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

MRI guidance supports real-time needle positioning during a percutaneous procedure when MRI is the selected imaging method and guidance is separately reportable.

CMS RVU26DEffective Oct 1, 2026One payment locality2.6K Medicare services in 2024

In Delaware, Medicare pays $422.33 for 77021 in the office.

$422.33Office (non-facility)
Not available in this settingHospital or facility
−1.1%vs the national office rate ($426.86)

Check a contract rate as a % of Medicare · 77021 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 77021 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 77021 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 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.

How Delaware compares for 77021

Across 109 of 109 payment localities, the office rate for 77021 runs from $372.63 in Arkansas to $596.93 in San Benito County, CA. Delaware pays $422.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

77021 in Delaware vs other payment areas
  1. Delaware · this page$422.33
  2. Los Angeles, CA · California$496.67+$74.34
  3. Washington, DC area · District of Columbia$496.62+$74.29
  4. Miami, FL · Florida$446.34+$24.01
  5. Chicago, IL · Illinois$432.54+$10.21
  6. Manhattan, NY · New York$492.37+$70.04
  7. Alaska · Alaska$474.45+$52.12

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

Every other payment area

77021 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$378.78—
ArkansasArkansas$372.63—
ArizonaArizona$414.84—
Bakersfield, CACalifornia$462.79—
Chico, CACalifornia$462.49—
El Centro, CACalifornia$462.51—
Fresno, CACalifornia$462.49—
Hanford, CACalifornia$462.49—

77021 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$372.63

$529.71

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

View every state and territory as a table
77021 office rate range by state
State / territoryOffice rate rangeLocalities
AK$474.451
AL$378.781
AR$372.631
AZ$414.841
CA$462.49–$596.9329
CO$450.891
CT$457.311
DC$496.621
DE$422.331
FL$411.69–$446.343
GA$386.83–$433.552
GU$477.171
HI$477.171
IA$393.341
ID$395.421
IL$395.71–$439.404
IN$398.081
KS$389.501
KY$384.961
LA$383.58–$405.082
MA$447.00–$501.402
MD$431.64–$496.623
ME$395.82–$422.502
MI$394.55–$415.562
MN$435.871
MO$374.99–$408.853
MS$373.981
MT$426.861
NC$400.751
ND$425.281
NE$396.291
NH$441.921
NJ$463.61–$490.192
NM$396.241
NV$426.791
NY$407.30–$503.235
OH$394.221
OK$386.101
OR$424.57–$468.632
PA$395.93–$443.652
PR$430.951
RI$439.891
SC$397.931
SD$425.091
TN$391.461
TX$392.89–$448.438
UT$404.071
VA$419.70–$496.622
VI$430.951
VT$421.791
WA$446.76–$514.032
WI$409.251
WV$378.831
WY$426.171

See 77021 in every payment locality

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.

How the rate is built · 77021

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.46

1.46 RVUs× 1.000 GPCI

Practice expense11.24

11.24 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

12.7800

Conversion factor

$33.4009

Medicare rate

$426.86

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,943

Code
77021
Physician work
1.46
Practice expense
11.24
Malpractice
0.08

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 77021 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0051.4673
Practice expense11.24× 0.98811.1051
Malpractice0.08× 0.8990.0719
Total RVUs12.6443
Conversion factor× 33.4009

Office rate, Delaware$422.33

Office: (1.46 × 1.005 + 11.24 × 0.988 + 0.08 × 0.899) × $33.4009 = $422.33

Open 77021 in the RVU calculator

Payment rules and modifiers for 77021

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

CMS payment indicators · 77021

MRI needle guidance, needle placement

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
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

77021 without 26 · national office

$426.86

MRI needle guidance, needle placement

77021-26 · Professional component

$70.14

Pays only the interpretation and report.

When to use modifier 26

Codes related to 77021

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

Codes related to 77021
CodeHow it relatesOffice range, Delaware
Used instead
77012CT guidance, needle placementCT guidance for needle biopsy when CT, rather than MRI, directs needle placement.$121.97
77022MRI ablation guidance, guidance and monitoringMRI guidance for parenchymal tissue ablation, a distinct treatment-guidance service.No office rate
77002Fluoroscopy guidance, needle placementX-ray guidance for needle localization when MRI is not the guidance method.$119.97
77003Fluoroscopic guidance, spinal or paraspinal injectionFluoroscopic guidance for spinal injection procedures rather than MRI needle guidance.$103.48

How 77021 has changed in Delaware

77021 · Office / nonfacility

$422.33

Effective 2026-10-01

The base rate is $21.48 higher than on 2025-10-01, moving from $400.85 to $422.33 (5.4%).

