CPT 77436: Surface Radiation Therapy Treatment Planning and Simulation

Medicare pays $54 on average nationally for this procedure.

CPT code 77436 describes treatment planning and simulation–aided field setting for surface radiation therapy (SRT), an external beam radiation service that uses low‑energy X‑rays to treat cancers and other conditions on or close to the skin surface; the service type is treatment planning and simulation and the typical site of service is an outpatient radiation oncology clinic or dermatologic radiation suite where imaging simulation and field placement are used to determine size and placement of radiation fields for accurate targeting.

For related coverage guidance, see recent payer policy updates: Destruction of Pre-Malignant Skin Lesions, Onychomycosis diagnostic testing and coverage, Treatment of Capillary Malformations (Port Wine Stains).

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Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old with a superficial basal cell carcinoma on the nasal ala referred to radiation oncology after surgery was declined due to cosmesis and comorbidities. The outpatient workflow begins with a consultation by a radiation oncologist who reviews pathology, photographs the lesion, and determines that surface radiation therapy (SRT) is appropriate. On the simulation day the provider performs treatment planning and simulation–aided field setting (77436), which includes measuring the lesion, selecting applicator size, marking field borders, documenting set‑up photos, and optionally obtaining imaging or surface mapping to confirm beam geometry. The plan defines field size, depth, dose per fraction, total dose, and shielding or bolus needs. Following planning, treatment is delivered at subsequent visits using low‑energy X‑ray SRT applicators until the prescribed dose is completed. Typical site of service is an outpatient radiation oncology clinic or ambulatory procedure center equipped for superficial radiation therapy. Common patient considerations include prior surgeries, lesion location near sensitive structures (eyes, nose, ears), anticoagulation status, and mobility for positioning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77418`	Radiation treatment delivery, superficial and/or orthovoltage, per fraction	Delivers the prescribed superficial radiation fractions after planning and field setup performed with `77436`.
`77295`	Therapeutic radiology simulation-aided field setting, complex	Used for more complex simulation and field setting when three‑dimensional planning or more extensive immobilization/imaging is required compared with `77436`.
`77261`	Therapeutic radiology simulation-aided field setting, simple	Used for straightforward simulation that may be less involved than the planning described in `77436` depending on payer definitions.
`77300`	Ionizing radiation treatment delivery, simple; orthovoltage or superficial, per treatment session (technical component)	Technical delivery code that may be billed by the facility or technical provider for each treatment session following physician planning under `77436`.
`77336`	Continuing medical physics consultation, per week, when billed	Medical physics services that may support planning accuracy, dosimetry checks, or verification associated with SRT planning and delivery.

Related Modifiers

5 rows

Modifier	Description	When to Use
25	CPT 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.,…
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…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code
207RC0000X
208600000X
363A00000X
207L00000X
225100000X
347C00000X
273Y00000X
163WC3500X

Related Payer Policy Updates

Specialty: Dermatology1 / 3

10 rows

Policy	Payer	Effective Date
Destruction of Pre-Malignant Skin Lesions	Anthem	2026-10-01
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Treatment of Capillary Malformations (Port Wine Stains)	universityofutahhealthplans	2026-09-28
Anzupgo	Cigna	2026-09-15
Zevaskyn Coverage for Recessive Dystrophic Epidermolysis Bullosa	Cigna	2026-09-01
Topical Acne-Non-Retinoid Products	Cigna	2026-08-15
Dermatology - Vtama Drug Quantity Management Policy - Per Days	Cigna	2026-08-15
Medical Necessity Guidelines: Acne and Rosacea Medications	harvard pilgrim health care	2026-08-11
Dermatology - Anzupgo Prior Authorization Policy	Cigna	2026-08-05
Light Therapy for Dermatologic Conditions	bcbsvermont	2026-08-01

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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77418`	Radiation treatment delivery, superficial and/or orthovoltage, per fraction	Delivers the prescribed superficial radiation fractions after planning and field setup performed with `77436`.
`77295`	Therapeutic radiology simulation-aided field setting, complex	Used for more complex simulation and field setting when three‑dimensional planning or more extensive immobilization/imaging is required compared with `77436`.
`77261`	Therapeutic radiology simulation-aided field setting, simple	Used for straightforward simulation that may be less involved than the planning described in `77436` depending on payer definitions.
`77300`	Ionizing radiation treatment delivery, simple; orthovoltage or superficial, per treatment session (technical component)	Technical delivery code that may be billed by the facility or technical provider for each treatment session following physician planning under `77436`.
`77336`	Continuing medical physics consultation, per week, when billed	Medical physics services that may support planning accuracy, dosimetry checks, or verification associated with SRT planning and delivery.

Related Modifiers

5 rows

Modifier	Description	When to Use
25	CPT 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.,…
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…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code
207RC0000X
208600000X
363A00000X
207L00000X
225100000X
347C00000X
273Y00000X
163WC3500X

Related Payer Policy Updates

Specialty: Dermatology1 / 3

10 rows

Policy	Payer	Effective Date
Destruction of Pre-Malignant Skin Lesions	Anthem	2026-10-01
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Treatment of Capillary Malformations (Port Wine Stains)	universityofutahhealthplans	2026-09-28
Anzupgo	Cigna	2026-09-15
Zevaskyn Coverage for Recessive Dystrophic Epidermolysis Bullosa	Cigna	2026-09-01
Topical Acne-Non-Retinoid Products	Cigna	2026-08-15
Dermatology - Vtama Drug Quantity Management Policy - Per Days	Cigna	2026-08-15
Medical Necessity Guidelines: Acne and Rosacea Medications	harvard pilgrim health care	2026-08-11
Dermatology - Anzupgo Prior Authorization Policy	Cigna	2026-08-05
Light Therapy for Dermatologic Conditions	bcbsvermont	2026-08-01

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 77436: Surface Radiation Therapy Treatment Planning and Simulation

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CPT 77436: Surface Radiation Therapy Treatment Planning and Simulation

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

What does CPT 77436 cover and where is it typically performed?

Which modifiers are commonly used with 77436 and when should they be applied?

What CPT codes are commonly billed alongside or related to 77436?

Which diagnoses or clinical scenarios are appropriate pairings for billing 77436?

Who performs 77436 and in what clinical settings is it usually delivered?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

What does CPT 77436 cover and where is it typically performed?

Which modifiers are commonly used with 77436 and when should they be applied?

What CPT codes are commonly billed alongside or related to 77436?

Which diagnoses or clinical scenarios are appropriate pairings for billing 77436?

Who performs 77436 and in what clinical settings is it usually delivered?

References