CPT 77425 Fee Schedule
Healthcare 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 |
National average reimbursement for CPT 77425 by major payers:
$10,824.17
$180.41
$275.52
$3,310.43
| 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 77425 | ||||||
United | 77425 | $825.00 | 1992898837 - CHINESE HOSPITAL ASSOCIATION | 940382780 - (CA) CHINESE HOSPITAL ASSOCIATION | CA | General Acute Care Hospital (282N00000X) |
United | 77425 | $5559.31 | 1023334950 - ASCENSION VIA CHRISTI HOSPITAL ST TERESA INC. | 271965272 - (KS) ASCENSION VIA CHRISTI HOSPITAL ST TERESA INC | KS | General Acute Care Hospital (282N00000X) |
United | 77425 | $5840.39 | 1528026267 - LONGVIEW MEDICAL CENTER LP, LONGVIEW REGIONAL MEDICAL CENTER | 621762420 | TX | General Acute Care Hospital (282N00000X) |
United | 77425 | $22489.66 | 1376596569 - WOMENS CENTER OF NORTHWEST ARKANSAS LLC, WILLOW CREEK WOMEN'S HOSPITAL | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 77425 | $5664.62 | 1629009964 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST JOSEPH WARREN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 77425 | $6092.75 | 1881697043 - HAYS MEDICAL CENTER INC | 480559088 - (KS) HAYS MEDICAL CENTER INC | KS | General Acute Care Hospital (282N00000X) |
United | 77425 | $825.00 | 1588663769 - KAWEAH DELTA HEALTH CARE DISTRICT, KAWEAH HEALTH MEDICAL CENTER | 941534475 | CA | General Acute Care Hospital (282N00000X) |
United | 77425 | $825.00 | 1033325378 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, QUEEN OF THE VALLEY HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | General Acute Care Hospital (282N00000X) |
United | 77425 | $11626.75 | 1316505043 - ETHICUS HOSPITAL DFW LLC, LEGENT ORTHOPEDIC HOSPITAL | 263044485 - (TX) ETHICUS HOSPITAL DFW | TX | General Acute Care Hospital (282N00000X) |
United | 77425 | $9859.00 | 1548268436 - STRAITH HOSPITAL FOR SPECIAL SURGERY, STRAITH MEMORIAL HOSPITAL | 381455020 - (MI) STRAITH HOSPITAL FOR SPECIAL SURGERY | MI | General Acute Care Hospital (282N00000X) |
United | 77425 | $34892.26 | 1548716665 - UPSTATE AFFILIATE ORGANIZATION, GHS CANCER INST-ANDREWS | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 77425 | $25290.47 | 1417990805 - NORTHFIELD HOSPITAL, NORTHFIELD HOSPITAL | 416007241 | MN | Rural Acute Care Hospital (282NR1301X) |
United | 77425 | $44562.66 | 1487904546 - PEACEHEALTH, ST. JOSEPH MEDICAL CENTER | 910565889 - PEACEHEALTH ST JOSEPH MEDICAL CENTER | WA | Rural Acute Care Hospital (282NR1301X) |
United | 77425 | $825.00 | 1194705202 - PALO VERDE HEALTH CARE DISTRICT, PALO VERDE HOSPITAL | 900214335 - PALO VERDE HOSPITAL HEALTHCARE DISTRICT | CA | General Acute Care Hospital (282N00000X) |
United | 77425 | $6518.12 | 1124341672 - BANNER IRONWOOD MEDICAL CENTER | 900412842 | AZ | General Acute Care Hospital (282N00000X) |
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 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 |
|---|---|---|
| 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) |
| 77425-CPT | High | Intraoperative Radiation Treatment Delivery Electrons Single Treatment Session (Reinstated 1/1/2012 Previous Description: Weekly Radiation Therapy;Intermediate) |
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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