CPT code 77021: MRI needle guidance, needle placement2026 Medicare rate & RVUs

Medicare pays $426.86 for 77021 nationally in the office. Local office rates run $372.63–$596.93.

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

What 77021 covers

This service covers MRI imaging used to direct needle placement during a percutaneous procedure, such as a biopsy, aspiration, or injection. The radiologist or other qualified imaging professional monitors the needle’s position and provides the imaging supervision and interpretation; the procedural clinician performs the intervention. It is typically furnished in an MRI suite when the target or approach calls for MRI guidance rather than CT, fluoroscopy, or another modality.

Select this code based on the imaging method and the service performed, not simply because an MRI was obtained. Documentation should identify the target, the needle-guidance procedure, and the imaging supervision and interpretation. Report it with the related procedure only when that procedure’s code does not already include the same guidance. CMS recognizes professional and technical components: modifier 26 reports the interpretation, modifier TC reports the equipment and staff, and no 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.

Where 77021 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

77021 rates by state

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

How the 77021 rate is calculated

Each of 77021’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.

Payment rules and modifiers for 77021

The CMS indicators that decide how 77021 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

77021 compared with similar codes

How to choose

77012CT guidanceNeedle placement

77021 reports MRI guidance for needle placement; 77012 is used when CT guides a needle biopsy.

77022MRI ablation guidanceGuidance and monitoring

77022 is specifically for MRI guidance during parenchymal tissue ablation. 77021 addresses needle placement for procedures such as biopsy, aspiration, or injection.

77002Fluoroscopy guidanceNeedle placement

77002 describes X-ray needle localization guidance. Choose 77021 when MRI, not X-ray, is used to guide needle placement.

Codes related to 77021

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates