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CPT 77431: Radiotherapy Management for One- or Two-Fraction Courses

CPT code 77431 represents professional management of a complete course of radiotherapy delivered in one or two fractions. It identifies services provided by radiation oncologists when they direct, coordinate, and supervise a focused, short-course regimen of external beam radiation. Nationally, this code is relevant for cancer care pathways that use hypofractionated or single-fraction treatments for palliative or select definitive indications and affects billing, utilization patterns, and care coordination across payers.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of what the code covers clinically, typical sites of service, and common modifiers used with this service. The publication also outlines benchmarks and payer coverage considerations, coding and billing implications for short-course radiotherapy, and clinical context where one- or two-fraction regimens are applied.

Data not available in the input is clearly noted where applicable, and the content focuses on national policy and coding implications rather than state-specific rules.

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Billing Code Overview

CPT code 77431 describes management of a complete course of radiotherapy when treatment is delivered in one or two small doses (fractions), which may be administered over a number of weeks. This procedure denotes the professional services for overseeing and directing the patient’s external beam radiation therapy plan through its entirety when fractionation is limited to one or two fractions.

Service type: Radiotherapy treatment management for single- or two-fraction courses
Typical site of service: Radiation oncology clinic or hospital outpatient radiation therapy department

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CPT 77431: Radiotherapy Management for One- or Two-Fraction Courses

Data not available in the input is clearly noted where applicable, and the content focuses on national policy and coding implications rather than state-specific rules.

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Billing Code Overview

Service type: Radiotherapy treatment management for single- or two-fraction courses
Typical site of service: Radiation oncology clinic or hospital outpatient radiation therapy department

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a confirmed localized malignancy (for example, early-stage breast cancer or prostate cancer) referred for fractionated external beam radiotherapy. The radiation oncologist conducts an initial consultation including history, physical exam, review of diagnostic imaging (CT/MRI/PET), and multidisciplinary discussion. A simulation session is scheduled to obtain a CT simulation with immobilization devices and to mark set-up references. Treatment planning is performed by the radiation oncologist and medical physicist to delineate target volumes and organs at risk, generate dose-volume constraints, and create a treatment plan. The patient then receives daily or alternate-day fractions over several weeks; the physician manages the complete course of radiotherapy, documents weekly on-treatment visits addressing toxicity, assesses response, and modifies the plan or provides treatment breaks as needed. Typical site of service is an outpatient radiation oncology clinic or hospital-based radiation therapy department where linear accelerator-based external beam radiotherapy is delivered. Typical service type is physician global management of a fractionated radiotherapy course, including supervision of simulation, planning, verification, and on-treatment management.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician professional portion of a service separate from the technical component.
`59`	Distinct procedural service	Use when a separate, distinct radiation-related procedure or service is performed on the same day that is not usually bundled.
`62`	Two surgeons	Use when two surgeons of different specialties share responsibility for a complex procedure related to radiation treatment planning or access procedures.
`78`	Unplanned return to the operating/procedure room for a related procedure during the postoperative period	Use for unplanned procedures related to treatment complications requiring return to procedure room.
`80`	Assistant surgeon	Use when an assistant surgeon provides services during a surgical procedure related to radiation therapy access.
`22`	Increased procedural services	Use when management complexity or time significantly exceeds typical for radiotherapy management.
`52`	Reduced services	Use when a planned course is partially reduced or discontinued and a reduced-service billing is required.
`53`	Discontinued procedure	Use when radiotherapy is initiated but discontinued due to patient-specific reasons before completion.
`55`	Postoperative management only	Use when only postoperative management by the surgeon is billed (rare for RT management; included when applicable).
`76`	Repeat procedure by same physician (Not listed in input; excluded)	Data not allowed per strict rules.
`00`	No modifier (default)	Use when no additional modifier applies and full global service is billed.
`11`	Primary care exception (placeholder in list)	Use per payer-specific policy to indicate primary or unusual billing context when applicable.

