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CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1314 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 77080 A Dxa bone density, axial 0.20 1.09 1.61 NA NA 0.18 XXX 77080 TC A Dxa bone density, axial 0.00 1.02 1.54 NA NA 0.17 XXX 77080 26 A Dxa bone density, axial 0.20 0.07 0.07 0.07 0.07 0.01 XXX 77081 A Dxa bone density/peripheral 0.22 0.47 0.56 NA NA 0.06 XXX 77081 TC A Dxa bone density/peripheral 0.00 0.40 0.49 NA NA 0.05 XXX 77081 26 A Dxa bone density/peripheral 0.22 0.07 0.07 0.07 0.07 0.01 XXX 77082 A Dxa bone density, vert fx 0.17 0.51 0.58 NA NA 0.06 XXX 77082 TC A Dxa bone density, vert fx 0.00 0.46 0.53 NA NA 0.05 XXX 77082 26 A Dxa bone density, vert fx 0.17 0.05 0.05 0.05 0.05 0.01 XXX 77083 A Radiographic absorptiometry 0.20 0.36 0.48 NA NA 0.06 XXX 77083 TC A Radiographic absorptiometry 0.00 0.31 0.42 NA NA 0.05 XXX 77083 26 A Radiographic absorptiometry 0.20 0.05 0.06 0.05 0.06 0.01 XXX 77084 A Magnetic image, bone marrow 1.60 14.44 13.79 NA NA 0.66 XXX 77084 TC A Magnetic image, bone marrow 0.00 13.82 13.19 NA NA 0.59 XXX 77084 26 A Magnetic image, bone marrow 1.60 0.62 0.60 0.62 0.60 0.07 XXX 77261 A Radiation therapy planning 1.39 0.51 0.51 0.51 0.51 0.07 XXX 77262 A Radiation therapy planning 2.11 0.73 0.74 0.73 0.74 0.11 XXX 77263 A Radiation therapy planning 3.14 1.08 1.09 1.08 1.09 0.16 XXX 77280 A Set radiation therapy field 0.70 4.34 4.19 NA NA 0.22 XXX 77280 TC A Set radiation therapy field 0.00 4.10 3.95 NA NA 0.18 XXX 77280 26 A Set radiation therapy field 0.70 0.24 0.24 0.24 0.24 0.04 XXX 77285 A Set radiation therapy field 1.05 7.87 7.40 NA NA 0.35 XXX 77285 TC A Set radiation therapy field 0.00 7.51 7.04 NA NA 0.30 XXX 77285 26 A Set radiation therapy field 1.05 0.36 0.36 0.36 0.36 0.05 XXX 77290 A Set radiation therapy field 1.56 13.15 11.64 NA NA 0.43 XXX 77290 TC A Set radiation therapy field 0.00 12.61 11.11 NA NA 0.35 XXX 77290 26 A Set radiation therapy field 1.56 0.54 0.53 0.54 0.53 0.08 XXX 77295 A Set radiation therapy field 4.56 7.36 12.90 NA NA 1.71 XXX 77295 TC A Set radiation therapy field 0.00 5.78 11.35 NA NA 1.48 XXX 77295 26 A Set radiation therapy field 4.56 1.58 1.55 1.58 1.55 0.23 XXX 77299 C Radiation therapy planning 0.00 0.00 0.00 NA NA 0.00 XXX 77299 TC C Radiation therapy planning 0.00 0.00 0.00 NA NA 0.00 XXX 77299 26 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77300 A Radiation therapy dose plan 0.62 1.16 1.26 NA NA 0.10 XXX 77300 TC A Radiation therapy dose plan 0.00 0.95 1.05 NA NA 0.07 XXX 77300 26 A Radiation therapy dose plan 0.62 0.21 0.21 0.21 0.21 0.03 XXX 77301 A Radiotherapy dose plan, imrt 7.99 56.26 49.93 NA NA 1.88 XXX 77301 TC A Radiotherapy dose plan, imrt 0.00 53.49 47.21 NA NA 1.48 XXX 77301 26 A Radiotherapy dose plan, imrt 7.99 2.77 2.72 2.77 2.72 0.40 XXX 77305 A Teletx isodose plan simple 0.70 0.89 1.20 NA NA 0.15 XXX 77305 TC A Teletx isodose plan simple 0.00 0.65 0.96 NA NA 0.11 XXX 77305 26 A Teletx isodose plan simple 0.70 0.24 0.24 0.24 0.24 0.04 XXX 77310 A Teletx isodose plan intermed 1.05 1.24 1.61 NA NA 0.18 XXX 77310 TC A Teletx isodose plan intermed 0.00 0.88 1.25 NA NA 0.13 XXX 77310 26 A Teletx isodose plan intermed 1.05 0.36 0.36 0.36 0.36 0.05 XXX 77315 A Teletx isodose plan complex 1.56 2.07 2.35 NA NA 0.22 XXX 77315 TC A Teletx isodose plan complex 0.00 1.53 1.82 NA NA 0.14 XXX 77315 26 A Teletx isodose plan complex 1.56 0.54 0.53 0.54 0.53 0.08 XXX

CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1315 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 77321 A Special teletx port plan 0.95 1.50 2.21 NA NA 0.26 XXX 77321 TC A Special teletx port plan 0.00 1.17 1.89 NA NA 0.21 XXX 77321 26 A Special teletx port plan 0.95 0.33 0.32 0.33 0.32 0.05 XXX 77326 A Brachytx isodose calc simp 0.93 2.91 2.85 NA NA 0.18 XXX 77326 TC A Brachytx isodose calc simp 0.00 2.59 2.54 NA NA 0.13 XXX 77326 26 A Brachytx isodose calc simp 0.93 0.32 0.31 0.32 0.31 0.05 XXX 77327 A Brachytx isodose calc interm 1.39 4.02 4.00 NA NA 0.25 XXX 77327 TC A Brachytx isodose calc interm 0.00 3.54 3.53 NA NA 0.18 XXX 77327 26 A Brachytx isodose calc interm 1.39 0.48 0.47 0.48 0.47 0.07 XXX 77328 A Brachytx isodose plan compl 2.09 5.15 5.28 NA NA 0.36 XXX 77328 TC A Brachytx isodose plan compl 0.00 4.43 4.57 NA NA 0.25 XXX 77328 26 A Brachytx isodose plan compl 2.09 0.72 0.71 0.72 0.71 0.11 XXX 77331 A Special radiation dosimetry 0.87 0.80 0.80 NA NA 0.06 XXX 77331 TC A Special radiation dosimetry 0.00 0.50 0.50 NA NA 0.02 XXX 77331 26 A Special radiation dosimetry 0.87 0.30 0.30 0.30 0.30 0.04 XXX 77332 A Radiation treatment aid(s) 0.54 1.53 1.52 NA NA 0.10 XXX 77332 TC A Radiation treatment aid(s) 0.00 1.34 1.34 NA NA 0.07 XXX 77332 26 A Radiation treatment aid(s) 0.54 0.19 0.18 0.19 0.18 0.03 XXX 77333 A Radiation treatment aid(s) 0.84 0.52 0.94 NA NA 0.15 XXX 77333 TC A Radiation treatment aid(s) 0.00 0.23 0.65 NA NA 0.11 XXX 77333 26 A Radiation treatment aid(s) 0.84 0.29 0.29 0.29 0.29 0.04 XXX 77334 A Radiation treatment aid(s) 1.24 2.68 2.93 NA NA 0.23 XXX 77334 TC A Radiation treatment aid(s) 0.00 2.25 2.51 NA NA 0.17 XXX 77334 26 A Radiation treatment aid(s) 1.24 0.43 0.42 0.43 0.42 0.06 XXX 77336 A Radiation physics consult 0.00 1.10 1.58 NA NA 0.16 XXX 77370 A Radiation physics consult 0.00 2.95 3.09 NA NA 0.18 XXX 77371 C Srs, multisource 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77372 A Srs, linear based 0.00 22.30 22.30 NA NA 0.13 XXX 77373 A Sbrt delivery 0.00 41.38 41.38 NA NA 0.13 XXX 77399 C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.00 XXX 77399 TC C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.00 XXX 77399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77401 A Radiation treatment delivery 0.00 0.45 0.79 NA NA 0.11 XXX 77402 A Radiation treatment delivery 0.00 4.27 3.65 NA NA 0.11 XXX 77403 A Radiation treatment delivery 0.00 3.66 3.20 NA NA 0.11 XXX 77404 A Radiation treatment delivery 0.00 4.11 3.53 NA NA 0.11 XXX 77406 A Radiation treatment delivery 0.00 4.14 3.56 NA NA 0.11 XXX 77407 A Radiation treatment delivery 0.00 6.96 5.76 NA NA 0.12 XXX 77408 A Radiation treatment delivery 0.00 5.03 4.31 NA NA 0.12 XXX 77409 A Radiation treatment delivery 0.00 5.63 4.76 NA NA 0.12 XXX 77411 A Radiation treatment delivery 0.00 5.60 4.73 NA NA 0.12 XXX 77412 A Radiation treatment delivery 0.00 6.63 5.57 NA NA 0.13 XXX 77413 A Radiation treatment delivery 0.00 6.69 5.61 NA NA 0.13 XXX 77414 A Radiation treatment delivery 0.00 7.53 6.24 NA NA 0.13 XXX 77416 A Radiation treatment delivery 0.00 7.56 6.27 NA NA 0.13 XXX 77417 A Radiology port film(s) 0.00 0.35 0.41 NA NA 0.04 XXX 77418 A Radiation tx delivery, imrt 0.00 12.88 14.20 NA NA 0.13 XXX 77421 A Stereoscopic x-ray guidance 0.39 2.33 2.63 NA NA 0.12 XXX

