CPT code 77003: Fluoroscopic guidance, spinal or paraspinal injection2026 Medicare rate & RVUs in Fort Worth, TX
Reports fluoroscopic needle guidance for a spinal or paraspinal injection when the primary procedure does not already include imaging guidance.
In Fort Worth, TX, Medicare pays $103.34 for 77003 in the office.
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.
On this page 11 sections
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 Fort Worth, TX 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. Fort Worth, TX pays $103.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Fort Worth, TX · this page$103.34
- Austin, TX · Texas$109.22+$5.88
- Beaumont, TX · Texas$96.94−$6.40
- Brazoria, TX · Texas$103.59+$0.25
- Dallas, TX · Texas$104.15+$0.81
- Galveston, TX · Texas$103.83+$0.49
- Houston, TX · Texas$104.75+$1.41
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $100.14 | — |
| Los Angeles, CACalifornia | $120.01 | — |
| Washington, DC areaDistrict of Columbia | $120.60 | — |
| Miami, FLFlorida | $110.51 | — |
| Chicago, ILIllinois | $107.26 | — |
| Manhattan, NYNew York | $120.26 | — |
| AlaskaAlaska | $119.05 | — |
| 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 | — |
| Madera, CACalifornia | $112.09 | — |
| Merced, CACalifornia | $112.09 | — |
| Modesto, CACalifornia | $112.09 | — |
| Napa, CACalifornia | $131.41 | — |
| Oxnard, CACalifornia | $119.60 | — |
| Redding, CACalifornia | $112.09 | — |
| Rest of CaliforniaCalifornia | $112.09 | — |
| Riverside, CACalifornia | $112.64 | — |
| Sacramento, CACalifornia | $118.04 | — |
| Salinas, CACalifornia | $117.60 | — |
| San Diego, CACalifornia | $120.67 | — |
| Marin County, CACalifornia | $139.61 | — |
| San Francisco, CACalifornia | $139.56 | — |
| San Benito County, CACalifornia | $142.70 | — |
| Santa Clara County, CACalifornia | $142.47 | — |
| San Luis Obispo, CACalifornia | $115.67 | — |
| Santa Cruz, CACalifornia | $122.06 | — |
| Santa Maria, CACalifornia | $118.13 | — |
| Santa Rosa, CACalifornia | $123.32 | — |
| Stockton, CACalifornia | $112.09 | — |
| Vallejo, CACalifornia | $131.33 | — |
| Visalia, CACalifornia | $112.09 | — |
| Yuba City, CACalifornia | $112.09 | — |
| ColoradoColorado | $109.74 | — |
| ConnecticutConnecticut | $111.69 | — |
| DelawareDelaware | $103.48 | — |
| Fort Lauderdale, FLFlorida | $106.98 | — |
| Rest of FloridaFlorida | $101.73 | — |
| Atlanta, GAGeorgia | $106.27 | — |
| Rest of GeorgiaGeorgia | $95.88 | — |
| Hawaii, Guam, HIHawaii | $115.24 | — |
| IowaIowa | $96.47 | — |
| IdahoIdaho | $97.01 | — |
| East St. Louis, ILIllinois | $99.58 | — |
| Rest of IllinoisIllinois | $98.25 | — |
| Suburban Chicago, ILIllinois | $108.22 | — |
| IndianaIndiana | $97.62 | — |
| KansasKansas | $95.73 | — |
| KentuckyKentucky | $95.17 | — |
| New Orleans, LALouisiana | $99.87 | — |
| Rest of LouisianaLouisiana | $94.91 | — |
| Metropolitan Boston, MAMassachusetts | $121.30 | — |
| Rest of MassachusettsMassachusetts | $108.93 | — |
| Baltimore area, MDMaryland | $111.33 | — |
| Rest of MarylandMaryland | $105.60 | — |
| Rest of MaineMaine | $97.26 | — |
| Southern Maine, MEMaine | $103.18 | — |
| Detroit, MIMichigan | $102.78 | — |
| Rest of MichiganMichigan | $97.52 | — |
