CPT code 77021: MRI needle guidance, needle placement2026 Medicare rate & RVUs in North Carolina
MRI guidance supports real-time needle positioning during a percutaneous procedure when MRI is the selected imaging method and guidance is separately reportable.
In North Carolina, Medicare pays $400.75 for 77021 in the office.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $400.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$400.75
- Los Angeles, CA · California$496.67+$95.92
- Washington, DC area · District of Columbia$496.62+$95.87
- Miami, FL · Florida$446.34+$45.59
- Chicago, IL · Illinois$432.54+$31.79
- Manhattan, NY · New York$492.37+$91.62
- Alaska · Alaska$474.45+$73.70
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $462.49 | — |
| Merced, CACalifornia | $462.49 | — |
| Modesto, CACalifornia | $462.49 | — |
| Napa, CACalifornia | $548.01 | — |
| Oxnard, CACalifornia | $495.55 | — |
| Redding, CACalifornia | $462.49 | — |
| Rest of CaliforniaCalifornia | $462.49 | — |
| Riverside, CACalifornia | $463.39 | — |
| Sacramento, CACalifornia | $488.57 | — |
| Salinas, CACalifornia | $486.83 | — |
| San Diego, CACalifornia | $500.69 | — |
| Marin County, CACalifornia | $583.98 | — |
| San Francisco, CACalifornia | $583.88 | — |
| San Benito County, CACalifornia | $596.93 | — |
| Santa Clara County, CACalifornia | $596.55 | — |
| San Luis Obispo, CACalifornia | $478.64 | — |
| Santa Cruz, CACalifornia | $507.36 | — |
| Santa Maria, CACalifornia | $489.31 | — |
| Santa Rosa, CACalifornia | $512.68 | — |
| Stockton, CACalifornia | $462.49 | — |
| Vallejo, CACalifornia | $547.88 | — |
| Visalia, CACalifornia | $462.49 | — |
| Yuba City, CACalifornia | $462.49 | — |
| ColoradoColorado | $450.89 | — |
| ConnecticutConnecticut | $457.31 | — |
| DelawareDelaware | $422.33 | — |
| Fort Lauderdale, FLFlorida | $433.90 | — |
| Rest of FloridaFlorida | $411.69 | — |
| Atlanta, GAGeorgia | $433.55 | — |
| Rest of GeorgiaGeorgia | $386.83 | — |
| Hawaii, Guam, HIHawaii | $477.17 | — |
| IowaIowa | $393.34 | — |
| IdahoIdaho | $395.42 | — |
| East St. Louis, ILIllinois | $399.54 | — |
| Rest of IllinoisIllinois | $395.71 | — |
| Suburban Chicago, ILIllinois | $439.40 | — |
| IndianaIndiana | $398.08 | — |
| KansasKansas | $389.50 | — |
| KentuckyKentucky | $384.96 | — |
| New Orleans, LALouisiana | $405.08 | — |
| Rest of LouisianaLouisiana | $383.58 | — |
| Metropolitan Boston, MAMassachusetts | $501.40 | — |
| Rest of MassachusettsMassachusetts | $447.00 | — |
| Baltimore area, MDMaryland | $455.68 | — |
| Rest of MarylandMaryland | $431.64 | — |
| Rest of MaineMaine | $395.82 | — |
| Southern Maine, MEMaine | $422.50 | — |
| Detroit, MIMichigan | $415.56 | — |
| Rest of MichiganMichigan | $394.55 | — |
| MinnesotaMinnesota | $435.87 | — |
| Metropolitan Kansas City, MOMissouri | $403.90 | — |
| Metropolitan St. Louis, MOMissouri | $408.85 | — |
| Rest of MissouriMissouri | $374.99 | — |
| MississippiMississippi | $373.98 | — |
| MontanaMontana | $426.86 | — |
| North DakotaNorth Dakota | $425.28 | — |
| NebraskaNebraska | $396.29 | — |
| New HampshireNew Hampshire | $441.92 | — |
| Northern New JerseyNew Jersey | $490.19 | — |
| Rest of New JerseyNew Jersey | $463.61 | — |
| New MexicoNew Mexico | $396.24 | — |
| NevadaNevada | $426.79 | — |
| NYC suburbs and Long Island, NYNew York | $503.23 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $465.28 | — |
| Queens, NYNew York | $499.49 | — |
| Rest of New YorkNew York | $407.30 | — |
| OhioOhio | $394.22 | — |
| OklahomaOklahoma | $386.10 | — |
| Portland, OROregon | $468.63 | — |
| Rest of OregonOregon | $424.57 | — |
| Metropolitan Philadelphia, PAPennsylvania | $443.65 | — |
| Rest of PennsylvaniaPennsylvania | $395.93 | — |
| Puerto RicoPuerto Rico | $430.95 | — |
| Rhode IslandRhode Island | $439.89 | — |
| South CarolinaSouth Carolina | $397.93 | — |
| South DakotaSouth Dakota | $425.09 | — |
| TennesseeTennessee | $391.46 | — |
| Austin, TXTexas | $448.43 | — |
| Beaumont, TXTexas | $392.89 | — |
| Brazoria, TXTexas | $423.29 | — |
| Dallas, TXTexas | $425.42 | — |
| Fort Worth, TXTexas | $421.70 | — |
| Galveston, TXTexas | $424.17 | — |
| Houston, TXTexas | $425.63 | — |
| Rest of TexasTexas | $407.46 | — |
| UtahUtah | $404.07 | — |
| VirginiaVirginia | $419.70 | — |
| Virgin Islands, VIUnited States Virgin Islands | $430.95 | — |
| VermontVermont | $421.79 | — |
| Rest of WashingtonWashington | $446.76 | — |
| King County, WAWashington | $514.03 | — |
| WisconsinWisconsin | $409.25 | — |
| West VirginiaWest Virginia | $378.83 | — |
| WyomingWyoming | $426.17 | — |
77021 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.