Taxonomy Code	Specialty	Notes
`2084P0800X`	Radiation Oncology	Primary specialty performing fractionated radiotherapy management.
`207RC0000X`	Radiation Therapist	Providers who deliver technical treatment setup and daily delivery (therapy staff).
`208800000X`	Medical Oncology	Often co-manages systemic therapy and coordinates care with radiation oncology.
`208D00000X`	Diagnostic Radiology	Provides imaging interpretation used in radiotherapy planning.
`363L00000X`	Medical Physics (Clinical)	Provides dosimetry and physics support for planning and QA.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Breast cancers commonly treated with fractionated external beam radiotherapy after lumpectomy or for chest wall treatment.
`C61`	Malignant neoplasm of prostate gland	Prostate cancer frequently treated with fractionated external beam radiotherapy, often in combination with hormonal therapy.
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Lung cancers may receive definitive or palliative fractionated radiotherapy to control local disease or symptoms.
`C71.9`	Malignant neoplasm of brain, unspecified	Primary brain tumors or brain metastases may be treated with fractionated radiotherapy to preserve neurological function.
`C79.51`	Secondary malignant neoplasm of bone	Bone metastases commonly receive palliative fractionated radiotherapy to reduce pain and prevent complications.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77261`	Therapeutic radiology simulation-aided field setting; complex	Simulation procedure used to localize and immobilize the patient prior to fractionated radiotherapy planning.
`77301`	Radiation treatment planning, simple	Initial treatment planning services required to design the radiotherapy course; used when planning complexity is low.
`77336`	Continuing medical physics consultation, dosimetry, and treatment devices, per course of radiation therapy	Physics and dosimetry services performed alongside physician management to ensure accurate dose delivery.
`77427`	Radiation treatment management for stereotactic body radiotherapy, per session	Used when stereotactic techniques are employed; relates as an alternative management code for highly hypofractionated courses.
`G0339`	Physician radiation treatment supervision and management, five treatments	Used for billing supervision and management in groupings for certain payers; relates to course-based counting of treatment visits.

CPT 77427: Radiation Therapy Management, External Beam

CPT-77432-SINGLE-SESSION-STEREOTACTIC-RADIOSURGERY-PROFESSIONAL

CPT 77432: Single-Session Stereotactic Radiosurgery, Professional Component

CPT-77435-STEREOTACTIC-BODY-RADIOTHERAPY-TREATMENT-MANAGEMENT

CPT 77435: Stereotactic Body Radiotherapy Treatment Management

CPT-77437-SUPERFICIAL-RADIATION-THERAPY-PER-FRACTION

CPT 77437: Surface Radiation Therapy (Superficial) Per Fraction

CPT-77438-ORTHOVOLTAGE-SURFACE-RADIATION-THERAPY-SINGLE-FRACTION

CPT 77438: Orthovoltage Surface Radiation Therapy, Single Fraction

CPT-77439-ULTRASOUND-GUIDED-SRT-FIELD-PLACEMENT

CPT 77439: Ultrasound Guidance for Surface Radiation Therapy Field Placement

CPT-77469-INTRAOPERATIVE-RADIATION-THERAPY-IORT-DURING-SURGERY

CPT 77469: Intraoperative Radiation Therapy during Surgery

CPT-77470-SPECIAL-RADIOTHERAPY-MANAGEMENT

CPT 77470: Special Radiotherapy Procedure Management

CPT-77499-UNLISTED-THERAPEUTIC-RADIOLOGY-TREATMENT-MANAGEMENT

CPT 77499: Unlisted Therapeutic Radiology Treatment Management

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician professional portion of a service separate from the technical component.
`59`	Distinct procedural service	Use when a separate, distinct radiation-related procedure or service is performed on the same day that is not usually bundled.
`62`	Two surgeons	Use when two surgeons of different specialties share responsibility for a complex procedure related to radiation treatment planning or access procedures.
`78`	Unplanned return to the operating/procedure room for a related procedure during the postoperative period	Use for unplanned procedures related to treatment complications requiring return to procedure room.
`80`	Assistant surgeon	Use when an assistant surgeon provides services during a surgical procedure related to radiation therapy access.
`22`	Increased procedural services	Use when management complexity or time significantly exceeds typical for radiotherapy management.
`52`	Reduced services	Use when a planned course is partially reduced or discontinued and a reduced-service billing is required.
`53`	Discontinued procedure	Use when radiotherapy is initiated but discontinued due to patient-specific reasons before completion.
`55`	Postoperative management only	Use when only postoperative management by the surgeon is billed (rare for RT management; included when applicable).
`76`	Repeat procedure by same physician (Not listed in input; excluded)	Data not allowed per strict rules.
`00`	No modifier (default)	Use when no additional modifier applies and full global service is billed.
`11`	Primary care exception (placeholder in list)	Use per payer-specific policy to indicate primary or unusual billing context when applicable.

