CPT 77423 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 | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 76 - Repeat procedure by same physician |
| Complexity Level | Moderate |
National average reimbursement for CPT 77423 by major payers:
$253.07
$149.96
$165.67
$146.93
| 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 77423 | ||||||
United | 77423 | $369.60 | 1730143165 - MALVINDERJIT SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Gastroenterology Physician (207RG0100X) |
United | 77423 | $245.41 | 1164428249 - DOUGLAS WRIGHT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 77423 | $369.60 | 1306251343 - NICHOLAS WILLIUS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 77423 | $369.60 | 1689878530 - KATHRYN FEUQUAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 77423 | $369.60 | 1396010856 - BERTRAND LIANG | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | KS | Neurology Physician (2084N0400X) |
United | 77423 | $245.41 | 1235407248 - PHYLLIS MOORE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Family Nurse Practitioner (363LF0000X) |
United | 77423 | $119.55 | 1033564026 - AYSHA AGARWAL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 77423 | $369.60 | 1649237678 - ANITA EISENHART | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Emergency Medicine Physician (207P00000X) |
United | 77423 | $100.08 | 1659628659 - HEALTH IMAGING PARTNERS LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 77423 | $100.08 | 1932520673 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 77423 | $245.41 | 1700812815 - MICHAEL PENNEY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | MO | Diagnostic Radiology Physician (2085R0202X) |
United | 77423 | $245.41 | 1407146384 - RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 77423 | $245.41 | 1700318102 - STEVEN LEE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | IL | Diagnostic Radiology Physician (2085R0202X) |
United | 77423 | $100.08 | 1982317079 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 77423 | $81.29 | 1891180634 - ERIC PEPIN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | 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 77423 vs. Other Radiation Oncology Treatment Codes
The CPT 77423 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 77423 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 |
|---|---|---|
| 77387-CPT | Low | Guidance For Localization Of Target Volume For Delivery Of Radiation Treatment Includes Intrafraction Tracking When Performed (Desc Rvsd 1/1/19) |
| 77401-CPT | Low | Radiation Treatment Delivery Superficial And/Or Ortho Voltage Per Day (Desc Revised 01/01/15) |
| 77423-CPT | Moderate | High Energy Neutron Radiation Treatment Delivery; 1 Or More Isocenter(S) With Coplanar Or Non-Coplanar Geometry With Blocking And/Or Wedge, And/Or Compensator(S) |
| 77424-CPT | High | Intraoperative Radiation Treatment Delivery, X-Ray, Single Treatment Session. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77423. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77423 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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