CPT code 77003: Fluoroscopic guidance, spinal or paraspinal injection2026 Medicare rate & RVUs in Mississippi

Reports fluoroscopic needle guidance for a spinal or paraspinal injection when the primary procedure does not already include imaging guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality22.1K Medicare services in 2024

In Mississippi, Medicare pays $92.55 for 77003 in the office.

$92.55Office (non-facility)
Not available in this settingHospital or facility
−11.5%vs the national office rate ($104.54)

Check a contract rate as a % of Medicare · 77003 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 77003 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Mississippi
  2. What 77003 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 77003 covers

This service uses fluoroscopy to guide a needle or catheter during a spinal or paraspinal injection, helping the practitioner advance and position it at the intended site. It is commonly performed by pain medicine physicians, anesthesiologists, radiologists, and other clinicians performing image-guided spine procedures in office or facility settings. Examples include guidance for an epidural injection or an injection near spinal structures when the associated procedure code does not include imaging guidance.

Report 77003 only as an add-on to an eligible primary procedure; CMS places its payment within that procedure’s global period. The primary code must describe the injection, and its coding rules must permit separate reporting of guidance. Documentation should identify the spinal or paraspinal target, the fluoroscopic guidance performed, and support the service with saved images and a written report. CMS separately prices professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Mississippi compares for 77003

Across 109 of 109 payment localities, the office rate for 77003 runs from $92.01 in Arkansas to $142.70 in San Benito County, CA. Mississippi pays $92.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

77003 in Mississippi vs other payment areas
  1. Mississippi · this page$92.55
  2. Los Angeles, CA · California$120.01+$27.46
  3. Washington, DC area · District of Columbia$120.60+$28.05
  4. Miami, FL · Florida$110.51+$17.96
  5. Chicago, IL · Illinois$107.26+$14.71
  6. Manhattan, NY · New York$120.26+$27.71
  7. Alaska · Alaska$119.05+$26.50

Other areas in Mississippi first, then benchmark localities. Bars start at $0.

Every other payment area

77003 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$93.42—
ArkansasArkansas$92.01—
ArizonaArizona$101.73—
Bakersfield, CACalifornia$112.25—
Chico, CACalifornia$112.09—
El Centro, CACalifornia$112.10—
Fresno, CACalifornia$112.09—
Hanford, CACalifornia$112.09—

77003 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$92.01

$127.40

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
77003 office rate range by state
State / territoryOffice rate rangeLocalities
AK$119.051
AL$93.421
AR$92.011
AZ$101.731
CA$112.09–$142.7029
CO$109.741
CT$111.691
DC$120.601
DE$103.481
FL$101.73–$110.513
GA$95.88–$106.272
GU$115.241
HI$115.241
IA$96.471
ID$97.011
IL$98.25–$108.224
IN$97.621
KS$95.731
KY$95.171
LA$94.91–$99.872
MA$108.93–$121.302
MD$105.60–$120.603
ME$97.26–$103.182
MI$97.52–$102.782
MN$105.781
MO$93.02–$100.563
MS$92.551
MT$104.541
NC$98.371
ND$103.551
NE$97.101
NH$107.751
NJ$113.15–$119.212
NM$97.981
NV$104.351
NY$99.89–$122.965
OH$97.321
OK$95.271
OR$103.72–$113.662
PA$97.63–$108.632
PR$105.431
RI$107.481
SC$97.971
SD$103.441
TN$96.201
TX$96.94–$109.228
UT$99.381
VA$102.64–$120.602
VI$105.431
VT$102.891
WA$108.81–$124.102
WI$99.901
WV$94.371
WY$104.111

See 77003 in every payment locality

How the 77003 rate is calculated

Each of 77003’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 77003

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense2.49

2.49 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

3.1300

Conversion factor

$33.4009

Medicare rate

$104.54

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Mississippi inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,931

Code
77003
Physician work
0.59
Practice expense
2.49
Malpractice
0.05

GPCI2026.csv

67

Locality
Mississippi
Physician work
1.000
Practice expense
0.861
Malpractice
0.739
Office calculation for 77003 in Mississippi
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense2.49× 0.8612.1439
Malpractice0.05× 0.7390.0370
Total RVUs2.7708
Conversion factor× 33.4009

Office rate, Mississippi$92.55

Office: (0.59 × 1 + 2.49 × 0.861 + 0.05 × 0.739) × $33.4009 = $92.55

Open 77003 in the RVU calculator

Payment rules and modifiers for 77003

The CMS indicators that decide how 77003 is paid alongside other services.

CMS payment indicators · 77003

Fluoroscopic guidance, spinal or paraspinal injection

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

77003 without 26 · national office

$104.54

Fluoroscopic guidance, spinal or paraspinal injection

77003-26 · Professional component

$28.39

Pays only the interpretation and report.

When to use modifier 26

How 77003 has changed in Mississippi

77003 · Office / nonfacility

$92.55

Effective 2026-10-01

The base rate is $4.90 higher than on 2025-10-01, moving from $87.65 to $92.55 (5.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $87.65changed to$92.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.59
    • Practice expense RVU 2.44 changed to 2.49
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.852 changed to 0.861
    • Malpractice GPCI 0.768 changed to 0.739

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $92.44changed to$87.65

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.51 changed to 2.44
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $90.93changed to$92.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $94.17changed to$90.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.53 changed to 2.51
    • Practice expense GPCI 0.847 changed to 0.852
    • Malpractice GPCI 0.720 changed to 0.768
  5. January 1, 2023

    RVU23A

    $95.06changed to$94.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.51 changed to 2.53
    • Practice expense GPCI 0.842 changed to 0.847
    • Malpractice GPCI 0.671 changed to 0.720

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $93.21changed to$95.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.42 changed to 2.51