$372.63
$529.71
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 | $474.45 | 1 |
| AL | $378.78 | 1 |
| AR | $372.63 | 1 |
| AZ | $414.84 | 1 |
| CA | $462.49–$596.93 | 29 |
| CO | $450.89 | 1 |
| CT | $457.31 | 1 |
| DC | $496.62 | 1 |
| DE | $422.33 | 1 |
| FL | $411.69–$446.34 | 3 |
| GA | $386.83–$433.55 | 2 |
| GU | $477.17 | 1 |
| HI | $477.17 | 1 |
| IA | $393.34 | 1 |
| ID | $395.42 | 1 |
| IL | $395.71–$439.40 | 4 |
| IN | $398.08 | 1 |
| KS | $389.50 | 1 |
| KY | $384.96 | 1 |
| LA | $383.58–$405.08 | 2 |
| MA | $447.00–$501.40 | 2 |
| MD | $431.64–$496.62 | 3 |
| ME | $395.82–$422.50 | 2 |
| MI | $394.55–$415.56 | 2 |
| MN | $435.87 | 1 |
| MO | $374.99–$408.85 | 3 |
| MS | $373.98 | 1 |
| MT | $426.86 | 1 |
| NC | $400.75 | 1 |
| ND | $425.28 | 1 |
| NE | $396.29 | 1 |
| NH | $441.92 | 1 |
| NJ | $463.61–$490.19 | 2 |
| NM | $396.24 | 1 |
| NV | $426.79 | 1 |
| NY | $407.30–$503.23 | 5 |
| OH | $394.22 | 1 |
| OK | $386.10 | 1 |
| OR | $424.57–$468.63 | 2 |
| PA | $395.93–$443.65 | 2 |
| PR | $430.95 | 1 |
| RI | $439.89 | 1 |
| SC | $397.93 | 1 |
| SD | $425.09 | 1 |
| TN | $391.46 | 1 |
| TX | $392.89–$448.43 | 8 |
| UT | $404.07 | 1 |
| VA | $419.70–$496.62 | 2 |
| VI | $430.95 | 1 |
| VT | $421.79 | 1 |
| WA | $446.76–$514.03 | 2 |
| WI | $409.25 | 1 |
| WV | $378.83 | 1 |
| WY | $426.17 | 1 |
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
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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.46 | × 1.000 | 1.4600 |
| Practice expense | 11.24 | × 0.933 | 10.4869 |
| Malpractice | 0.08 | × 0.639 | 0.0511 |
| Total RVUs | 11.9980 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$400.75
Office: (1.46 × 1 + 11.24 × 0.933 + 0.08 × 0.639) × $33.4009 = $400.75
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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) | 9 | The concept doesn’t apply. |
| 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
77021 without 26 · national office
$426.86
MRI needle guidance, needle placement
77021-26 · Professional component
$70.14
Pays only the interpretation and report.
How 77021 has changed in North Carolina
77021 · Office / nonfacility
$400.75
Effective 2026-10-01
The base rate is $24.32 higher than on 2025-10-01, moving from $376.43 to $400.75 (6.5%).
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
$376.43changed to$400.75
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$396.32changed to$376.43
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 11.18 changed to 10.89
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$389.85changed to$396.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$407.12changed to$389.85
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$415.50changed to$407.12
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$440.97changed to$415.50
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 11.94 changed to 11.26
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$442.97changed to$440.97
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$453.91changed to$442.97
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$373.64changed to$453.91
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 9.47 changed to 11.85
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$380.56changed to$373.64
- 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
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$381.11changed to$380.56
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 9.75 changed to 9.70
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$389.17changed to$381.11
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.95 changed to 9.75
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$387.23changed to$389.17
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$374.03changed to$387.23
- 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 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$365.40changed to$374.03
- 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 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $365.40
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $400.75 | Not available in this setting | RVU26D |
| 2026-07-01 | $400.75 | Not available in this setting | RVU26C |
| 2026-04-01 | $400.75 | Not available in this setting | RVU26B |
| 2026-01-01 | $400.75 | Not available in this setting | RVU26A |
| 2025-10-01 | $376.43 | Not available in this setting | RVU25D |
| 2025-07-01 | $376.43 | Not available in this setting | RVU25C |
| 2025-04-01 | $376.43 | Not available in this setting | RVU25B |
| 2025-01-01 | $376.43 | Not available in this setting | RVU25A |
| 2024-10-01 | $396.32 | Not available in this setting | RVU24D |
| 2024-07-01 | $396.32 | Not available in this setting | RVU24C |
| 2024-04-01 | $396.32 | Not available in this setting | RVU24B |
| 2024-03-09 | $396.32 | Not available in this setting | RVU24AR |
| 2024-01-01 | $389.85 | Not available in this setting | RVU24A |
| 2023-10-01 | $407.12 | Not available in this setting | RVU23D |
| 2023-07-01 | $407.12 | Not available in this setting | RVU23C |
| 2023-04-01 | $407.12 | Not available in this setting | RVU23B |
| 2023-01-01 | $407.12 | Not available in this setting | RVU23A |
| 2022-10-01 | $415.50 | Not available in this setting | RVU22D |
| 2022-07-01 | $415.50 | Not available in this setting | RVU22C |
| 2022-04-01 | $415.50 | Not available in this setting | RVU22B |
| 2022-01-01 | $415.50 | Not available in this setting | RVU22A |
| 2021-10-01 | $440.97 | Not available in this setting | RVU21D |
| 2021-07-01 | $440.97 | Not available in this setting | RVU21C |
| 2021-04-01 | $440.97 | Not available in this setting | RVU21B |
| 2021-01-01 | $440.97 | Not available in this setting | RVU21A |
| 2020-10-01 | $442.97 | Not available in this setting | RVU20D |
| 2020-07-01 | $442.97 | Not available in this setting | RVU20C |
| 2020-04-01 | $442.97 | Not available in this setting | RVU20B |
| 2020-01-01 | $442.97 | Not available in this setting | RVU20A |
| 2019-10-01 | $453.91 | Not available in this setting | RVU19D |
| 2019-07-01 | $453.91 | Not available in this setting | RVU19C |
| 2019-04-01 | $453.91 | Not available in this setting | RVU19B |
| 2019-01-01 | $453.91 | Not available in this setting | RVU19A |
| 2018-10-01 | $373.64 | Not available in this setting | RVU18D |
| 2018-07-01 | $373.64 | Not available in this setting | RVU18C |
| 2018-04-01 | $373.64 | Not available in this setting | RVU18B |
| 2018-01-01 | $373.64 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $380.56 | Not available in this setting | RVU17D |
| 2017-07-01 | $380.56 | Not available in this setting | RVU17C |
| 2017-04-01 | $380.56 | Not available in this setting | RVU17B |
| 2017-01-01 | $380.56 | Not available in this setting | RVU17A |
| 2016-10-01 | $381.11 | Not available in this setting | RVU16D |
| 2016-07-01 | $381.11 | Not available in this setting | RVU16C |
| 2016-04-01 | $381.11 | Not available in this setting | RVU16B |
| 2016-01-01 | $381.11 | Not available in this setting | RVU16A |
| 2015-10-01 | $389.17 | Not available in this setting | RVU15D |
| 2015-07-01 | $389.17 | Not available in this setting | RVU15C |
| 2015-04-01 | $387.23 | Not available in this setting | RVU15B |
| 2015-01-01 | $387.23 | Not available in this setting | RVU15A |
| 2014-10-01 | $374.03 | Not available in this setting | RVU14D |
| 2014-07-01 | $374.03 | Not available in this setting | RVU14C |
| 2014-04-01 | $374.03 | Not available in this setting | RVU14B |
| 2014-01-01 | $374.03 | Not available in this setting | RVU14A |
| 2013-10-01 | $365.40 | Not available in this setting | RVU13D |
| 2013-07-01 | $365.40 | Not available in this setting | RVU13C |
| 2013-04-01 | $365.40 | Not available in this setting | RVU13B |
| 2013-01-01 | $365.40 | Not available in this setting | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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