CPT code 77021: MRI needle guidance, needle placement2026 Medicare rate & RVUs in New York
MRI guidance supports real-time needle positioning during a percutaneous procedure when MRI is the selected imaging method and guidance is separately reportable.
Medicare pays $407.30–$503.23 for 77021 in the office in New York, from Rest of New York to NYC suburbs and Long Island, NY. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 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.
Where 77021 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
5 payment localities
$407.30 to $503.23
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | $492.37 | Unavailable |
| NYC suburbs and Long Island, NY | $503.23 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $465.28 | Unavailable |
| Queens, NY | $499.49 | Unavailable |
| Rest of New York | $407.30 | Unavailable |
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.
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.
77021 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
Fee sheets
Put 77021 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet