Cost analysis for CPT 77290 — Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved
Average Medicare Payment
$143.51
2023 data
Total Payments (2023)
$24.9M
Services (2023)
150.8K
Price Change (2014–2023)
-17.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $174.14 | $61.7M | 334.7K | — |
| 2015 | $173.16 | $53.5M | 298.8K | -0.6% |
| 2016 | $165.95 | $42.8M | 243.3K | -4.2% |
| 2017 | $163.88 | $39.7M | 225.1K | -1.2% |
| 2018 | $165.45 | $38.6M | 215.5K | +1.0% |
| 2019 | $161.28 | $36.2M | 206.7K | -2.5% |
| 2020 | $159.35 | $31.4M | 177.2K | -1.2% |
| 2021 | $157.05 | $30.0M | 173.7K | -1.4% |
| 2022 | $148.44 | $26.9M | 160.7K | -5.5% |
| 2023 | $143.51 | $24.9M | 150.8K | -3.3% |
The most expensive state pays 4.6x more than the cheapest for this procedure. AZ averages $291.68 vs SD at $63.75.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AZ | $291.68 | $1.6M | 5.5K | 96 |
| FL | $266.70 | $4.3M | 16.3K | 312 |
| CA | $233.03 | $3.8M | 16.5K | 348 |
| AL | $220.85 | $506.6K | 2.3K | 51 |
| TX | $219.66 | $1.8M | 8.2K | 229 |
| NV | $207.67 | $230.5K | 1.1K | 25 |
| ND | $202.71 | $79.5K | 392 | 11 |
| RI | $181.04 | $66.6K | 368 | 12 |
| LA | $175.56 | $311.1K | 1.8K | 48 |
| MD | $174.10 | $660.0K | 3.8K | 73 |
| HI | $171.99 | $84.6K | 492 | 13 |
| MN | $170.17 | $253.5K | 1.5K | 63 |
| AR | $169.66 | $201.6K | 1.2K | 25 |
| WA | $164.39 | $623.9K | 3.8K | 107 |
| NJ | $158.15 | $865.1K | 5.5K | 84 |
| GA | $155.99 | $633.0K | 4.1K | 105 |
| NE | $154.16 | $166.2K | 1.1K | 23 |
| NM | $151.43 | $51.3K | 339 | 11 |
| OK | $139.95 | $331.0K | 2.4K | 33 |
| AK | $138.98 | $43.1K | 310 | 7 |
| UT | $137.82 | $156.7K | 1.1K | 30 |
| WY | $137.06 | $38.5K | 281 | 3 |
| KY | $133.67 | $292.9K | 2.2K | 59 |
| TN | $131.80 | $579.5K | 4.4K | 69 |
| OR | $131.80 | $158.7K | 1.2K | 47 |
| NY | $130.30 | $916.8K | 7.0K | 209 |
| VA | $129.84 | $514.1K | 4.0K | 83 |
| SC | $129.50 | $310.4K | 2.4K | 55 |
| IN | $125.31 | $416.9K | 3.3K | 77 |
| DE | $120.74 | $128.5K | 1.1K | 16 |
| IL | $119.68 | $684.7K | 5.7K | 154 |
| CO | $117.48 | $209.8K | 1.8K | 63 |
| NC | $116.02 | $487.5K | 4.2K | 124 |
| MT | $115.43 | $77.6K | 672 | 16 |
| WV | $113.45 | $79.9K | 704 | 16 |
| NH | $112.92 | $107.8K | 955 | 25 |
| ID | $111.05 | $95.3K | 858 | 18 |
| KS | $107.92 | $153.4K | 1.4K | 29 |
| PA | $102.81 | $712.8K | 6.9K | 187 |
| MI | $96.93 | $368.7K | 3.8K | 109 |
| OH | $95.87 | $394.9K | 4.1K | 147 |
| CT | $93.87 | $152.4K | 1.6K | 46 |
| MA | $93.64 | $386.4K | 4.1K | 113 |
| MS | $91.10 | $117.4K | 1.3K | 27 |
| MO | $86.84 | $272.0K | 3.1K | 81 |
| ME | $85.28 | $64.6K | 757 | 18 |
| WI | $84.61 | $171.0K | 2.0K | 80 |
| IA | $73.96 | $103.3K | 1.4K | 36 |
| DC | $71.70 | $44.0K | 614 | 13 |
| VT | $63.77 | $22.1K | 347 | 10 |
| SD | $63.75 | $38.0K | 596 | 13 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Scott Tropper | Radiation Oncology | AZ | $393.0K | 1.1K | $346.83 |
| Coyle Connolly | Dermatology | NJ | $308.0K | 769 | $400.46 |
| David Greene | Radiation Oncology | CA | $279.1K | 708 | $394.22 |
| Steven Kurtzman | Radiation Oncology | CA | $262.2K | 541 | $484.64 |
| David Herold | Radiation Oncology | FL | $244.3K | 666 | $366.81 |
| Johnny Gurgen | Dermatology | FL | $189.8K | 563 | $337.11 |
| Travis Hamblin | Dermatology | AZ | $187.1K | 546 | $342.74 |
| Todd Scarbrough | Radiation Oncology | AL | $175.9K | 554 | $317.45 |
| John Binhlam | Dermatology | TN | $170.0K | 525 | $323.88 |
| Jeffrey Kanski | Radiation Oncology | FL | $161.9K | 458 | $353.39 |
| Michael Dattoli | Radiation Oncology | FL | $139.5K | 431 | $323.71 |
| Mark Pomper | Radiation Oncology | FL | $137.5K | 384 | $357.95 |
| Stephen Doggett | Radiation Oncology | CA | $134.7K | 368 | $366.02 |
| Daniel Harris | General Surgery | OK | $127.7K | 398 | $320.89 |
| Ankit Agarwal | Radiation Oncology | CA | $100.5K | 201 | $500.09 |
| Daniel Taheri | Dermatology | CA | $92.4K | 234 | $394.87 |
| Sidney Smith | Dermatology | WA | $91.9K | 244 | $376.44 |
| Robert Beer | Dermatology | CA | $90.7K | 190 | $477.53 |
| Parthiv Mehta | Radiation Oncology | IL | $80.3K | 234 | $343.37 |
| Central Arkansas Radiation Therapy Institute Inc | Radiation Therapy Center | AR | $78.0K | 315 | $247.50 |
The data suggests significant pricing inconsistencies for CPT 77290. With a 4.6x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 17.6% since 2014, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.