2025 CPT code 77385
(Active) Effective Date: N/A Revision Date: N/A Radiation Oncology - IMRT Treatment Delivery Radiology Procedures > Radiation Oncology Treatment Feed
Intensity-modulated radiation therapy (IMRT) delivery; simple. Includes guidance and tracking when performed.
Modifiers may be applicable depending on the circumstances of service.Consult the most recent CPT® guidelines for appropriate modifier usage.
Medical necessity for IMRT is established when the benefits of using this technique outweigh the risks and burdens of the treatment. Factors to consider include tumor location, size and proximity to critical organs; patient's overall health; and the potential for improved local control and reduced toxicity compared to conventional techniques.
The radiation oncologist is responsible for treatment planning, including target delineation, dose calculation and treatment delivery.The medical physicist is responsible for the quality assurance of the treatment plan and equipment.Dosimetrists assist in calculating radiation doses.Radiation therapists operate the linear accelerator and deliver radiation.
- Radiology Procedures > Radiation Oncology Treatment
- Radiation Oncology Treatment > IMRT Treatment Delivery
In simple words: This code covers the technical part of a type of radiation therapy (IMRT) that uses a computer to precisely target tumors with high-intensity radiation while protecting healthy tissue.If imaging is used to guide the radiation, that part of the treatment is included in this code. The doctor's work in planning and managing the treatment is billed separately.
This CPT code encompasses the technical component of intensity-modulated radiation therapy (IMRT) treatment delivery, categorized as simple.Simple IMRT includes treatments for sites such as prostate and breast cancer, or those using physical compensator-based IMRT. The code inherently bundles the technical aspects of image guidance and tracking if performed during the procedure.The professional component of image guidance and tracking, if applicable, should be billed separately using CPT code 77387 with modifier 26.
Example 1: A 60-year-old male diagnosed with prostate cancer undergoes IMRT treatment using a physical compensator.The treatment involves a single treatment area with two ports and two simple blocks, meeting the criteria for simple IMRT (77385)., A 45-year-old female diagnosed with early-stage breast cancer receives IMRT treatment utilizing a physical compensator. The treatment involves a single treatment area with three ports and uses three simple blocks.This still qualifies as simple IMRT (77385)., A 72-year-old male with lung cancer requires IMRT treatment. The treatment involves multiple treatment areas, custom blocking and complex field shaping, requiring the use of CPT code 77386 (complex IMRT).
The following documentation is required:* Physician order specifying the treatment plan.* Imaging studies (CT, MRI) to delineate the target volume and organs at risk.* Treatment plan generated by the treatment planning system.* Treatment delivery verification reports.* Treatment records including daily dose, date, and total dose delivered.
** Always refer to the most up-to-date CPT® manual and payer-specific guidelines for accurate coding and reimbursement.This information is for general guidance only and should not be considered definitive.
- Revenue Code: P7A (ONCOLOGY - RADIATION THERAPY)
- RVU: This information is not provided in the source and would need to be obtained from the appropriate fee schedule.
- Global Days: The global period is not specified for this code and will depend on payer specific guidelines.Consult payer-specific guidelines for the global surgical period details.
- Payment Status: Active
- Modifier TC rule: The technical component of image guidance and tracking is bundled into 77385.Do not use modifier TC with this code.The professional component is billed separately using 77387-26.
- Fee Schedule: Historical fee schedule information is not provided and will vary by payer and date.
- Specialties:Radiation Oncology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Radiation Oncology Clinic