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77525 Proton treatment complex

What 77525 is

CMS fee schedule short descriptor: Proton treatment complex.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 77525 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 77525 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 77525? These codes are bundled into it

77525 is a Column 1 code in 223 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0591THlth&wb coaching indiv 1st1 - modifier may bypassCheck pair
0592THlth&wb coaching indiv f-up1 - modifier may bypassCheck pair
0593THlth&wb coaching group1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj0 - no modifier bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt0 - no modifier bypassCheck pair
11920Correct skin color 6.0 cm/<0 - no modifier bypassCheck pair
11921Correct skn color 6.1-20.0cm0 - no modifier bypassCheck pair
16000Initial treatment of burn(s)0 - no modifier bypassCheck pair
16020Dress/debrid p-thick burn s0 - no modifier bypassCheck pair
16025Dress/debrid p-thick burn m0 - no modifier bypassCheck pair
16030Dress/debrid p-thick burn l0 - no modifier bypassCheck pair
36000Place needle in vein1 - modifier may bypassCheck pair
36410Vnpnxr 3yr/> phy/qhp dx/ther1 - modifier may bypassCheck pair
36425Venipuncture cutdown 1 yr/>0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
51701Insert bladder catheter0 - no modifier bypassCheck pair
51702Insert temp bladder cath0 - no modifier bypassCheck pair
51703Insert bladder cath complex0 - no modifier bypassCheck pair
77371Srs multisource0 - no modifier bypassCheck pair
77372Srs linear based0 - no modifier bypassCheck pair
77373Strtctc bdy rad ther tx dlvr0 - no modifier bypassCheck pair
77402Radiation tx delivery lvl 10 - no modifier bypassCheck pair
77407Radiation tx delivery lvl 20 - no modifier bypassCheck pair
77412Radiation tx delivery lvl 30 - no modifier bypassCheck pair
77520Proton trmt simple w/o comp1 - modifier may bypassCheck pair
77522Proton trmt simple w/comp1 - modifier may bypassCheck pair
77523Proton trmt intermediate1 - modifier may bypassCheck pair
90832Psytx w pt 30 minutes0 - no modifier bypassCheck pair
90833Psytx w pt w e/m 30 min0 - no modifier bypassCheck pair

Showing 30 of 223 column 2 codes. Use the pair checker for any specific combination.

77525 is bundled into these codes

77525 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 77525 is the code that denies.

Column 1 codeShort descriptionModifier indicator
32701Thorax stereo rad targetw/tx0Check pair
77301Radiotherapy dose plan imrt0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.