Summary & Overview
CPT 77387: Image Guidance for Radiation Therapy Targeting
CPT code 77387 denotes imaging guidance used to locate the target site for delivery of radiation treatment to a tumor, an essential clinical adjunct in modern radiation oncology. This service improves targeting accuracy, reduces radiation exposure to adjacent healthy tissues, and supports safe delivery of therapeutic doses. Nationally, image-guidance services like 77387 are integral to quality cancer care and influence treatment planning, throughput, and coding workflows across ambulatory and hospital-based radiation programs.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of what 77387 represents, how it fits into radiation therapy service lines, and the payer landscape relevant to its use. The analysis summarizes common billing modifiers and operational considerations, offers benchmark references where available, and highlights clinical context for use alongside external beam radiation procedures.
This publication is intended for revenue cycle staff, clinical administrators, and policy analysts seeking a national-level primer on CPT code 77387, including service characterization, typical sites of service, and the payer mix relevant to reimbursement and prior authorization processes.
Billing Code Overview
CPT code 77387 describes the use of imaging guidance to locate the target site for delivery of radiation treatment over a tumor. The service supports precise targeting of radiation to the tumor while protecting surrounding healthy tissues.
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Service type: Image-guided radiation therapy guidance
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Typical site of service: Radiation oncology departments, hospital outpatient departments, and freestanding radiation therapy centers
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with a confirmed localized prostate adenocarcinoma scheduled for external beam radiation therapy. On simulation day the radiation oncologist and medical physicist perform CT-based treatment planning. During each treatment fraction the provider uses imaging guidance to localize the target and verify patient position before delivery of therapeutic radiation. Imaging modalities commonly used include on-board cone beam CT or orthogonal kV imaging to align the patient and internal markers, protecting surrounding healthy tissues such as bladder and rectum. The clinical workflow: initial consultation and staging imaging → CT simulation with immobilization and fiducial marker placement if needed → treatment planning and dose calculation → daily image-guided localization using 77387 prior to fraction delivery → periodic on-treatment assessments and follow-up after course completion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation of imaging guidance separate from technical equipment or facility services |
TC |