How much does Medicare pay for CPT 77295?

Medicare allowed an average of $274.90 per service and paid $218.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1527.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77295?

3d radiation therapy planning. It was billed 86,774 times to 77,454 Medicare beneficiaries by 2,835 providers in 2024.

Does 77295 pay differently in an office than a hospital?

Yes. The allowed amount averaged $375.58 in an office setting and $222.88 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 77295 most?

Radiation Oncology, with 84,735 services from 2,783 clinicians. Next are Radiation Therapy Center, Diagnostic Radiology, Hematology-Oncology.

CPT 77295

3d radiation therapy planning

$274.90Medicare-allowed amount per service, averaged across 86,774 services

Providers submitted

$1527.38

Asking price, not received

Medicare allowed

$274.90

The fee schedule figure

Medicare paid

$218.08

Balance is patient coinsurance

Providers submitted an average of $1527.38 for this code and Medicare allowed $274.90 — 5.6× 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 $218.08 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $375.58
Hospital / facility: $222.88

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. 29,560 services were billed in an office setting and 57,214 in a facility.

Services: 86,774
Beneficiaries: 77,454
Providers billing it: 2,835
Total allowed: $23,854,173

What Medicare pays for CPT 77295

Across 86,774 services billed by 2,835 providers to 77,454 beneficiaries, Medicare allowed an average of $274.90 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 77295

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	84,735	75,759	$274.01	2,783
Radiation Therapy Center	962	857	$274.68	16
Diagnostic Radiology	670	483	$365.10	23
Hematology-Oncology	139	125	$247.55	5
Pediatric Medicine	99	87	$243.91	1
Ambulatory Surgical Center	68	67	$436.62	2
Osteopathic Manipulative Medicine	41	21	$537.19	1
Internal Medicine	35	32	$210.58	2
Interventional Radiology	14	12	$484.07	1
Neurosurgery	11	11	$210.62	1

77295 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	9,760	$332.10	$233.10	287
Florida	6,231	$343.79	$271.76	208
Texas	4,904	$334.68	$272.22	163
New York	4,047	$274.10	$198.48	135
Pennsylvania	3,949	$241.62	$190.22	159
Illinois	3,362	$244.95	$189.59	118
Massachusetts	3,160	$245.57	$182.29	98
Ohio	3,127	$238.75	$190.56	111
Virginia	2,885	$262.55	$205.01	73
North Carolina	2,738	$252.13	$204.76	98
Maryland	2,557	$299.53	$227.49	68
Tennessee	2,456	$243.16	$204.91	62
New Jersey	2,371	$253.97	$185.18	64
Washington	2,356	$282.20	$215.31	84
Georgia	2,347	$254.41	$205.72	89
Indiana	2,243	$231.72	$193.39	67
Missouri	2,074	$229.56	$187.89	62
Michigan	1,818	$238.90	$191.15	80
Arizona	1,559	$345.59	$279.95	61
South Carolina	1,492	$267.45	$218.15	46
Wisconsin	1,332	$235.37	$190.15	62
Iowa	1,278	$209.36	$172.87	30
Kentucky	1,190	$227.90	$185.51	43
Arkansas	1,119	$246.12	$213.48	26
Colorado	1,114	$245.69	$189.92	46
Alabama	1,037	$294.23	$244.88	32
Oklahoma	1,037	$242.94	$203.38	26
Connecticut	991	$237.04	$175.94	37
Kansas	959	$245.75	$203.74	28
Oregon	920	$270.44	$208.99	42
Minnesota	919	$269.14	$209.87	42
Louisiana	903	$307.69	$257.41	34
Mississippi	852	$212.02	$177.36	21
Nevada	825	$316.62	$247.70	19
Nebraska	632	$291.93	$245.96	19
New Hampshire	601	$219.65	$175.84	18
Delaware	586	$219.44	$173.85	13
Idaho	528	$247.89	$206.16	17
Utah	511	$217.51	$174.00	20
Montana	462	$218.93	$174.14	15
District of Columbia	459	$262.92	$185.82	12
South Dakota	444	$214.44	$172.85	11
Hawaii	412	$254.09	$188.86	12
Alaska	357	$284.79	$188.83	11
North Dakota	350	$337.94	$258.68	10
Rhode Island	349	$277.01	$210.28	12
New Mexico	307	$312.67	$262.58	12
West Virginia	299	$277.47	$229.24	11
Maine	228	$212.12	$173.57	11
Vermont	204	$237.62	$185.57	8
Wyoming	133	$230.04	$179.63	2

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
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
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.