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

    $400.85changed to$422.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 10.89 changed to 11.24
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $422.08changed to$400.85

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.18 changed to 10.89

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $415.20changed to$422.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $438.63changed to$415.20

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.27 changed to 11.18
    • Malpractice RVU 0.09 changed to 0.08
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $452.65changed to$438.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.26 changed to 11.27
    • Malpractice RVU 0.07 changed to 0.09
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $480.65changed to$452.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.94 changed to 11.26

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $481.90changed to$480.65

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.52 changed to 11.94
    • Malpractice RVU 0.08 changed to 0.07
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $493.24changed to$481.90

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.85 changed to 11.52
    • Malpractice RVU 0.09 changed to 0.08
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $405.40changed to$493.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.47 changed to 11.85

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $415.15changed to$405.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.70 changed to 9.47
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $418.14changed to$415.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.75 changed to 9.70
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $427.06changed to$418.14

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.95 changed to 9.75

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $424.94changed to$427.06

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $412.52changed to$424.94

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.53 changed to 9.95
    • Malpractice RVU 0.12 changed to 0.10
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $405.20changed to$412.52

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.87 changed to 9.53
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $405.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$422.33Not available in this settingRVU26D
2026-07-01$422.33Not available in this settingRVU26C
2026-04-01$422.33Not available in this settingRVU26B
2026-01-01$422.33Not available in this settingRVU26A
2025-10-01$400.85Not available in this settingRVU25D
2025-07-01$400.85Not available in this settingRVU25C
2025-04-01$400.85Not available in this settingRVU25B
2025-01-01$400.85Not available in this settingRVU25A
2024-10-01$422.08Not available in this settingRVU24D
2024-07-01$422.08Not available in this settingRVU24C
2024-04-01$422.08Not available in this settingRVU24B
2024-03-09$422.08Not available in this settingRVU24AR
2024-01-01$415.20Not available in this settingRVU24A
2023-10-01$438.63Not available in this settingRVU23D
2023-07-01$438.63Not available in this settingRVU23C
2023-04-01$438.63Not available in this settingRVU23B
2023-01-01$438.63Not available in this settingRVU23A
2022-10-01$452.65Not available in this settingRVU22D
2022-07-01$452.65Not available in this settingRVU22C
2022-04-01$452.65Not available in this settingRVU22B
2022-01-01$452.65Not available in this settingRVU22A
2021-10-01$480.65Not available in this settingRVU21D
2021-07-01$480.65Not available in this settingRVU21C
2021-04-01$480.65Not available in this settingRVU21B
2021-01-01$480.65Not available in this settingRVU21A
2020-10-01$481.90Not available in this settingRVU20D
2020-07-01$481.90Not available in this settingRVU20C
2020-04-01$481.90Not available in this settingRVU20B
2020-01-01$481.90Not available in this settingRVU20A
2019-10-01$493.24Not available in this settingRVU19D
2019-07-01$493.24Not available in this settingRVU19C
2019-04-01$493.24Not available in this settingRVU19B
2019-01-01$493.24Not available in this settingRVU19A
2018-10-01$405.40Not available in this settingRVU18D
2018-07-01$405.40Not available in this settingRVU18C
2018-04-01$405.40Not available in this settingRVU18B
2018-01-01$405.40Not available in this settingRVU18AR1
2017-10-01$415.15Not available in this settingRVU17D
2017-07-01$415.15Not available in this settingRVU17C
2017-04-01$415.15Not available in this settingRVU17B
2017-01-01$415.15Not available in this settingRVU17A
2016-10-01$418.14Not available in this settingRVU16D
2016-07-01$418.14Not available in this settingRVU16C
2016-04-01$418.14Not available in this settingRVU16B
2016-01-01$418.14Not available in this settingRVU16A
2015-10-01$427.06Not available in this settingRVU15D
2015-07-01$427.06Not available in this settingRVU15C
2015-04-01$424.94Not available in this settingRVU15B
2015-01-01$424.94Not available in this settingRVU15A
2014-10-01$412.52Not available in this settingRVU14D
2014-07-01$412.52Not available in this settingRVU14C
2014-04-01$412.52Not available in this settingRVU14B
2014-01-01$412.52Not available in this settingRVU14A
2013-10-01$405.20Not available in this settingRVU13D
2013-07-01$405.20Not available in this settingRVU13C
2013-04-01$405.20Not available in this settingRVU13B
2013-01-01$405.20Not available in this settingRVU13AR

Price 77021 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

77021 billing questions

How does 77021 differ from CT-guided needle placement?

77021 is for MRI guidance. Use a CT guidance code, such as 77012 for needle biopsy guidance, when CT is the imaging method.

Can 77021 be reported with an MRI-guided breast biopsy?

Breast biopsy codes such as 19085 include MRI guidance for the first lesion. Do not separately report 77021 for guidance already included in the biopsy service.

Which modifiers report the components?

Use modifier 26 for the professional interpretation and modifier TC for the technical component. Billing without either modifier represents the global service.

Does 77021 describe the biopsy or injection itself?

No. It reports MRI guidance for needle placement and the associated imaging supervision and interpretation; the biopsy, aspiration, or injection is represented by its own procedure code.

How should documentation support 77021?

Document the target and percutaneous procedure, the use of MRI to guide needle placement, and the imaging supervision and interpretation. Check that the associated procedure code does not already include that guidance.

Is 77021 interchangeable with MRI ablation guidance?

No. 77021 addresses MRI guidance for needle placement; 77022 is used for MRI guidance of parenchymal tissue ablation.

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 77021PPRRVU2026_Oct_nonQPP.csv, line 8,943 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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