How much does Medicare pay for CPT 77427?

Medicare allowed an average of $188.33 per service and paid $149.46 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $752.85, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77427?

Radiation treatment management, 5 treatment sessions. It was billed 843,253 times to 274,958 Medicare beneficiaries by 4,602 providers in 2024.

Does 77427 pay differently in an office than a hospital?

Yes. The allowed amount averaged $189.01 in an office setting and $187.71 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 77427 most?

Radiation Oncology, with 828,440 services from 4,465 clinicians. Next are Dermatology, Diagnostic Radiology, Radiation Therapy Center.

CPT 77427

Radiation treatment management, 5 treatment sessions

$188.33Medicare-allowed amount per service, averaged across 843,253 services

Providers submitted

$752.85

Asking price, not received

Medicare allowed

$188.33

The fee schedule figure

Medicare paid

$149.46

Balance is patient coinsurance

Providers submitted an average of $752.85 for this code and Medicare allowed $188.33 — 4.0× 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 $149.46 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $189.01
Hospital / facility: $187.71

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. 407,644 services were billed in an office setting and 435,609 in a facility.

Services: 843,253
Beneficiaries: 274,958
Providers billing it: 4,602
Total allowed: $158,809,837

What Medicare pays for CPT 77427

Across 843,253 services billed by 4,602 providers to 274,958 beneficiaries, Medicare allowed an average of $188.33 per service. That is 3.1 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 77427

Specialty	Services	Beneficiaries	Avg allowed	Providers
Radiation Oncology	828,440	269,155	$188.38	4,465
Dermatology	4,784	2,233	$186.39	61
Diagnostic Radiology	3,711	1,327	$192.13	25
Radiation Therapy Center	1,373	334	$187.88	3
Physician Assistant	1,269	639	$158.96	20
Hematology-Oncology	1,169	379	$191.25	7
Internal Medicine	742	222	$191.40	4
Otolaryngology	556	156	$176.09	1
Family Practice	419	143	$186.05	1
Pediatric Medicine	192	103	$208.63	2
Osteopathic Manipulative Medicine	160	30	$201.44	1
Nurse Practitioner	152	91	$157.07	4
Gynecological Oncology	94	41	$180.13	1
Micrographic Dermatologic Surgery	65	39	$184.95	3
Interventional Radiology	57	15	$202.40	1

77427 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
Florida	86,302	$191.34	$147.85	366
California	75,874	$200.92	$147.41	424
Texas	61,026	$184.75	$147.72	294
New York	41,220	$205.14	$147.67	297
Pennsylvania	39,334	$188.03	$147.50	267
Illinois	33,389	$192.58	$147.53	178
Ohio	27,447	$183.23	$147.31	192
New Jersey	27,404	$202.30	$147.51	109
North Carolina	27,166	$180.50	$147.20	155
Tennessee	25,127	$174.75	$147.59	100
Massachusetts	24,953	$196.03	$147.42	148
Arizona	22,856	$183.07	$147.32	114
Virginia	22,021	$186.84	$147.19	89
Georgia	21,941	$183.13	$147.07	133
Michigan	21,369	$186.11	$146.95	156
Maryland	20,240	$194.23	$147.81	89
Indiana	18,684	$175.85	$146.90	91
Washington	18,125	$191.11	$147.50	118
South Carolina	15,860	$180.30	$147.27	62
Missouri	15,414	$180.62	$146.56	89
Wisconsin	13,893	$180.63	$147.46	113
Alabama	12,825	$178.78	$148.10	66
Colorado	12,198	$188.12	$147.61	74
Louisiana	11,707	$179.97	$147.97	54
Kansas	11,209	$179.02	$146.82	38
Minnesota	10,940	$184.40	$147.70	106
Oklahoma	9,504	$178.06	$147.36	32
Iowa	9,107	$176.69	$146.47	42
Kentucky	8,996	$180.30	$147.61	64
Mississippi	8,572	$175.64	$146.80	27
Arkansas	8,510	$175.59	$148.11	36
Oregon	8,361	$186.88	$147.25	65
Connecticut	7,470	$197.58	$147.46	59
Nebraska	6,093	$174.66	$147.16	25
Nevada	5,892	$184.44	$147.64	33
New Hampshire	5,359	$181.55	$147.50	28
Idaho	5,098	$176.61	$146.84	20
West Virginia	4,233	$183.02	$147.01	24
Delaware	4,137	$185.77	$147.56	15
Utah	3,710	$184.18	$147.25	34
Montana	3,704	$186.85	$147.50	17
South Dakota	3,621	$180.73	$146.97	17
Rhode Island	3,056	$191.26	$147.73	20
Maine	3,026	$180.04	$147.16	17
North Dakota	2,858	$188.55	$147.73	17
New Mexico	2,727	$183.94	$147.28	19
District of Columbia	2,466	$201.44	$147.77	17
Alaska	2,446	$231.49	$147.85	12
Hawaii	2,321	$190.60	$147.45	20
Vermont	1,860	$190.30	$146.59	12
Wyoming	1,252	$191.75	$147.75	5
Guam	215	$191.57	$148.46	1
Puerto Rico	135	$186.38	$148.49	2

Related codes

77401Superficial and/or low voltage radiation treatment delivery$40.31
77470Special radiation treatment$112.71
77435Management of cranial lesion surgery$640.39
77417X-ray during radiation therapy$15.06
77432Management of complete single session course of cranial lesion surgery$426.09

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.