Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesClinical Treatment Planning (External and Internal Sources) for Radiation TreatmentCPT cpt-77285-radiation-therapy-simulation-port-localization
    Ask Trek AI about this page

    CPT 77285: Radiation Therapy Simulation for Port Localization

    Medicare pays $316 on average nationally for this procedure.

    CPT code 77285 describes a radiation therapy simulation procedure in which a provider uses a simulator or other imaging modality to determine the size and location of ports for radiation therapy; service type: radiation therapy simulation/planning, typical site of service: radiation oncology department or outpatient imaging/simulation suite.

    For related coverage guidance, see recent payer policy updates: Pediatric Neurodevelopmental and Autism Spectrum Disorder (ASD) Screening Corporate Medical Policy, Inhaled Nitric Oxide Therapy (for New Mexico Only), Inhaled Nitric Oxide Therapy (for North Carolina Only).

    Customize your policy alerts

    Sign up for cpt 77285 policy alerts

    Get alerted when payer policies referencing 77285 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult newly diagnosed with a localized malignancy (for example, breast, lung, prostate, or head and neck cancer) referred to radiation oncology for planning of external beam radiation therapy. The patient presents to the radiation simulation suite on a scheduled day. Computed tomography (CT) simulation is performed with the patient positioned reproducibly using immobilization devices. The radiation oncologist and dosimetrist review imaging to determine the optimal size, number, and exact anatomic locations of treatment ports (field borders) or isocenters and any necessary patient markers or tattoos. When port placement requires fluoroscopic or other imaging correlation, a simulator or imaging modality is used to verify port coordinates relative to anatomic landmarks. The resulting port/field setup information is used to create the treatment plan and portals on the treatment machine and documented in the simulation and planning notes.

    Typical workflow steps:

    • Patient registration and consent.

    • Immobilization and CT simulation (with or without contrast) while in treatment position.

    • Acquisition of simulation images and, when indicated, use of an on-board simulator or fluoroscopy to localize and mark port sites.

    • Attending radiation oncologist documents port size, shape, location, and any blocking or beam-modifying devices.

    • Transmission of simulation data to dosimetry for treatment planning, and scheduling of subsequent treatment delivery sessions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    77295Therapeutic radiology simulation-aided field settings, complexOften performed when the simulation requires complex field arrangements; may be billed for complex simulations following initial port localization.

    | 77261 | Therapeutic radiology simulation, simple | Represents simpler simulation setups; may be used for straightforward port/field determinations when less complexity is documented.

    | 77301 | Radiation treatment delivery, simple; per day | Represents daily treatment delivery codes that follow simulation/port determination once the treatment plan is complete.

    | 77370 | Special radiation physics consultation, or complex physics consultation | Used when advanced physics input is required after port determination to finalize machine settings or special beam modifications.

    | 77290 | Therapeutic radiology portal/field and/or block verification; simple | Used for verification films or images that confirm port/field placement prior to or during the course of treatment.

    | 77014 | CT guidance for localization during therapeutic procedures | May be used when CT guidance is separately reported for localization during simulation if payer policy permits.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    207RH0000X
    208000000X
    101YM0800X
    2080P0204X
    207Q00000X
    163WM0102X
    1223X0400X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    C15.9Malignant neoplasm of esophagus, unspecified
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C22.0Liver cell carcinoma
    C25.9Malignant neoplasm of pancreas, unspecified
    C33Malignant neoplasm of trachea
    C34.11Malignant neoplasm of upper lobe, right bronchus or lung
    C34.12Malignant neoplasm of upper lobe, left bronchus or lung
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C34.91Malignant neoplasm of unspecified part of right bronchus or lung

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Pediatrics/Neonatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Pediatric Neurodevelopmental and Autism Spectrum Disorder (ASD) Screening Corporate Medical Policybcbsvermont2026-12-01
    Inhaled Nitric Oxide Therapy (for New Mexico Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for North Carolina Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Inhaled Nitric Oxide Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Clinical Policy: NICU Apnea Bradycardia GuidelinesAmbetter Nevada2026-10-01
    DRG Newborn Inpatient Stays - FacilityBlue Cross Blue Shield - Maine2026-10-01
    Pediatric Preventive ScreeningOscar Health2026-10-01
    Infant Nutritional FormulaCigna2026-09-15
    Pediatric Preventive ScreeningBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    CPT-77261-RADIATION-TREATMENT-PLANNING-INITIAL

    CPT 77261: Radiation Treatment Planning, Simple

    CPT-77262-RADIATION-THERAPY-TREATMENT-PLANNING-DETAILED

    CPT 77262: Radiation Therapy Treatment Planning and Management

    CPT-77263-RADIATION-THERAPY-TREATMENT-PLANNING

    CPT 77263: Complex Radiation Therapy Treatment Planning

    CPT-77280-RADIATION-THERAPY-SIMULATION-SIMPLE

    CPT 77280: Simple Radiation Therapy Simulation and Port Localization

    CPT-77290-RADIATION-TREATMENT-SIMULATION-PLANNING

    CPT 77290: 3D Radiation Therapy Simulation and Treatment Field Localization

    CPT-77293-4D-CT-RESPIRATION-CORRELATED-SIMULATION-FOR-RADIATION-PLANNING

    CPT 77293: 4D (respiration‑correlated) CT Simulation for Radiotherapy

    CPT-77295-3D-DOSE-RECONSTRUCTION-VOLUMETRIC-DOSE-CALCULATION

    CPT 77295: 3D Dose Reconstruction and Volumetric Dose Calculation

    CPT-77299-THERAPEUTIC-RADIOLOGY-TREATMENT-PLANNING-UNLISTED

    CPT 77299: Therapeutic Radiology Clinical Treatment Planning

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.