| MinnesotaMinnesota | $105.78 | — |
| Metropolitan Kansas City, MOMissouri | $99.43 | — |
| Metropolitan St. Louis, MOMissouri | $100.56 | — |
| Rest of MissouriMissouri | $93.02 | — |
| MississippiMississippi | $92.55 | — |
| MontanaMontana | $104.54 | — |
| North CarolinaNorth Carolina | $98.37 | — |
| North DakotaNorth Dakota | $103.55 | — |
| NebraskaNebraska | $97.10 | — |
| New HampshireNew Hampshire | $107.75 | — |
| Northern New JerseyNew Jersey | $119.21 | — |
| Rest of New JerseyNew Jersey | $113.15 | — |
| New MexicoNew Mexico | $97.98 | — |
| NevadaNevada | $104.35 | — |
| NYC suburbs and Long Island, NYNew York | $122.96 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $113.68 | — |
| Queens, NYNew York | $121.68 | — |
| Rest of New YorkNew York | $99.89 | — |
| OhioOhio | $97.32 | — |
| OklahomaOklahoma | $95.27 | — |
| Portland, OROregon | $113.66 | — |
| Rest of OregonOregon | $103.72 | — |
| Metropolitan Philadelphia, PAPennsylvania | $108.63 | — |
| Rest of PennsylvaniaPennsylvania | $97.63 | — |
| Puerto RicoPuerto Rico | $105.43 | — |
| Rhode IslandRhode Island | $107.48 | — |
| South CarolinaSouth Carolina | $97.97 | — |
| South DakotaSouth Dakota | $103.44 | — |
| TennesseeTennessee | $96.20 | — |
| UtahUtah | $99.38 | — |
| VirginiaVirginia | $102.64 | — |
| Virgin Islands, VIUnited States Virgin Islands | $105.43 | — |
| VermontVermont | $102.89 | — |
| Rest of WashingtonWashington | $108.81 | — |
| King County, WAWashington | $124.10 | — |
| WisconsinWisconsin | $99.90 | — |
| West VirginiaWest Virginia | $94.37 | — |
| WyomingWyoming | $104.11 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $119.05 | 1 |
| AL | $93.42 | 1 |
| AR | $92.01 | 1 |
| AZ | $101.73 | 1 |
| CA | $112.09–$142.70 | 29 |
| CO | $109.74 | 1 |
| CT | $111.69 | 1 |
| DC | $120.60 | 1 |
| DE | $103.48 | 1 |
| FL | $101.73–$110.51 | 3 |
| GA | $95.88–$106.27 | 2 |
| GU | $115.24 | 1 |
| HI | $115.24 | 1 |
| IA | $96.47 | 1 |
| ID | $97.01 | 1 |
| IL | $98.25–$108.22 | 4 |
| IN | $97.62 | 1 |
| KS | $95.73 | 1 |
| KY | $95.17 | 1 |
| LA | $94.91–$99.87 | 2 |
| MA | $108.93–$121.30 | 2 |
| MD | $105.60–$120.60 | 3 |
| ME | $97.26–$103.18 | 2 |
| MI | $97.52–$102.78 | 2 |
| MN | $105.78 | 1 |
| MO | $93.02–$100.56 | 3 |
| MS | $92.55 | 1 |
| MT | $104.54 | 1 |
| NC | $98.37 | 1 |
| ND | $103.55 | 1 |
| NE | $97.10 | 1 |
| NH | $107.75 | 1 |
| NJ | $113.15–$119.21 | 2 |
| NM | $97.98 | 1 |
| NV | $104.35 | 1 |
| NY | $99.89–$122.96 | 5 |
| OH | $97.32 | 1 |
| OK | $95.27 | 1 |
| OR | $103.72–$113.66 | 2 |
| PA | $97.63–$108.63 | 2 |
| PR | $105.43 | 1 |
| RI | $107.48 | 1 |
| SC | $97.97 | 1 |
| SD | $103.44 | 1 |
| TN | $96.20 | 1 |
| TX | $96.94–$109.22 | 8 |
| UT | $99.38 | 1 |
| VA | $102.64–$120.60 | 2 |
| VI | $105.43 | 1 |
| VT | $102.89 | 1 |
| WA | $108.81–$124.10 | 2 |
| WI | $99.90 | 1 |
| WV | $94.37 | 1 |
| WY | $104.11 | 1 |
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
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 Fort Worth, TX 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
100
- Locality
- Fort Worth, TX
- Physician work
- 1.009
- Practice expense
- 0.986
- Malpractice
- 0.871
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.009 | 0.5953 |
