How much does Medicare pay for CPT 77262?

Medicare allowed an average of $106.12 per service and paid $83.80 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $260.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77262?

Intermediate radiation therapy planning. It was billed 1,899 times to 1,802 Medicare beneficiaries by 83 providers in 2024.

Does 77262 pay differently in an office than a hospital?

Yes. The allowed amount averaged $106.24 in an office setting and $104.95 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 77262 most?

Dermatology, with 1,390 services from 61 clinicians. Next are Radiation Oncology, Micrographic Dermatologic Surgery, Otolaryngology.

CPT 77262

Intermediate radiation therapy planning

$106.12Medicare-allowed amount per service, averaged across 1,899 services

Providers submitted

$260.83

Asking price, not received

Medicare allowed

$106.12

The fee schedule figure

Medicare paid

$83.80

Balance is patient coinsurance

Providers submitted an average of $260.83 for this code and Medicare allowed $106.12 — 2.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $83.80 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $106.24
Hospital / facility: $104.95

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,719 services were billed in an office setting and 180 in a facility.

Services: 1,899
Beneficiaries: 1,802
Providers billing it: 83
Total allowed: $201,522

What Medicare pays for CPT 77262

Across 1,899 services billed by 83 providers to 1,802 beneficiaries, Medicare allowed an average of $106.12 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 77262

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	1,390	1,323	$106.60	61
Radiation Oncology	310	291	$105.74	15
Micrographic Dermatologic Surgery	67	62	$105.97	2
Otolaryngology	51	51	$100.23	1
Pathology	41	39	$101.76	1
Diagnostic Radiology	28	24	$105.79	2
Family Practice	12	12	$101.00	1

77262 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	273	$110.57	$82.54	7
Florida	227	$106.78	$84.14	6
Pennsylvania	168	$104.82	$82.26	8
Texas	134	$105.79	$82.80	5
Arizona	114	$108.49	$83.95	6
North Carolina	91	$103.33	$84.00	6
South Carolina	91	$102.60	$84.09	3
Alabama	74	$96.15	$77.12	3
Georgia	70	$105.95	$84.06	4
Delaware	68	$109.05	$77.11	2
Illinois	57	$107.10	$82.23	4
Iowa	51	$100.23	$82.66	1
Tennessee	50	$100.45	$84.10	3
Mississippi	36	$103.12	$84.18	2
Montana	34	$105.17	$84.13	1
New Jersey	31	$113.37	$81.55	2
New York	30	$120.16	$84.07	1
Ohio	29	$107.12	$84.16	2
Louisiana	28	$105.94	$84.10	1
Wisconsin	26	$102.45	$84.25	1
Kentucky	25	$100.73	$84.07	2
West Virginia	22	$104.82	$85.25	1
South Dakota	20	$103.53	$83.81	1
Minnesota	16	$95.99	$84.04	1
Alaska	15	$139.59	$84.21	1
New Mexico	15	$105.93	$84.20	1
Washington	15	$99.09	$84.21	1
Massachusetts	15	$115.20	$84.30	1
Missouri	14	$97.56	$84.09	1
Oregon	13	$107.44	$84.30	1
Idaho	12	$93.35	$77.50	1
Indiana	12	$107.28	$84.18	1
Michigan	12	$102.48	$83.61	1
Virginia	11	$103.69	$83.79	1

Related codes

77280Obtaining data needed to develop the optimal radiation treatment$227.81
77263Complex radiation therapy planning$164.97
77290Obtaining data needed to develop the optimal radiation treatment$213.71
772953d radiation therapy planning$274.90
77293Obtaining respiratory data needed to develop the optimal radiation tre$168.95
77261Simple radiation therapy planning$69.44
77285Obtaining data needed to develop the optimal radiation treatment$422.93

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.