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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 77425 |
| Medicaid Fee Schedule | View Medicaid rates for 77425 |
National average reimbursement for CPT 77425 by major payers:

$10,824.17

$180.41

$275.52

$3,849.14
Choose a payer to see a sample of rates for CPT 77425.
Peacehealth St Joseph Medical Center
Mercy Health
St Joseph Health Northern California LLC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 77425 vs. Other Radiation Oncology Treatment Codes
The CPT 77425 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 77425 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 |
|---|---|---|
| 77423-CPT | Moderate | High-Energy Radiation Therapy, Radiation Therapy Using High-Energy Neutrons Is Directed At The Affected Site. Neutrons Damage Cells That Do Not Have Any Oxygen In Them. Blocks Or Wedges May Be Used To Hold Tissues Perfectly Still During Treatment. |
| 77424-CPT | High | Intraoperat Radiati Treatmn Dlvery X-Ray Sngle Treatmn S, Intraoperative Radiation Treatment Delivery X-Ray Single Treatment S |
| 77425-CPT | High | Intraoperative Radiation Treatment Delivery Electrons Single Treatment Session (Reinstated 1/1/2012 Previous Description: Weekly Radiation Therapy;Intermediate) |
| 77427-CPT | Moderate | Physician Services Radiation, Physician Review And Management Of All Aspects Of Radiation Therapy From Dose Calculation And Delivery To Care Supervision. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77425 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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