| Practice expense | 2.49 | × 0.986 | 2.4551 |
| Malpractice | 0.05 | × 0.871 | 0.0436 |
| Total RVUs | 3.0940 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Fort Worth, TX$103.34
Office: (0.59 × 1.009 + 2.49 × 0.986 + 0.05 × 0.871) × $33.4009 = $103.34
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 77003 has changed in Fort Worth, TX
77003 · Office / nonfacility
$103.34
Effective 2026-10-01
The base rate is $3.78 higher than on 2025-10-01, moving from $99.56 to $103.34 (3.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$99.56changed to$103.34
- 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
- Work GPCI 1.011 changed to 1.009
- Practice expense GPCI 0.998 changed to 0.986
- Malpractice GPCI 0.902 changed to 0.871
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$105.08changed to$99.56
- 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.
March 9, 2024
RVU24AR
$103.36changed to$105.08
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$107.21changed to$103.36
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.53 changed to 2.51
- Work GPCI 1.013 changed to 1.011
- Practice expense GPCI 0.996 changed to 0.998
- Malpractice GPCI 0.721 changed to 0.902
January 1, 2023
RVU23A
$108.46changed to$107.21
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.51 changed to 2.53
- Work GPCI 1.016 changed to 1.013
- Practice expense GPCI 0.995 changed to 0.996
- Malpractice GPCI 0.539 changed to 0.721
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$106.23changed to$108.46
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.42 changed to 2.51
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$101.86changed to$106.23
- 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
- Work GPCI 1.011 changed to 1.016
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.643 changed to 0.539
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$98.45changed to$101.86
- 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
- Work GPCI 1.007 changed to 1.011
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.747 changed to 0.643
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$94.88changed to$98.45
- 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.
January 1, 2018
RVU18AR1
$94.60changed to$94.88
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.02 changed to 2.03
- Work GPCI 1.006 changed to 1.007
- Practice expense GPCI 0.991 changed to 0.986
- Malpractice GPCI 0.760 changed to 0.747
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$85.75changed to$94.60
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.77 changed to 2.02
- Work GPCI 1.005 changed to 1.006
- Practice expense GPCI 0.995 changed to 0.991
- Malpractice GPCI 0.772 changed to 0.760
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$85.70changed to$85.75
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.76 changed to 1.77
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$85.28changed to$85.70
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$89.86changed to$85.28
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.90 changed to 1.76
- Work GPCI 1.002 changed to 1.005
- Practice expense GPCI 0.987 changed to 0.995
- Malpractice GPCI 0.799 changed to 0.772
Held through RVU15B.
