CPT 77412: Complex External Beam Radiation Delivery
Medicare pays $465 and commercial payers pay $414 on average nationally for this procedure.
CPT code 77412 describes the delivery of external beam radiation therapy, level 3 complexity, encompassing advanced photon techniques such as multiple isocenter photon therapy, photon therapy with active motion management, total skin electron therapy, or mixed electron/photon fields, and includes imaging guidance when performed; the service type is complex external beam radiation delivery and the typical site of service is an outpatient radiation oncology department or hospital-based radiation therapy suite.
For related coverage guidance, see recent payer policy updates: Radiation oncology coverage and treatment delivery guidelines, Proton Beam Therapy, Radiation and Oncologic Procedures.
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National Reimbursement Benchmarks
National averages for CPT 77412 place Medicare above the BUCA commercial aggregate: Medicare’s mean is $464.8 versus BUCA’s mean of $413.9, a difference of $50.9 that positions Medicare at the higher end of average reimbursements for this code. This gap suggests Medicare payments cluster somewhat above a broad commercial benchmark represented by BUCA, while other commercial payers show wider variation around their means.
Dispersion measured as P75 minus P25 highlights which payers are tightest and widest. Blue Cross Blue Shield has the widest interquartile spread at $199.7 ($600.3 − $410.6), followed by UnitedHealth Group at $223.4 ($468.9 − $245.5) and Cigna at $259.5 ($435.0 − $167.5). Aetna is the tightest with a spread of $186.0 ($235.0 − $49.8). BUCA’s interquartile spread is $199.1 ($505.7 − $300.6). These dispersion values indicate significant variability across commercial payers compared with Medicare’s documented quartiles.