Radiology Physician (2085R0202X) |
United | 77280 | $190.64 | 1821595091 - KELSEY GRACE | 381917674 - (MI) CHELSEA COMMUNITY HOSPITAL | MI | Emergency Medicine Physician (207P00000X) |
United | 77280 | $837.57 | 1780655795 - RALPH PICKARD | 800863895 | CO | Pediatric Radiology Physician (2085P0229X) |
United | 77280 | $814.96 | 1902845043 - NOEL TAN | 592013191 | FL | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | 77280 | $52.02 | 1518904424 - EFROSYNI SFAKIANAKI | 592579938 - UNIVERSITY OF MIAMI | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 77280 | $40.77 | 1497068035 - KEVIN SIMMONS | 853861695 - MUSC COMMUNITY PHYSICIANS | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 77280 | $208.00 | 1144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL | 760246499 - (TX) TOPS SPECIALTY HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 77280 | $59.11 | 1093150898 - KEVIN HOFFMAN | 833817826 - (MI) EPMG SOUTHWEST MICHIGAN PLLC | MI | Emergency Medicine Physician (207P00000X) |
United | 77280 | $70.81 | 1538139738 - PETER KALOS | 900730395 | AZ | Anesthesiology Physician (207L00000X) |
United | 77280 | $191.38 | 1972031334 - SOHINEE KADYLAK | 233030169 - (PA) SOCIETY HILL ANESTHESIA, P.C. | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 77280 | $34.02 | 1962821991 - BERTHINA COLEMAN | 381459362 - WILLIAM BEAUMONT HOSPITAL | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 77280 | $273.47 | 1669446167 - MICHAEL BLACK | 851035186 - (VA) DOGWOOD ANESTHESIA PROVIDERS LLC | FL | Anesthesiology Physician (207L00000X) |
United | 77280 | $111.61 | 1821380932 - SVETLANA YABLOK | 223970667 - (NY) NORTH SHORE-LIJ RADIOLOGY SERVICES P C | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 77280 | $130.50 | 1942627054 - DANIEL DEVINCENT | 610458376 - PIKEVILLE MEDICAL CENTER INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 77280 vs. Other Radiation Oncology Treatment Codes
The CPT 77280 code is part of the Radiology Procedures services used for Radiation Oncology Treatment. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 77280 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 77280-CPT | Moderate | Therap.X-Ray Simulat.Field Set . |
| 77285-CPT | Moderate | Therapeut Radio.Simulat-Aided Field Set; |
| 77290-CPT | Moderate | Obtaining Data Needed To Develop The Optimal Radiation Treatment, 3 Or More Treatment Areas Or Any Number Of Treatment Areas Where Special Treatment Is Involved |
| 77293-CPT | Moderate | Respiratory Motion Management Simulation (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77280 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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