{
    "code": "77295",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/77295/2016/A",
    "release_specific_url": "https://localishealth.com/cpt/77295/2016/D",
    "description": "Building the treatment plan in three dimensions from a planning CT scan. The target volume and the nearby organs at risk are outlined slice by slice, beams are shaped to conform to the tumor's actual shape, and the software produces dose-volume histograms showing how much dose the tumor and each surrounding structure will receive. It sits above the conventional simulation levels because the whole plan is designed and evaluated in a 3D volumetric dataset rather than on flat reference images.",
    "answer": {
        "question": "How much did Medicare pay for CPT 77295 in Q4 2016?",
        "text": "Medicare paid $495.89 for CPT 77295 in the office (non-facility) setting and $495.89 in a facility under the Q4 2016 Physician Fee Schedule, effective October 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it increased 0.9%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "D",
        "label": "Q4 2016",
        "effective": "October 1 – December 31, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 495.89,
        "facility": 495.89,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 4.29,
        "practice_expense_non_facility": 9.33,
        "practice_expense_facility": 9.33,
        "malpractice": 0.23
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q4 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/D",
        "file": "PPRRVU16_V0804.csv",
        "row": 12555,
        "sha256": "376b12d2df1b1c1abaed1e123e9501352bf559c75a0a4f87f52878742af491c9"
    },
    "modified_at": "2026-08-04T03:07:13+00:00"
}