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    v1.0.30
    OpenPayerBilling CodesRadiation Treatment ManagementCPT cpt-77439-ultrasound-guided-srt-field-placement
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    CPT 77439: Ultrasound-Guided SRT Field Localization for Cutaneous Tumors

    Medicare pays $17 on average nationally for this procedure.

    CPT code 77439 describes ultrasound guidance used to localize and define surface radiation therapy (SRT) treatment fields for cutaneous tumors; the service type is image-guided localization for SRT and the typical site of service is a radiation oncology clinic or outpatient treatment facility, reported once per course of treatment in addition to the primary SRT delivery code.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a biopsy-proven primary cutaneous malignancy such as basal cell carcinoma, squamous cell carcinoma, or early-stage cutaneous melanoma located on a cosmetically sensitive area (face, ear, scalp). The patient is referred to a dermatologic radiation oncology or surface radiation therapy (SRT) clinic for definitive superficial radiation therapy when surgery is contraindicated, declined, or would cause unacceptable functional/cosmetic outcomes.

    The clinical workflow begins with consultation, review of the pathology report and lesion mapping, and determination of candidacy for SRT. Prior to the first SRT delivery session, the provider performs ultrasound imaging to identify tumor depth and lateral extent, mark field boundaries, and select applicator size and energy. Ultrasound-guided field placement is performed once per course of treatment and documented in the medical record, including images, measurements, and justification for field selection. The primary SRT delivery code(s) are billed separately for each treatment fraction; 77439 is reported a single time per course in addition to the primary delivery service code. Care coordination includes informed consent, simulation/planning notes, treatment delivery records, and follow-up visits to assess response and toxicity.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    77401Superficial radiation treatment delivery, small field, 1 fractionOne of the common SRT delivery codes billed per fraction for superficial lesions; billed separately from 77439.
    77402Superficial radiation treatment delivery, intermediate field, 1 fractionAlternative SRT delivery code for intermediate field size; each fraction billed in addition to the single 77439 per course.
    77403Superficial radiation treatment delivery, large field, 1 fractionUsed for larger treatment fields; delivered fractions billed alongside the once-per-course 77439.
    76937Ultrasound guidance for placement of radiation therapy fieldsRelated ultrasound guidance code for some payers; 77439 specifically describes ultrasound guidance for SRT and is reported once per course in addition to the primary SRT delivery code.
    77295Radiation therapy plan, complexMay be used when more complex treatment planning is required prior to SRT; complements the field placement documentation though typically used for external beam planning.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    25CPT 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.,…
    59Modifier 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…
    76Modifier -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…
    77Modifier 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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    26Modifier 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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207N00000X
    2080P0207X
    363L00000X
    363A00000X
    111NN1001X
    363LA2200X
    261QM1000X
    163WN0003X

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01
    Topical Acne-Non-Retinoid ProductsCigna2026-08-15
    Dermatology - Vtama Drug Quantity Management Policy - Per DaysCigna2026-08-15
    Medical Necessity Guidelines: Acne and Rosacea Medicationsharvard pilgrim health care2026-08-11
    Dermatology - Anzupgo Prior Authorization PolicyCigna2026-08-05
    Light Therapy for Dermatologic Conditionsbcbsvermont2026-08-01

    Related Codes

    CPT-77427-RADIATION-THERAPY-MANAGEMENT-EXTERNAL-BEAM

    CPT 77427: Radiation Treatment Management

    CPT-77431-RADIOTHERAPY-MANAGEMENT-ONE-TWO-FRACTION-COURSE

    CPT 77431: Management of Short-Course Fractionated Radiotherapy

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

    CPT 77432: Stereotactic Radiosurgery, Single Session (Professional Component)

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

    CPT 77435: Stereotactic Body Radiotherapy Course (≤5 Fractions)

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

    CPT 77437: Superficial Radiation Therapy, Per Fraction

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

    CPT 77438: Orthovoltage Surface Radiation Therapy, Single Fraction

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

    CPT 77469: Intraoperative Radiation Therapy Management

    CPT-77470-SPECIAL-RADIOTHERAPY-MANAGEMENT

    CPT 77470: Special Radiotherapy Procedures Requiring Additional Management

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

    CPT 77499: Therapeutic Radiology Treatment Management, Unlisted

    Frequently Asked Questions

    References

    1. 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. 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. 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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