Taxonomy Code	Specialty	Notes
`2084P0800X`	Radiation Oncology	Primary specialty performing fractionated radiotherapy management.
`207RC0000X`	Radiation Therapist	Providers who deliver technical treatment setup and daily delivery (therapy staff).
`208800000X`	Medical Oncology	Often co-manages systemic therapy and coordinates care with radiation oncology.
`208D00000X`	Diagnostic Radiology	Provides imaging interpretation used in radiotherapy planning.
`363L00000X`	Medical Physics (Clinical)	Provides dosimetry and physics support for planning and QA.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Breast cancers commonly treated with fractionated external beam radiotherapy after lumpectomy or for chest wall treatment.
`C61`	Malignant neoplasm of prostate gland	Prostate cancer frequently treated with fractionated external beam radiotherapy, often in combination with hormonal therapy.
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Lung cancers may receive definitive or palliative fractionated radiotherapy to control local disease or symptoms.
`C71.9`	Malignant neoplasm of brain, unspecified	Primary brain tumors or brain metastases may be treated with fractionated radiotherapy to preserve neurological function.
`C79.51`	Secondary malignant neoplasm of bone	Bone metastases commonly receive palliative fractionated radiotherapy to reduce pain and prevent complications.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77261`	Therapeutic radiology simulation-aided field setting; complex	Simulation procedure used to localize and immobilize the patient prior to fractionated radiotherapy planning.
`77301`	Radiation treatment planning, simple	Initial treatment planning services required to design the radiotherapy course; used when planning complexity is low.
`77336`	Continuing medical physics consultation, dosimetry, and treatment devices, per course of radiation therapy	Physics and dosimetry services performed alongside physician management to ensure accurate dose delivery.
`77427`	Radiation treatment management for stereotactic body radiotherapy, per session	Used when stereotactic techniques are employed; relates as an alternative management code for highly hypofractionated courses.
`G0339`	Physician radiation treatment supervision and management, five treatments	Used for billing supervision and management in groupings for certain payers; relates to course-based counting of treatment visits.

CPT 77427: Radiation Therapy Management, External Beam

CPT-77432-SINGLE-SESSION-STEREOTACTIC-RADIOSURGERY-PROFESSIONAL

CPT 77432: Single-Session Stereotactic Radiosurgery, Professional Component

CPT-77435-STEREOTACTIC-BODY-RADIOTHERAPY-TREATMENT-MANAGEMENT

CPT 77435: Stereotactic Body Radiotherapy Treatment Management

CPT-77437-SUPERFICIAL-RADIATION-THERAPY-PER-FRACTION

CPT 77437: Surface Radiation Therapy (Superficial) Per Fraction

CPT-77438-ORTHOVOLTAGE-SURFACE-RADIATION-THERAPY-SINGLE-FRACTION

CPT 77438: Orthovoltage Surface Radiation Therapy, Single Fraction

CPT-77439-ULTRASOUND-GUIDED-SRT-FIELD-PLACEMENT

CPT 77439: Ultrasound Guidance for Surface Radiation Therapy Field Placement

CPT-77469-INTRAOPERATIVE-RADIATION-THERAPY-IORT-DURING-SURGERY

CPT 77469: Intraoperative Radiation Therapy during Surgery

CPT-77470-SPECIAL-RADIOTHERAPY-MANAGEMENT

CPT 77470: Special Radiotherapy Procedure Management

CPT-77499-UNLISTED-THERAPEUTIC-RADIOLOGY-TREATMENT-MANAGEMENT

CPT 77499: Unlisted Therapeutic Radiology Treatment Management

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

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CPT 77431: Radiotherapy Management for One- or Two-Fraction Courses

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Billing Code Overview

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CPT 77431: Radiotherapy Management for One- or Two-Fraction Courses

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References