How much does Medicare pay for CPT 77293?

Medicare allowed an average of $168.95 per service and paid $134.71 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $777.30, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77293?

Obtaining respiratory data needed to develop the optimal radiation treatment. It was billed 27,368 times to 26,004 Medicare beneficiaries by 1,218 providers in 2024.

Does 77293 pay differently in an office than a hospital?

Yes. The allowed amount averaged $277.91 in an office setting and $102.98 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 77293 most?

Radiation Oncology, with 26,760 services from 1,202 clinicians. Next are Radiation Therapy Center, Diagnostic Radiology, Internal Medicine.

CPT 77293

Obtaining respiratory data needed to develop the optimal radiation treatment

$168.95Medicare-allowed amount per service, averaged across 27,368 services

Providers submitted

$777.30

Asking price, not received

Medicare allowed

$168.95

The fee schedule figure

Medicare paid

$134.71

Balance is patient coinsurance

Providers submitted an average of $777.30 for this code and Medicare allowed $168.95 — 4.6× 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 $134.71 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $277.91
Hospital / facility: $102.98

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. 10,321 services were billed in an office setting and 17,047 in a facility.

Services: 27,368
Beneficiaries: 26,004
Providers billing it: 1,218
Total allowed: $4,623,824

What Medicare pays for CPT 77293

Across 27,368 services billed by 1,218 providers to 26,004 beneficiaries, Medicare allowed an average of $168.95 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 77293

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	26,760	25,451	$166.54	1,202
Radiation Therapy Center	477	429	$288.20	8
Diagnostic Radiology	70	67	$191.20	4
Internal Medicine	33	31	$264.23	2
Hematology-Oncology	28	26	$273.07	2

77293 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
Texas	2,746	$203.90	$165.33	103
California	2,448	$197.21	$139.66	106
Florida	1,973	$263.20	$212.10	86
Illinois	1,318	$142.73	$112.75	64
Pennsylvania	1,280	$132.66	$103.99	64
Ohio	1,206	$140.75	$116.43	56
New York	1,008	$169.90	$122.34	46
Tennessee	998	$129.62	$111.44	40
North Carolina	969	$141.78	$117.11	48
Missouri	833	$111.30	$90.69	34
Arkansas	784	$210.83	$190.47	23
Massachusetts	761	$137.88	$103.96	33
Georgia	677	$175.30	$147.74	30
Indiana	662	$125.27	$104.56	29
Virginia	660	$192.40	$151.79	26
South Carolina	660	$194.76	$162.00	28
Michigan	628	$142.19	$115.82	40
Kentucky	617	$120.50	$100.86	26
Wisconsin	534	$130.85	$105.00	25
Maryland	501	$174.41	$130.03	27
New Jersey	461	$118.78	$87.15	20
Minnesota	447	$155.28	$121.35	18
Kansas	397	$134.78	$112.49	17
Washington	378	$196.98	$160.66	20
Alabama	370	$212.36	$178.78	17
Arizona	346	$182.65	$146.86	14
Iowa	332	$97.14	$81.68	15
Colorado	294	$104.38	$81.60	15
Oklahoma	291	$140.42	$117.89	12
Louisiana	273	$262.96	$227.56	13
Alaska	235	$278.52	$196.51	7
Oregon	210	$102.11	$81.41	12
Connecticut	210	$144.85	$107.46	10
New Hampshire	196	$130.81	$105.56	11
Nevada	194	$190.22	$150.01	7
South Dakota	176	$100.78	$81.46	8
Rhode Island	150	$183.77	$141.50	6
West Virginia	139	$100.04	$81.07	6
North Dakota	130	$180.78	$139.81	7
Hawaii	114	$174.65	$128.06	5
Mississippi	108	$96.21	$81.56	6
Idaho	105	$190.88	$162.64	4
Montana	104	$102.23	$81.67	7
Delaware	102	$100.87	$81.86	5
Nebraska	98	$156.82	$132.35	6
Utah	88	$101.30	$81.45	6
Vermont	58	$168.25	$126.28	4
Wyoming	40	$179.78	$136.36	2
Maine	28	$260.34	$225.45	2
New Mexico	19	$106.19	$81.54	1
District of Columbia	12	$113.30	$81.68	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
77261Simple radiation therapy planning$69.44
77285Obtaining data needed to develop the optimal radiation treatment$422.93
77262Intermediate radiation therapy planning$106.12

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.