CPT 77386: Intensity Modulated Radiation Treatment Delivery, Complex

Commercial payers pay $770 on average nationally for this procedure.

CPT code 77386 describes intensity modulated radiation treatment delivery (IMRT) with guidance and tracking, complex; it represents delivery of advanced, modulated radiation therapy for complex treatment plans and typically involves image guidance and intrafraction tracking during the radiation therapy treatment encounter, most often performed in an outpatient radiation oncology or hospital-based radiation treatment setting.

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National Reimbursement Benchmarks

National commercial reimbursements for CPT 77386 cluster around the BUCA average commercial rate of $770.00, but individual payers show meaningful spread. Cigna sits well above that average with a mean of $1,426.30 and a wide P75–P25 window ($1,626.50−$1,091.50 = $535.00), reflecting high-end variability; Blue Cross Blue Shield’s mean of $732.40 is close to BUCA with a narrower P75–P25 window ($815.20−$636.20 = $179.00). Aetna’s rates are tighter still around its mean of $417.90 with a P75–P25 range of ($498.10−$310.10 = $188.00), and UnitedHealth Group shows moderate dispersion with a range of ($688.00−$379.10 = $308.90).

Comparative dispersion highlights Cigna as the most variable payer and Blue Cross Blue Shield and Aetna as the tightest in middle-percentile spread, while UnitedHealth Group falls between those extremes. Across these commercial payers, BUCA’s average sits near the market midpoint, illustrating that commercial contractual outcomes for 77386 span a broad continuum rather than clustering at a single level.

National Payer Mean Reimbursement Rates

State Reimbursement Rates

State: Alaska1 / 51

Rate by payer

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old adult diagnosed with a squamous cell carcinoma of the oral cavity (for example, C01 base of tongue or C02.1 border of tongue) referred for definitive or adjuvant radiation therapy. The radiation oncology team evaluates the patient during a consultation visit, reviews staging imaging (CT/MRI/PET), and develops an IMRT treatment plan to deliver conformal high-dose radiation to the primary tumor and at-risk nodal basins while sparing adjacent normal tissues (oral mucosa, salivary glands, mandible, spinal cord). Simulation is performed with immobilization (thermoplastic mask), CT simulation with contrast, and image fusion for target delineation. The dosimetrist and medical physicist generate an IMRT plan with inverse planning and multi‑leaf collimator modulation. Daily treatment delivery uses image guidance and tracking; for complex cases the team bills 77386 for the delivery of intensity modulated radiation treatment when complex delivery and guidance/tracking are performed. Typical workflow steps: consultation → simulation/immobilization → target/organ delineation → IMRT planning and physics QA → daily guided IMRT delivery with intrafraction tracking as indicated → on‑treatment visits and toxicity management → completion and surveillance. Common clinical considerations include dose fractionation (definitive vs adjuvant), concurrent systemic therapy, management of acute mucositis, and documentation of guidance/tracking methods used during delivery.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 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…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑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…
53	Modifier 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…
54	Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…	- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
62	Modifier 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…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2085R0001X	Radiation Oncology Physician	A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially mali…
2085B0100X	Body Imaging Physician	A Radiology doctor of Osteopathy that specializes in Body Imaging.
2085N0700X	Neuroradiology Physician	A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs…
363AM0700X	Medical Physician Assistant	Physician Assistants & Advanced Practice Nursing Providers · Physician Assistant
3418M1130X	Military or U.S. Coast Guard Water Transport Ambulance	Vehicle and staff for patient emergency or non-emergency sea/water transport
103TM1700X	Deactivated - Psychologist Men & Masculinity
261Q00000X	Clinic/Center	A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limite…
364SC0200X	Critical Care Medicine Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

Frequently Asked Questions

References

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.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.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.

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State Reimbursement Rates

State: Alaska1 / 51

Rate by payer

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 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…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑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…
53	Modifier 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…
54	Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…	- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
62	Modifier 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…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2085R0001X	Radiation Oncology Physician	A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially mali…
2085B0100X	Body Imaging Physician	A Radiology doctor of Osteopathy that specializes in Body Imaging.
2085N0700X	Neuroradiology Physician	A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs…
363AM0700X	Medical Physician Assistant	Physician Assistants & Advanced Practice Nursing Providers · Physician Assistant
3418M1130X	Military or U.S. Coast Guard Water Transport Ambulance	Vehicle and staff for patient emergency or non-emergency sea/water transport
103TM1700X	Deactivated - Psychologist Men & Masculinity
261Q00000X	Clinic/Center	A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limite…
364SC0200X	Critical Care Medicine Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

Frequently Asked Questions

References

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.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.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.

CPT 77386: Intensity Modulated Radiation Treatment Delivery, Complex

Sign up for cpt 77386 policy alerts

National Reimbursement Benchmarks

CPT 77386: Intensity Modulated Radiation Treatment Delivery, Complex

Sign up for cpt 77386 policy alerts

National Reimbursement Benchmarks

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

What does CPT 77386 represent and where is it typically performed?

Which billing modifiers are commonly used with 77386 and when are they applied?

What do the national payer reimbursement benchmarks show for 77386?

How does 77386 relate to CPT codes 77385 and 77387?

In what clinical situations and workflow is 77386 most commonly used?

References

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

What does CPT 77386 represent and where is it typically performed?

Which billing modifiers are commonly used with 77386 and when are they applied?

What do the national payer reimbursement benchmarks show for 77386?

How does 77386 relate to CPT codes 77385 and 77387?

In what clinical situations and workflow is 77386 most commonly used?

References