CMS Pub. 100-04, ch. 4, § 200.3.2

Radiosurgery (SRS) Planning and Delivery

(Rev. 3941; Issued: 12-22-17; Effective: 01- 01-18; Implementation: 01-02-18)

Effective for services furnished on or after January 1, 2014, hospitals must report SRS

planning and delivery services using only the CPT codes that accurately describe the

service furnished. For the delivery services, hospitals must report CPT code 77371,

77372, or 77373.

CPT Code Long Descriptor

77371 Radiation treatment delivery, stereotactic radiosurgery (srs), complete

course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based

77372 Radiation treatment delivery, stereotactic radiosurgery (srs), complete

course of treatment of cranial lesion(s) consisting of 1 session; linear

accelerator based

77373 Stereotactic body radiation therapy, treatment delivery, per fraction to 1

or more lesions, including image guidance, entire course not to exceed 5

fractions

As instructed in the CY 2014 OPPS/ASC final rule, CPT code 77371 is to be used only

for single session cranial SRS cases performed with a Cobalt-60 device, and CPT code

77372 is to be used only for single session cranial SRS cases performed with a linac-based device. The term “cranial” means that the pathological lesion(s) that are the target

of the radiation is located in the patient’s cranium or head. The term “single session”

means that the entire intracranial lesion(s) that comprise the patient’s diagnosis are

treated in their entirety during a single treatment session on a single day. CPT code

77372 is never to be used for the first fraction or any other fraction of a fractionated SRS

treatment. CPT code 77372 is to be used only for single session cranial linac-based SRS

treatment. Fractionated SRS treatment is any SRS delivery service requiring more than a

single session of SRS treatment for a cranial lesion, up to a total of no more than five

fractions, and one to five sessions (but no more than five) for non-cranial lesions. CPT

code 77373 is to be used for any fraction (including the first fraction) in any series of

fractionated treatments, regardless of the anatomical location of the lesion or lesions

being radiated. Fractionated cranial SRS is any cranial SRS that exceeds one treatment

session and fractionated non-cranial SRS is any non-cranial SRS, regardless of the

number of fractions but never more than five. Therefore, CPT code 77373 is the

exclusive code (and the use of no other SRS treatment delivery code is permitted) for any

and all fractionated SRS treatment services delivered anywhere in the body, including,

but not limited to, the cranium or head. 77372 is not to be used for the first fraction of a

fractionated cranial SRS treatment series and must only be used in cranial SRS when

there is a single treatment session to treat the patient’s entire condition.

In addition, for the planning services, hospitals must report the specific CPT code that

accurately describes the service provided. The planning services may include but are not

limited to CPT code 77290, 77295, 77300, 77334, or 77370.

CPT Code Long Descriptor

77290 Therapeutic radiology simulation-aided field setting; complex

77295 Therapeutic radiology simulation-aided field setting; 3-dimensional

77300 Basic radiation dosimetry calculation, central axis depth dose calculation,

tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors,

calculation of non-ionizing radiation surface and depth dose, as required

during course of treatment, only when prescribed by the treating

physician

77334 Treatment devices, design and construction; complex (irregular blocks,

special shields, compensators, wedges, molds or casts)

77370 Special medical radiation physics consultation

Effective for cranial single session stereotactic radiosurgery procedures (CPT code 77371

or 77372) furnished on or after January 1, 2016, costs for certain adjunctive services

(e.g., planning and preparation) are not factored into the APC payment rate for APC 5627

(Level 7 Radiation Therapy). Rather, the ten planning and preparation codes, will be paid

according to their assigned status indicator when furnished 30 days prior or 30 days post

SRS treatment delivery. A list of the excluded planning and preparation CPT codes is

provided in the CY 2018 OPPS/ASC final rule with comment period.