Healthcare Insights

Exploring radiation oncology procedures by volume and charges

Physicians have used ionizing radiation to treat cancer since 1896—only a year after X-rays were discovered by Wilhelm Röntgen.

The radiation therapies used in radiation oncology aim to damage cancer cells’ DNA, slowing or preventing tumors from growing and, in some cases, eliminating tumors entirely.

As the medical use of radiation has become safer and more precise, patients have access to a growing variety of palliative and curative radiation oncology procedures. Unfortunately, this heightened demand has also created a deficit of physicians within the field of radiation oncology.

The charts below show the radiation oncology procedures performed most frequently during 2021, as well as those with the highest total charges.

Top 10 radiation oncology procedures by volume

RankHCPCS/CPT codeHCPCS/CPT description# Total proceduresExplore dataset
177427Radiation treatment management (5 treatments)66,596Explore
277336Medical radiation physics consultation46,683Explore
377334Radiation treatment aid(s)27,116Explore
477523Proton beam radiation treatment, intermediate26,847Explore
577300Radiation therapy dose planning21,227Explore
677263Radiation therapy planning17,985Explore
777280Radiation therapy field simulation, 1 treatment area13,793Explore
877290Radiation therapy field simulation, 3+ treatment areas13,061Explore
977338Multi-leaf collimator device for IMRT10,962Explore
1077387Guidance for radiation therapy delivery10,723Explore

Fig 1. Data from Definitive Healthcare’s platform on commercial claims analytics. Top CPT codes are from imaging center reports from CY 2021 and include radiation oncology procedures.

Most common radiation oncology procedures by volume

Radiation treatment management (5 treatments) was the most commonly performed radiation oncology procedure in 2021, with 66,596 procedures reported. This procedure code is reported once for every five treatment sessions a patient receives. Typically, these sessions include a medical examination, a review of therapy dosage and reviews of lab and imaging results.

The next most common procedure, the medical radiation physics consultation, is a technical service performed by a radiation physicist as part of a routine treatment plan. During this procedure, the radiation physicist reviews a patient’s treatment chart and record to ensure the radiation oncologist’s prescribed dosage, delivery specifications and safety considerations are being followed.

The radiation treatment aid(s) procedure ranks third by total 2021 procedures. This procedure code is reported when a patient requires a customized treatment device to be made for their oncology treatment. These can include wax molds designed for a specific body part, custom-made eye shields and immobilizing/restraining devices.

Top 10 radiation oncology procedures by total charges

RankHCPCS/CPT codeHCPCS/CPT descriptionTotal chargesExplore dataset
177523Proton beam radiation treatment, intermediate$133,633,609 Explore
277427Radiation treatment management (5 treatments)$41,704,736 Explore
377301Radiation therapy dose planning for IMRT$36,150,303 Explore
477334Radiation treatment aid(s)$18,550,260 Explore
577336Medical radiation physics consultation$14,682,656 Explore
677373SBRT delivery$14,495,827 Explore
7772953-D radiotherapy planning$13,423,577 Explore
877300Radiation therapy dose planning$12,939,721 Explore
977290Radiation therapy field simulation, 3+ treatment areas$12,842,426 Explore
1077338Multi-leaf collimator device for IMRT$12,514,936 Explore

Fig 2. Data from Definitive Healthcare’s platform on commercial claims analytics. Top CPT codes are from imaging center reports from CY 2021 and include radiation oncology procedures.

Most common radiation oncology procedures by total charges

With over $133 million in total charges—more than three times the total charges of the runner-up—proton beam radiation treatment delivery (intermediate) had the greatest total charges in 2021. This common treatment involves irradiating one or more body parts via radiation ports. Often, this treatment involves the use of a custom block or compensator to direct radiation more precisely. These customized components are charged under the radiation treatment aid(s) code.

Providers charged more than $41 million for radiation treatment management (5 treatments) in 2021. Falling just behind at $36 million in total charges is the intensity-modulated radiation therapy (IMRT) dose planning procedure, in which a physician uses 3-D computed tomography (CT) or magnetic resonance imaging (MRI) to calculate precise radiation doses while minimizing damage to normal tissue surrounding a tumor. This procedure is the first of two IMRT treatment phases, the second being treatment delivery.

Stereotactic body radiation therapy (SBRT) is similar to IMRT but provides higher doses of radiation per treatment, usually across fewer treatment sessions. SBRT delivery was the radiation oncology procedure with the sixth-highest total charges in 2021. The reduced treatment duration of SBRT is associated with lower costs overall compared to IMRT, but also with higher genitourinary toxicity.

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