CPT 77261
Global XXX ActiveTher radiology tx plng smpl
CPT 77261 Billing & Documentation Guide
CPT code 77261 (Ther radiology tx plng smpl) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.27, a non-facility practice expense RVU of 0.75, and a malpractice RVU of 0.07, a total non-facility RVU of 2.09 and facility RVU of 2.09. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $71.43, though rates vary from $65.14 to $91.6 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 77261, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 77261 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 77261 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 77261
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.27 | 1.27 |
| Practice Expense RVU | 0.75 | 0.75 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 2.09 | 2.09 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 77261
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $74.85 | $74.85 | $71.85 - $84.46 | 29 |
| Florida | $72.1 | $72.1 | $69.88 - $74.41 | 3 |
| Georgia | $69.18 | $69.18 | $67.55 - $70.81 | 2 |
| Illinois | $71.24 | $71.24 | $68.94 - $73.26 | 4 |
| Michigan | $69.24 | $69.24 | $67.93 - $70.54 | 2 |
| North Carolina | $67.29 | $67.29 | $67.29 - $67.29 | 1 |
| New York | $75.56 | $75.56 | $67.86 - $79.26 | 5 |
| Ohio | $67.65 | $67.65 | $67.65 - $67.65 | 1 |
| Pennsylvania | $69.84 | $69.84 | $67.63 - $72.05 | 2 |
| Texas | $69.49 | $69.49 | $67.39 - $71.08 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 77261
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 77261 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0591T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0592T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0593T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 11920 | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 11921 | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 16000 | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 16010 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 16015 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 77261
What does CPT code 77261 mean? +
CPT code 77261 represents: Ther radiology tx plng smpl. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 77261? +
The 2026 Medicare national average non-facility payment for CPT 77261 is $71.43. Rates range from $65.14 to $91.6 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 77261? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 77261? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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