<strong>CMS</strong>-1403-FC<br />

Physi-<br />

cian<br />

Work<br />

Fully<br />

Implemented<br />

Non-<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transitional<br />

Non-<br />

Facility<br />

PE<br />

Fully<br />

Imple-<br />

mented<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transi-<br />

tional<br />

Facility<br />

PE<br />

1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights<br />

Reserved. Applicable FARS/DFARS apply.<br />

2 If values are reflected for codes not payable by Medicare, please note that these values have <strong>been</strong><br />

established as a courtesy to the general public and are not used for Medicare<br />

payment.<br />

1315<br />

Mal-<br />

Practice<br />

RVUs 2 Global<br />

CPT 1 /<br />

HCPCS Mod Status Description<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

77321 A Special teletx port plan 0.95 1.50 2.21 NA NA 0.26 XXX<br />

77321 TC A Special teletx port plan 0.00 1.17 1.89 NA NA 0.21 XXX<br />

77321 26 A Special teletx port plan 0.95 0.33 0.32 0.33 0.32 0.05 XXX<br />

77326 A Brachytx isodose calc simp 0.93 2.91 2.85 NA NA 0.18 XXX<br />

77326 TC A Brachytx isodose calc simp 0.00 2.59 2.54 NA NA 0.13 XXX<br />

77326 26 A Brachytx isodose calc simp 0.93 0.32 0.31 0.32 0.31 0.05 XXX<br />

77327 A Brachytx isodose calc interm 1.39 4.02 4.00 NA NA 0.25 XXX<br />

77327 TC A Brachytx isodose calc interm 0.00 3.54 3.53 NA NA 0.18 XXX<br />

77327 26 A Brachytx isodose calc interm 1.39 0.48 0.47 0.48 0.47 0.07 XXX<br />

77328 A Brachytx isodose plan compl 2.09 5.15 5.28 NA NA 0.36 XXX<br />

77328 TC A Brachytx isodose plan compl 0.00 4.43 4.57 NA NA 0.25 XXX<br />

77328 26 A Brachytx isodose plan compl 2.09 0.72 0.71 0.72 0.71 0.11 XXX<br />

77331 A Special radiation dosimetry 0.87 0.80 0.80 NA NA 0.06 XXX<br />

77331 TC A Special radiation dosimetry 0.00 0.50 0.50 NA NA 0.02 XXX<br />

77331 26 A Special radiation dosimetry 0.87 0.30 0.30 0.30 0.30 0.04 XXX<br />

77332 A Radiation treatment aid(s) 0.54 1.53 1.52 NA NA 0.10 XXX<br />

77332 TC A Radiation treatment aid(s) 0.00 1.34 1.34 NA NA 0.07 XXX<br />

77332 26 A Radiation treatment aid(s) 0.54 0.19 0.18 0.19 0.18 0.03 XXX<br />

