77338 — Design and construction of radiation treatment device for high precision radiation therapy

What the market charges

Across 29,139 negotiated rates, the middle 80% fall between $225 and $844, with a median of $400.

What Medicare pays

Medicare allowed an average of $294 for this code, across 202,283 services billed by 3,886 providers. At the median, the market charges 1.4 times what Medicare pays for this code.

Where this is billed, and what it costs there

The states billing 77338 most, by Medicare service volume, each compared against the national average of $294. Each links to the providers Mishe lists there.

  • California — 355 providers billed it, Medicare allowed $328 — 12% above the national average
  • Florida — 303 providers billed it, Medicare allowed $355 — 21% above the national average
  • Texas — 260 providers billed it, Medicare allowed $337 — 15% above the national average
  • New York — 242 providers billed it, Medicare allowed $322 — 10% above the national average
  • Pennsylvania — 211 providers billed it, Medicare allowed $246 — 16% below the national average
  • Illinois — 148 providers billed it, Medicare allowed $272 — 7% below the national average
  • Ohio — 165 providers billed it, Medicare allowed $266 — 10% below the national average
  • Massachusetts — 123 providers billed it, Medicare allowed $247 — 16% below the national average

Claim-editing rules

These are National Correct Coding Initiative procedure-to-procedure edits — the rules a payer applies when deciding whether two codes billed together are both payable.

Codes this one absorbs

Billed together, 77338 is the payable code and these are not separately payable. 136 pairs in total.

  • 11920 — no modifier can override this edit
  • 11921 — no modifier can override this edit
  • 16000 — no modifier can override this edit
  • 16020 — no modifier can override this edit
  • 16025 — no modifier can override this edit
  • 16030 — no modifier can override this edit
  • 36000 — a modifier may allow both to be paid
  • 36410 — a modifier may allow both to be paid
  • 36425 — no modifier can override this edit
  • 36591 — no modifier can override this edit
  • 36592 — no modifier can override this edit
  • 51701 — no modifier can override this edit

Codes that absorb this one

Billed alongside any of these, 77338 is not separately payable. 7 pairs in total.

  • 32701 — no modifier can override this edit
  • 61796 — no modifier can override this edit
  • 61798 — no modifier can override this edit
  • 63620 — no modifier can override this edit
  • 77385 — a modifier may allow both to be paid
  • 77386 — a modifier may allow both to be paid
  • G6015 — a modifier may allow both to be paid

Deploy this for your team

Every figure on this page came from published payer and Medicare data, assembled by Mishe. The same pricing, claim-editing and care-pathway intelligence runs underneath the plans Mishe operates.

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