Summary & Overview
CPT 77767: Surface Brachytherapy for Small Skin Tumor
CPT code 77767 represents a surface brachytherapy procedure that applies a high-energy radioactive source to treat a skin tumor up to 2.0 cm in diameter or uses a single channel directly on or near the skin surface. The code specifically includes dose calculation prior to loading into the catheter when that calculation is performed. This procedure is clinically significant for localized dermatologic malignancies and select benign lesions where targeted radiation spares surrounding tissue.
Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of the code, typical sites of service, common modifiers, and payer coverage considerations. The publication outlines common billing practices and benchmarking topics relevant to ambulatory radiation oncology and outpatient procedural settings.
The article provides practical reference material: a description of the service captured by the code, typical clinical scenarios, payer landscape, and items for operational consideration such as dose calculation being an included component when performed. Data not available in the input will be identified as such in specific sections where applicable.
Billing Code Overview
CPT code 77767 describes a brachytherapy procedure in which a high-energy radioactive substance is applied to treat a skin tumor up to 2.0 cm in diameter, or a single channel is used directly on or adjacent to the skin surface. The description specifies that the service includes calculation of the radioactive dose prior to loading into the catheter when that calculation is performed.
-
Service type: Superficial brachytherapy / surface applicator brachytherapy for skin lesions
-
Typical site of service: Outpatient procedure setting such as an ambulatory surgical center or hospital outpatient department; may also be performed in specialized radiation oncology clinics
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a dermatology-oncology clinic with a biopsy-confirmed primary cutaneous basal cell carcinoma measuring 1.2 cm in greatest diameter on the lateral nose. The lesion is superficial-to-mid dermal and located in a cosmetically sensitive area. After multidisciplinary review, the decision is made to proceed with high-dose-rate (HDR) surface brachytherapy using a single-channel applicator directly on the skin surface to deliver a localized radiation dose.
The clinical workflow includes: a consultation visit documenting lesion size, location, pathology, performance status, and informed consent; treatment planning with surface molding and imaging as needed; dose calculation and loading of the radioactive source into the applicator; delivery of the prescribed fractionated HDR brachytherapy; and post-treatment follow-up for wound care and toxicity assessment. The procedure requires coordination among the radiation oncologist, medical physicist (dose calculation and source loading verification), dosimetrist, and treatment therapist. Billing captures the application of a high energy radioactive substance to a skin tumor up to 2.0 cm in diameter or a single-channel surface treatment, including pre-loading dose calculation when performed, as defined by 77767.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |