CPT 77470 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 | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 77470 |
National average reimbursement for CPT 77470 by major payers:
$189.23
$246.03
$227.43
$267.03
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 77470 | $442.73 | 1639515281 - BENJAMIN SAVAGE | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | 77470 | $544.02 | 1902030380 - KRISTEN MUSSER | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 77470 | $101.27 | 1447293188 - RANDALL JOHNSON | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurological Surgery Physician (207T00000X) |
United | 77470 | $442.73 | 1902030380 - KRISTEN MUSSER | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 77470 | $101.27 | 1245809714 - BROOKE HENSCHEL | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Nurse Practitioner (363L00000X) |
United | 77470 | $174.58 | 1043240609 - KIMBERLY SARGENT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 77470 | $257.41 | 1639308588 - SUZANNE RHODES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 77470 | $174.58 | 1316931702 - JON SHERECK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Orthopaedic Trauma Physician (207XX0801X) |
United | 77470 | $442.73 | 1740221910 - SUMON BHATTACHARJEE | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurological Surgery Physician (207T00000X) |
United | 77470 | $544.02 | 1265048805 - HILLARY BASHAW | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Nurse Practitioner (363L00000X) |
United | 77470 | $544.02 | 1740893114 - LAURAN BRICE | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Nurse Practitioner (363L00000X) |
United | 77470 | $101.27 | 1235226143 - JUAN ALBINO-RODRIGUEZ | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Interventional Pain Medicine Physician (208VP0014X) |
United | 77470 | $101.27 | 1447996863 - ALISON MARTIN | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 77470 | $442.73 | 1568447605 - DAVID NEUENFELDT | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 77470 | $544.02 | 1144656851 - DACY REIMER | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Adult Health Nurse Practitioner (363LA2200X) |
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 77470 vs. Other Radiation Oncology Treatment Codes
The CPT 77470 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 77470 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 |
|---|---|---|
| 77431-CPT | Low | Radiation Therapy Management W, Radiation Therapy Management With Complete Course Of Therapyconsisting Radiation Therapy Managementwith Complete Course Of Therapy |
| 77469-CPT | Moderate | Radiation Treatment Management, Management Of A Radiation Treatment Given During Surgery. |
| 77470-CPT | Low | Special Treatment Procedure (E, Special Treatment Procedure (Eg Total Body Irradiationhemibody Irradiation Per Oral Vaginal Coneirradiation) Special Treatment Procedure (Eg To Tal Body Irradiation |
| 77620-CPT | Moderate | Cancer Treatment Using Heat, Hyperthermia Cancer Treatment Exposes The Body To A Heat Source To Raise The Body Temperature. Hyperthermia Is Most Often Used With Another Form Of Cancer Treatment. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 77470 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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