Simul Parikh, Medical Director of OncoHealth, Medical Director at Lake Huron Medical Center, shared on LinkedIn:
“The new few schedule came out for radiation oncology for freestanding and for hospitals. The way it is being presented is inaccurate. Both ASTROgram and recent other newsletter are quoting a 21% increase in 77412 for freestanding. The reason this is inaccurate is they are using the wrong baseline of $391. In late March 2026, this was revised (the number of RVUs was revised). If you look at the actual baseline, the difference is about 7%. This is a very important difference.
I used Claude to pull the current numbers from the CMS CPT code look up for 2026. Then, I used the recently published final rule numbers. I created a generic clinic of 300 patients of a representative mix of all disease sites, EBRT, SBRT, curative and palliative cases. I did this last year and that’s why our predictions were spot-on.
I ran the numbers and I believe them to be close to accurate. Hospitals stand to be about 15% better on technical and 3% worse on professional – so they will be 12% up from 2026 and about 6% up from 2025.
Freestanding overall will be a wash. Most centers are about 15-20% down in 2026 as compared to 2025. When you run it with the 2027 numbers, it is a wash. The treatment delivery codes are boosted a bit, but everything else came down. If you’re a practice that uses 77407 as your majority code, you may actually end up below 2026 numbers, based on fractionation and % of EBRT vs other.
So, unless something changes, as usual, the hospital wins and freestanding loses.
What is the plan moving forward? How do we keep community cancer centers alive?”
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