How much does Medicare pay for CPT 77331?

Medicare allowed an average of $51.76 per service and paid $41.14 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $181.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77331?

Special radiation therapy planning. It was billed 17,382 times to 5,774 Medicare beneficiaries by 226 providers in 2024.

Does 77331 pay differently in an office than a hospital?

Yes. The allowed amount averaged $59.60 in an office setting and $45.09 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 77331 most?

Radiation Oncology, with 17,287 services from 222 clinicians. Next are Diagnostic Radiology, Radiation Therapy Center, Ambulatory Surgical Center.

CPT 77331

Special radiation therapy planning

$51.76Medicare-allowed amount per service, averaged across 17,382 services

Providers submitted

$181.35

Asking price, not received

Medicare allowed

$51.76

The fee schedule figure

Medicare paid

$41.14

Balance is patient coinsurance

Providers submitted an average of $181.35 for this code and Medicare allowed $51.76 — 3.5× 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 $41.14 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $59.60
Hospital / facility: $45.09

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. 7,998 services were billed in an office setting and 9,384 in a facility.

Services: 17,382
Beneficiaries: 5,774
Providers billing it: 226
Total allowed: $899,692

What Medicare pays for CPT 77331

Across 17,382 services billed by 226 providers to 5,774 beneficiaries, Medicare allowed an average of $51.76 per service. That is 3.0 services per beneficiary, so this is a code patients typically receive more than once. 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 77331

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	17,287	5,721	$51.84	222
Diagnostic Radiology	50	25	$51.51	2
Radiation Therapy Center	30	13	$20.29	1
Ambulatory Surgical Center	15	15	$32.85	1

77331 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	4,349	$46.61	$36.69	29
Alabama	2,865	$59.21	$50.34	4
Florida	1,379	$64.86	$49.40	35
Tennessee	849	$49.50	$42.55	10
New Jersey	832	$48.73	$36.29	8
Pennsylvania	824	$47.29	$36.35	15
New York	823	$50.45	$39.89	13
Michigan	814	$43.64	$34.94	4
Virginia	681	$46.43	$35.39	13
Arizona	463	$62.67	$50.71	11
Washington	386	$50.07	$37.78	11
Louisiana	348	$62.72	$50.78	5
Oklahoma	328	$56.16	$48.25	3
Illinois	322	$48.54	$35.38	11
Mississippi	317	$42.29	$35.53	5
Maryland	201	$45.61	$34.78	6
Arkansas	199	$57.30	$49.33	2
Massachusetts	195	$45.83	$34.41	3
Ohio	170	$44.82	$35.42	4
Kansas	162	$54.30	$44.60	4
Georgia	147	$51.88	$42.54	5
North Carolina	145	$43.99	$35.62	4
South Carolina	129	$47.01	$37.24	5
Indiana	81	$60.56	$50.66	1
Colorado	68	$45.60	$35.80	3
Nebraska	61	$43.30	$36.22	3
Hawaii	55	$67.82	$50.62	1
District of Columbia	53	$46.94	$35.68	1
Texas	35	$61.78	$50.68	2
West Virginia	22	$59.14	$50.36	1
Alaska	22	$59.77	$35.72	1
Kentucky	21	$45.42	$32.50	1
New Mexico	18	$43.51	$33.67	1
Iowa	18	$42.66	$33.71	1

Related codes

77300Calculation of radiation therapy dose$41.81
77334Design and construction of complex radiation treatment device$75.55
77336Continuing radiation therapy consultation per week$87.27
77338Design and construction of radiation treatment device for high precisi$294.26
77301High precision radiation therapy planning$830.13
77332Design and construction of simple radiation treatment device$30.27
77373Cranial lesion surgery$965.17
77370Special medical radiation therapy consultation$146.53
77307Complex radiation therapy planning for delivery of external radiation$178.50
77333Design and construction of intermediate radiation treatment device$73.71
77321Special radiation therapy planning for delivery of external radiation$66.64
77318Complex radiation therapy planning for delivery of internal radiation$389.02

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.