January 1, 2014
RVU14A
$94.15changed to$89.86
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.18 changed to 1.90
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.979 changed to 0.987
- Malpractice GPCI 0.826 changed to 0.799
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $94.15
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $103.34 | Not available in this setting | RVU26D |
| 2026-07-01 | $103.34 | Not available in this setting | RVU26C |
| 2026-04-01 | $103.34 | Not available in this setting | RVU26B |
| 2026-01-01 | $103.34 | Not available in this setting | RVU26A |
| 2025-10-01 | $99.56 | Not available in this setting | RVU25D |
| 2025-07-01 | $99.56 | Not available in this setting | RVU25C |
| 2025-04-01 | $99.56 | Not available in this setting | RVU25B |
| 2025-01-01 | $99.56 | Not available in this setting | RVU25A |
| 2024-10-01 | $105.08 | Not available in this setting | RVU24D |
| 2024-07-01 | $105.08 | Not available in this setting | RVU24C |
| 2024-04-01 | $105.08 | Not available in this setting | RVU24B |
| 2024-03-09 | $105.08 | Not available in this setting | RVU24AR |
| 2024-01-01 | $103.36 | Not available in this setting | RVU24A |
| 2023-10-01 | $107.21 | Not available in this setting | RVU23D |
| 2023-07-01 | $107.21 | Not available in this setting | RVU23C |
| 2023-04-01 | $107.21 | Not available in this setting | RVU23B |
| 2023-01-01 | $107.21 | Not available in this setting | RVU23A |
| 2022-10-01 | $108.46 | Not available in this setting | RVU22D |
| 2022-07-01 | $108.46 | Not available in this setting | RVU22C |
| 2022-04-01 | $108.46 | Not available in this setting | RVU22B |
| 2022-01-01 | $108.46 | Not available in this setting | RVU22A |
| 2021-10-01 | $106.23 | Not available in this setting | RVU21D |
| 2021-07-01 | $106.23 | Not available in this setting | RVU21C |
| 2021-04-01 | $106.23 | Not available in this setting | RVU21B |
| 2021-01-01 | $106.23 | Not available in this setting | RVU21A |
| 2020-10-01 | $101.86 | Not available in this setting | RVU20D |
| 2020-07-01 | $101.86 | Not available in this setting | RVU20C |
| 2020-04-01 | $101.86 | Not available in this setting | RVU20B |
| 2020-01-01 | $101.86 | Not available in this setting | RVU20A |
| 2019-10-01 | $98.45 | Not available in this setting | RVU19D |
| 2019-07-01 | $98.45 | Not available in this setting | RVU19C |
| 2019-04-01 | $98.45 | Not available in this setting | RVU19B |
| 2019-01-01 | $98.45 | Not available in this setting | RVU19A |
| 2018-10-01 | $94.88 | Not available in this setting | RVU18D |
| 2018-07-01 | $94.88 | Not available in this setting | RVU18C |
| 2018-04-01 | $94.88 | Not available in this setting | RVU18B |
| 2018-01-01 | $94.88 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $94.60 | Not available in this setting | RVU17D |
| 2017-07-01 | $94.60 | Not available in this setting | RVU17C |
| 2017-04-01 | $94.60 | Not available in this setting | RVU17B |
| 2017-01-01 | $94.60 | Not available in this setting | RVU17A |
| 2016-10-01 | $85.75 | Not available in this setting | RVU16D |
| 2016-07-01 | $85.75 | Not available in this setting | RVU16C |
| 2016-04-01 | $85.75 | Not available in this setting | RVU16B |
| 2016-01-01 | $85.75 | Not available in this setting | RVU16A |
| 2015-10-01 | $85.70 | Not available in this setting | RVU15D |
| 2015-07-01 | $85.70 | Not available in this setting | RVU15C |
| 2015-04-01 | $85.28 | Not available in this setting | RVU15B |
| 2015-01-01 | $85.28 | Not available in this setting | RVU15A |
| 2014-10-01 | $89.86 | Not available in this setting | RVU14D |
| 2014-07-01 | $89.86 | Not available in this setting | RVU14C |
| 2014-04-01 | $89.86 | Not available in this setting | RVU14B |
| 2014-01-01 | $89.86 | Not available in this setting | RVU14A |
| 2013-10-01 | $94.15 | Not available in this setting | RVU13D |
| 2013-07-01 | $94.15 | Not available in this setting | RVU13C |
| 2013-04-01 | $94.15 | Not available in this setting | RVU13B |
| 2013-01-01 | $94.15 | Not available in this setting | RVU13AR |
Where the Fort Worth, TX rate applies
Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 77003 in Fort Worth · multiple payment areas
- Arlington
- 77003 in Azle · multiple payment areas
- Bedford
- Benbrook
- Blue Mound
- 77003 in Briar · multiple payment areas
- 77003 in Burleson · multiple payment areas
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
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