77333 A Radiation treatment aid(s) 0.84 0.52 0.94 NA NA 0.15 XXX<br />

77333 TC A Radiation treatment aid(s) 0.00 0.23 0.65 NA NA 0.11 XXX<br />

77333 26 A Radiation treatment aid(s) 0.84 0.29 0.29 0.29 0.29 0.04 XXX<br />

77334 A Radiation treatment aid(s) 1.24 2.68 2.93 NA NA 0.23 XXX<br />

77334 TC A Radiation treatment aid(s) 0.00 2.25 2.51 NA NA 0.17 XXX<br />

77334 26 A Radiation treatment aid(s) 1.24 0.43 0.42 0.43 0.42 0.06 XXX<br />

77336 A Radiation physics consult 0.00 1.10 1.58 NA NA 0.16 XXX<br />

77370 A Radiation physics consult 0.00 2.95 3.09 NA NA 0.18 XXX<br />

77371 C Srs, multisource 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

77372 A Srs, linear based 0.00 22.30 22.30 NA NA 0.13 XXX<br />

77373 A Sbrt delivery 0.00 41.38 41.38 NA NA 0.13 XXX<br />

77399 C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77399 TC C External radiation dosimetry 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

77401 A Radiation treatment delivery 0.00 0.45 0.79 NA NA 0.11 XXX<br />

77402 A Radiation treatment delivery 0.00 4.27 3.65 NA NA 0.11 XXX<br />

77403 A Radiation treatment delivery 0.00 3.66 3.20 NA NA 0.11 XXX<br />

77404 A Radiation treatment delivery 0.00 4.11 3.53 NA NA 0.11 XXX<br />

77406 A Radiation treatment delivery 0.00 4.14 3.56 NA NA 0.11 XXX<br />

77407 A Radiation treatment delivery 0.00 6.96 5.76 NA NA 0.12 XXX<br />

77408 A Radiation treatment delivery 0.00 5.03 4.31 NA NA 0.12 XXX<br />

77409 A Radiation treatment delivery 0.00 5.63 4.76 NA NA 0.12 XXX<br />

77411 A Radiation treatment delivery 0.00 5.60 4.73 NA NA 0.12 XXX<br />

77412 A Radiation treatment delivery 0.00 6.63 5.57 NA NA 0.13 XXX<br />

77413 A Radiation treatment delivery 0.00 6.69 5.61 NA NA 0.13 XXX<br />

77414 A Radiation treatment delivery 0.00 7.53 6.24 NA NA 0.13 XXX<br />

77416 A Radiation treatment delivery 0.00 7.56 6.27 NA NA 0.13 XXX<br />

77417 A Radiology port film(s) 0.00 0.35 0.41 NA NA 0.04 XXX<br />

77418 A Radiation tx delivery, imrt 0.00 12.88 14.20 NA NA 0.13 XXX<br />

77421 A Stereoscopic x-ray guidance 0.39 2.33 2.63 NA NA 0.12 XXX

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