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $90.68changed to$93.21

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.21 changed to 2.42
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.856 changed to 0.842
    • Malpractice GPCI 0.521 changed to 0.671

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $88.76changed to$90.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.12 changed to 2.21
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.870 changed to 0.856
    • Malpractice GPCI 0.370 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $85.71changed to$88.76

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.03 changed to 2.12
    • Malpractice RVU 0.04 changed to 0.05

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $85.09changed to$85.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.02 changed to 2.03
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.492 changed to 0.370

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $77.12changed to$85.09

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.77 changed to 2.02
    • Practice expense GPCI 0.864 changed to 0.867
    • Malpractice GPCI 0.613 changed to 0.492

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $77.08changed to$77.12

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.76 changed to 1.77

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $76.70changed to$77.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $81.35changed to$76.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.90 changed to 1.76
    • Practice expense GPCI 0.865 changed to 0.864
    • Malpractice GPCI 0.687 changed to 0.613

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $85.68changed to$81.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.18 changed to 1.90
    • Practice expense GPCI 0.866 changed to 0.865
    • Malpractice GPCI 0.761 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $85.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$92.55Not available in this settingRVU26D
2026-07-01$92.55Not available in this settingRVU26C
2026-04-01$92.55Not available in this settingRVU26B
2026-01-01$92.55Not available in this settingRVU26A
2025-10-01$87.65Not available in this settingRVU25D
2025-07-01$87.65Not available in this settingRVU25C
2025-04-01$87.65Not available in this settingRVU25B
2025-01-01$87.65Not available in this settingRVU25A
2024-10-01$92.44Not available in this settingRVU24D
2024-07-01$92.44Not available in this settingRVU24C
2024-04-01$92.44Not available in this settingRVU24B
2024-03-09$92.44Not available in this settingRVU24AR
2024-01-01$90.93Not available in this settingRVU24A
2023-10-01$94.17Not available in this settingRVU23D
2023-07-01$94.17Not available in this settingRVU23C
2023-04-01$94.17Not available in this settingRVU23B
2023-01-01$94.17Not available in this settingRVU23A
2022-10-01$95.06Not available in this settingRVU22D
2022-07-01$95.06Not available in this settingRVU22C
2022-04-01$95.06Not available in this settingRVU22B
2022-01-01$95.06Not available in this settingRVU22A
2021-10-01$93.21Not available in this settingRVU21D
2021-07-01$93.21Not available in this settingRVU21C
2021-04-01$93.21Not available in this settingRVU21B
2021-01-01$93.21Not available in this settingRVU21A
2020-10-01$90.68Not available in this settingRVU20D
2020-07-01$90.68Not available in this settingRVU20C
2020-04-01$90.68Not available in this settingRVU20B
2020-01-01$90.68Not available in this settingRVU20A
2019-10-01$88.76Not available in this settingRVU19D
2019-07-01$88.76Not available in this settingRVU19C
2019-04-01$88.76Not available in this settingRVU19B
2019-01-01$88.76Not available in this settingRVU19A
2018-10-01$85.71Not available in this settingRVU18D
2018-07-01$85.71Not available in this settingRVU18C
2018-04-01$85.71Not available in this settingRVU18B
2018-01-01$85.71Not available in this settingRVU18AR1
2017-10-01$85.09Not available in this settingRVU17D
2017-07-01$85.09Not available in this settingRVU17C
2017-04-01$85.09Not available in this settingRVU17B
2017-01-01$85.09Not available in this settingRVU17A
2016-10-01$77.12Not available in this settingRVU16D
2016-07-01$77.12Not available in this settingRVU16C
2016-04-01$77.12Not available in this settingRVU16B
2016-01-01$77.12Not available in this settingRVU16A
2015-10-01$77.08Not available in this settingRVU15D
2015-07-01$77.08Not available in this settingRVU15C
2015-04-01$76.70Not available in this settingRVU15B
2015-01-01$76.70Not available in this settingRVU15A
2014-10-01$81.35Not available in this settingRVU14D
2014-07-01$81.35Not available in this settingRVU14C
2014-04-01$81.35Not available in this settingRVU14B
2014-01-01$81.35Not available in this settingRVU14A
2013-10-01$85.68Not available in this settingRVU13D
2013-07-01$85.68Not available in this settingRVU13C
2013-04-01$85.68Not available in this settingRVU13B
2013-01-01$85.68Not available in this settingRVU13AR

Price 77003 for an earlier date of service

Where the Mississippi rate applies

Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Aberdeen
  • Ackerman
  • Agricola
  • Alcorn State University
  • Algoma
  • Alligator
  • Amory

Browse all communities in Mississippi

77003 billing questions

Can 77003 be billed by itself?

No. It is an add-on code and must be reported with an eligible primary procedure. CMS places payment within the primary procedure’s global period.

When should 77003 be distinguished from 62323?

Use 77003 for spinal or paraspinal fluoroscopic guidance when the primary procedure does not include guidance. Code 62323 describes a lumbar or sacral epidural injection that includes imaging guidance, so separate reporting of 77003 is not appropriate for that service.

Which modifiers identify the components?

Modifier 26 reports the professional interpretation, and modifier TC reports the technical component, including equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports 77003?

Document the spinal or paraspinal target and the fluoroscopic guidance used to position the needle or catheter. Retain supporting images and a written report.

Can 77003 accompany an injection code that says without imaging guidance?

It may be reported when fluoroscopy was performed and the primary code permits separate reporting of guidance. For example, 62322 describes a lumbar or sacral epidural injection without imaging guidance.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 77003PPRRVU2026_Oct_nonQPP.csv, line 8,931 (RVU26D)
Geographic factors for MississippiGPCI2026.csv, line 67 (RVU26D)

Open CMS sourceHow we calculate rates

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