Billing code 77002: Fluoroscopy guidanceMedicare rate & RVUs
Reports fluoroscopic x-ray guidance used to position a needle for procedures such as joint aspiration, injection, or tissue sampling.
Medicare pays $121.25 for 77002 nationally in the office. Local office rates run $106.19–$167.75.
Medicare rate · 77002
Fluoroscopy guidance
Swap in your local Medicare rate.
- Work RVUs
- 0.53
- Total RVUs
- 3.63
- Global days
- ZZZ
National rate · 2026
$121.25
Office setting, before claim adjustments.
See every locality for 77002 → · Billed by an NP, PA or therapist? →
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 10 sections
What 77002 covers
The service uses live x-ray imaging to guide a needle toward a target and confirm its position during a procedure. Radiologists, interventional radiologists, orthopedists, and pain physicians may use it for procedures such as joint aspiration or injection, or needle sampling of a lesion. The fluoroscopic guidance and its interpretation are distinct from the needle procedure itself.
Report 77002 only with a primary procedure; it is an add-on code and is paid within that procedure’s global period. The record should identify the target, document use of fluoroscopy to guide needle placement, and support the interpretation. Modifier 26 represents the professional interpretation, while modifier TC represents the equipment and staff. Reporting 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.
Where 77002 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$106.19 to $167.75
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $107.89 | Unavailable |
| Alaska* | $136.14 | Unavailable |
| Arizona | $117.88 | Unavailable |
| Arkansas | $106.19 | Unavailable |
| Atlanta | $123.20 | Unavailable |
| Austin | $127.06 | Unavailable |
| Bakersfield | $130.87 | Unavailable |
| Baltimore/Surr. Cntys | $129.31 | Unavailable |
| Beaumont | $111.95 | Unavailable |
| Brazoria | $120.17 | Unavailable |
| Chicago | $123.61 | Unavailable |
| Chico | $130.74 | Unavailable |
| Colorado | $127.71 | Unavailable |
| Connecticut | $129.75 | Unavailable |
| Dallas | $120.81 | Unavailable |
| Dc + Md/Va Suburbs | $140.54 | Unavailable |
| Delaware | $119.97 | Unavailable |
| Detroit | $118.58 | Unavailable |
| East St. Louis | $114.42 | Unavailable |
| El Centro | $130.74 | Unavailable |
| Fort Lauderdale | $123.65 | Unavailable |
| Fort Worth | $119.80 | Unavailable |
| Fresno | $130.74 | Unavailable |
| Galveston | $120.44 | Unavailable |
| Hanford-Corcoran | $130.74 | Unavailable |
| Hawaii, Guam | $134.69 | Unavailable |
| Houston | $121.17 | Unavailable |
| Idaho | $112.36 | Unavailable |
| Indiana | $113.10 | Unavailable |
| Iowa | $111.75 | Unavailable |
| Kansas | $110.77 | Unavailable |
| Kentucky | $109.79 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $140.23 | Unavailable |
| Madera | $130.74 | Unavailable |
| Manhattan | $139.72 | Unavailable |
| Merced | $130.74 | Unavailable |
| Metropolitan Boston | $141.65 | Unavailable |
| Metropolitan Kansas City | $114.98 | Unavailable |
| Metropolitan Philadelphia | $126.01 | Unavailable |
| Metropolitan St. Louis | $116.34 | Unavailable |
| Miami | $127.48 | Unavailable |
| Minnesota | $123.27 | Unavailable |
| Mississippi | $106.69 | Unavailable |
| Modesto | $130.74 | Unavailable |
| Montana** | $121.24 | Unavailable |
| Napa | $154.20 | Unavailable |
| Nebraska | $112.54 | Unavailable |
| Nevada** | $121.12 | Unavailable |
| New Hampshire | $125.27 | Unavailable |
| New Mexico | $113.03 | Unavailable |
| New Orleans | $115.40 | Unavailable |
| North Carolina | $113.92 | Unavailable |
| North Dakota** | $120.45 | Unavailable |
| Northern Nj | $138.80 | Unavailable |
| Nyc Suburbs/Long Island | $142.84 | Unavailable |
| Ohio | $112.36 | Unavailable |
| Oklahoma | $110.01 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $139.84 | Unavailable |
| Portland | $132.53 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $132.03 | Unavailable |
| Puerto Rico | $122.35 | Unavailable |
| Queens | $141.57 | Unavailable |
| Redding | $130.74 | Unavailable |
| Rest Of California | $130.74 | Unavailable |
| Rest Of Florida | $117.42 | Unavailable |
| Rest Of Georgia | $110.46 | Unavailable |
| Rest Of Illinois | $113.11 | Unavailable |
| Rest Of Louisiana | $109.44 | Unavailable |
| Rest Of Maine | $112.56 | Unavailable |
| Rest Of Maryland | $122.54 | Unavailable |
| Rest Of Massachusetts | $126.67 | Unavailable |
| Rest Of Michigan | $112.53 | Unavailable |
| Rest Of Missouri | $107.11 | Unavailable |
| Rest Of New Jersey | $131.49 | Unavailable |
| Rest Of New York | $115.74 | Unavailable |
| Rest Of Oregon | $120.44 | Unavailable |
| Rest Of Pennsylvania | $112.79 | Unavailable |
| Rest Of Texas | $115.90 | Unavailable |
| Rest Of Washington | $126.57 | Unavailable |
| Rhode Island | $124.81 | Unavailable |
| Riverside-San Bernardino-Ontario | $131.18 | Unavailable |
| Sacramento-Roseville-Folsom | $137.92 | Unavailable |
| Salinas | $137.42 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $141.20 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $164.11 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $164.06 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $167.75 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $167.56 | Unavailable |
| San Luis Obispo-Paso Robles | $135.13 | Unavailable |
| Santa Cruz-Watsonville | $142.97 | Unavailable |
| Santa Maria-Santa Barbara | $138.09 | Unavailable |
| Santa Rosa-Petaluma | $144.46 | Unavailable |
| Seattle (King Cnty) | $145.09 | Unavailable |
| South Carolina | $113.28 | Unavailable |
| South Dakota** | $120.36 | Unavailable |
| Southern Maine | $119.83 | Unavailable |
| Stockton | $130.74 | Unavailable |
| Suburban Chicago | $125.16 | Unavailable |
| Tennessee | $111.33 | Unavailable |
| Utah | $114.98 | Unavailable |
| Vallejo | $154.14 | Unavailable |
| Vermont | $119.56 | Unavailable |
| Virgin Islands | $122.35 | Unavailable |
| Virginia | $119.11 | Unavailable |
| Visalia | $130.74 | Unavailable |
| West Virginia | $108.43 | Unavailable |
| Wisconsin | $116.03 | Unavailable |
| Wyoming** | $120.90 | Unavailable |
| Yuba City | $130.74 | Unavailable |
77002 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.
$106.19
$149.25
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 | $136.14 | 1 |
| AL | $107.89 | 1 |
| AR | $106.19 | 1 |
| AZ | $117.88 | 1 |
| CA | $130.74–$167.75 | 29 |
| CO | $127.71 | 1 |
| CT | $129.75 | 1 |
| DC | $140.54 | 1 |
| DE | $119.97 | 1 |
| FL | $117.42–$127.48 | 3 |
| GA | $110.46–$123.20 | 2 |
| GU | $134.69 | 1 |
| HI | $134.69 | 1 |
| IA | $111.75 | 1 |
| ID | $112.36 | 1 |
| IL | $113.11–$125.16 | 4 |
| IN | $113.10 | 1 |
| KS | $110.77 | 1 |
| KY | $109.79 | 1 |
| LA | $109.44–$115.40 | 2 |
| MA | $126.67–$141.65 | 2 |
| MD | $122.54–$140.54 | 3 |
| ME | $112.56–$119.83 | 2 |
| MI | $112.53–$118.58 | 2 |
| MN | $123.27 | 1 |
| MO | $107.11–$116.34 | 3 |
| MS | $106.69 | 1 |
| MT | $121.24 | 1 |
| NC | $113.92 | 1 |
| ND | $120.45 | 1 |
| NE | $112.54 | 1 |
| NH | $125.27 | 1 |
| NJ | $131.49–$138.80 | 2 |
| NM | $113.03 | 1 |
| NV | $121.12 | 1 |
| NY | $115.74–$142.84 | 5 |
| OH | $112.36 | 1 |
| OK | $110.01 | 1 |
| OR | $120.44–$132.53 | 2 |
| PA | $112.79–$126.01 | 2 |
| PR | $122.35 | 1 |
| RI | $124.81 | 1 |
| SC | $113.28 | 1 |
| SD | $120.36 | 1 |
| TN | $111.33 | 1 |
| TX | $111.95–$127.06 | 8 |
| UT | $114.98 | 1 |
| VA | $119.11–$140.54 | 2 |
| VI | $122.35 | 1 |
| VT | $119.56 | 1 |
| WA | $126.57–$145.09 | 2 |
| WI | $116.03 | 1 |
| WV | $108.43 | 1 |
| WY | $120.90 | 1 |
How the 77002 rate is calculated
Each of 77002’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 · 77002
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.53Practice expense 3.06Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 77002
The CMS indicators that decide how 77002 is paid alongside other services.
CMS payment indicators · 77002
Fluoroscopy guidance
| 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
77002 without 26 · national office
$121.25
Fluoroscopy guidance
77002-26 · Professional component
$27.05
Pays only the interpretation and report.
77002 compared with similar codes
Compare codes
77002 vs 77003 vs 77012 vs 77021: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77003Fluoroscopic guidance
- Use 77003 for fluoroscopic needle guidance in spinal or paraspinal procedures; 77002 describes guidance for other needle-placement targets.
- 77012CT guidance
- Both involve image-guided needle placement, but 77012 uses CT guidance rather than fluoroscopy.
- 77021MRI needle guidance
- 77021 describes MRI guidance for needle placement; 77002 is for fluoroscopic x-ray guidance.
77002 billing questions
Can 77002 be reported by itself?
No. CMS identifies 77002 as an add-on code that must be billed with a primary procedure.
When is 77002 used with a joint injection?
It may be reported when fluoroscopy guides needle placement for a joint procedure, such as a large-joint aspiration or injection, and the guidance is separately reportable.
How does 77002 differ from 77003?
Both describe fluoroscopic needle guidance, but 77003 is for guidance in spinal or paraspinal procedures. Use 77002 for other needle-placement targets.
What do modifiers 26 and TC represent?
Modifier 26 identifies the professional interpretation; modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 77002?
Document the needle target, the use of fluoroscopy to guide placement, and the interpretation. The claim must also include the primary procedure.
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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