$111.31–$158.03
77021 reports MRI guidance for needle placement; 77012 is used when CT guides a needle biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
77021 MRI needle guidance Medicare reimbursement rates
MRI guidance supports real-time needle positioning during a percutaneous procedure when MRI is the selected imaging method and guidance is separately reportable. Compare 77021 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 77021?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$372.63–$596.93
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $224.30 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 77021 pays more and less
109 payment localities
$372.63 to $596.93
Radiology
About 77021: MRI-guided needle placement
MRI guidance supports real-time needle positioning during a percutaneous procedure when MRI is the selected imaging method and guidance is separately reportable.
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.
CMS billing rules for 77021
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU1.46 · 11%
- Practice expense (office) RVU11.24 · 88%
- Malpractice RVU0.08 · 1%
2.6K
Medicare services in 2024 · #2271 by national volume
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.
77021 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
77022
No office rateMri gdn parnchyma tiss abltj
77022 is specifically for MRI guidance during parenchymal tissue ablation. 77021 addresses needle placement for procedures such as biopsy, aspiration, or injection.
$106.19–$167.75
77002 describes X-ray needle localization guidance. Choose 77021 when MRI, not X-ray, is used to guide needle placement.
See how rates vary across the country
77021 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 77021 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $378.78 | Facility Unavailable |
| Alaska* | Office $474.45 | Facility Unavailable |
| Arizona | Office $414.84 | Facility Unavailable |
| Arkansas | Office $372.63 | Facility Unavailable |
| Atlanta | Office $433.55 | Facility Unavailable |
| Austin | Office $448.43 | Facility Unavailable |
| Bakersfield | Office $462.79 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $455.68 | Facility Unavailable |
| Beaumont | Office $392.89 | Facility Unavailable |
| Brazoria | Office $423.29 | Facility Unavailable |
| Chicago | Office $432.54 | Facility Unavailable |
| Chico | Office $462.49 | Facility Unavailable |
| Colorado | Office $450.89 | Facility Unavailable |
| Connecticut | Office $457.31 | Facility Unavailable |
| Dallas | Office $425.42 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $496.62 | Facility Unavailable |
| Delaware | Office $422.33 | Facility Unavailable |
| Detroit | Office $415.56 | Facility Unavailable |
| East St. Louis | Office $399.54 | Facility Unavailable |
| El Centro | Office $462.51 | Facility Unavailable |
| Fort Lauderdale | Office $433.90 | Facility Unavailable |
| Fort Worth | Office $421.70 | Facility Unavailable |
| Fresno | Office $462.49 | Facility Unavailable |
| Galveston | Office $424.17 | Facility Unavailable |
| Hanford-Corcoran | Office $462.49 | Facility Unavailable |
| Hawaii, Guam | Office $477.17 | Facility Unavailable |
| Houston | Office $425.63 | Facility Unavailable |
| Idaho | Office $395.42 | Facility Unavailable |
| Indiana | Office $398.08 | Facility Unavailable |
| Iowa | Office $393.34 | Facility Unavailable |
| Kansas | Office $389.50 | Facility Unavailable |
| Kentucky | Office $384.96 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $496.67 | Facility Unavailable |
| Madera | Office $462.49 | Facility Unavailable |
| Manhattan | Office $492.37 | Facility Unavailable |
| Merced | Office $462.49 | Facility Unavailable |
| Metropolitan Boston | Office $501.40 | Facility Unavailable |
| Metropolitan Kansas City | Office $403.90 | Facility Unavailable |
| Metropolitan Philadelphia | Office $443.65 | Facility Unavailable |
| Metropolitan St. Louis | Office $408.85 | Facility Unavailable |
| Miami | Office $446.34 | Facility Unavailable |
| Minnesota | Office $435.87 | Facility Unavailable |
| Mississippi | Office $373.98 | Facility Unavailable |
| Modesto | Office $462.49 | Facility Unavailable |
| Montana** | Office $426.86 | Facility Unavailable |
| Napa | Office $548.01 | Facility Unavailable |
| Nebraska | Office $396.29 | Facility Unavailable |
| Nevada** | Office $426.79 | Facility Unavailable |
| New Hampshire | Office $441.92 | Facility Unavailable |
| New Mexico | Office $396.24 | Facility Unavailable |
| New Orleans | Office $405.08 | Facility Unavailable |
| North Carolina | Office $400.75 | Facility Unavailable |
| North Dakota** | Office $425.28 | Facility Unavailable |
| Northern Nj | Office $490.19 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $503.23 | Facility Unavailable |
| Ohio | Office $394.22 | Facility Unavailable |
| Oklahoma | Office $386.10 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $495.55 | Facility Unavailable |
| Portland | Office $468.63 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $465.28 | Facility Unavailable |
| Puerto Rico | Office $430.95 | Facility Unavailable |
| Queens | Office $499.49 | Facility Unavailable |
| Redding | Office $462.49 | Facility Unavailable |
| Rest Of California | Office $462.49 | Facility Unavailable |
| Rest Of Florida | Office $411.69 | Facility Unavailable |
| Rest Of Georgia | Office $386.83 | Facility Unavailable |
| Rest Of Illinois | Office $395.71 | Facility Unavailable |
| Rest Of Louisiana | Office $383.58 | Facility Unavailable |
| Rest Of Maine | Office $395.82 | Facility Unavailable |
| Rest Of Maryland | Office $431.64 | Facility Unavailable |
| Rest Of Massachusetts | Office $447.00 | Facility Unavailable |
| Rest Of Michigan | Office $394.55 | Facility Unavailable |
| Rest Of Missouri | Office $374.99 | Facility Unavailable |
| Rest Of New Jersey | Office $463.61 | Facility Unavailable |
| Rest Of New York | Office $407.30 | Facility Unavailable |
| Rest Of Oregon | Office $424.57 | Facility Unavailable |
| Rest Of Pennsylvania | Office $395.93 | Facility Unavailable |
| Rest Of Texas | Office $407.46 | Facility Unavailable |
| Rest Of Washington | Office $446.76 | Facility Unavailable |
| Rhode Island | Office $439.89 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $463.39 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $488.57 | Facility Unavailable |
| Salinas | Office $486.83 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $500.69 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $583.98 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $583.88 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $596.93 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $596.55 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $478.64 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $507.36 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $489.31 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $512.68 | Facility Unavailable |
| Seattle (King Cnty) | Office $514.03 | Facility Unavailable |
| South Carolina | Office $397.93 | Facility Unavailable |
| South Dakota** | Office $425.09 | Facility Unavailable |
| Southern Maine | Office $422.50 | Facility Unavailable |
| Stockton | Office $462.49 | Facility Unavailable |
| Suburban Chicago | Office $439.40 | Facility Unavailable |
| Tennessee | Office $391.46 | Facility Unavailable |
| Utah | Office $404.07 | Facility Unavailable |
| Vallejo | Office $547.88 | Facility Unavailable |
| Vermont | Office $421.79 | Facility Unavailable |
| Virgin Islands | Office $430.95 | Facility Unavailable |
| Virginia | Office $419.70 | Facility Unavailable |
| Visalia | Office $462.49 | Facility Unavailable |
| West Virginia | Office $378.83 | Facility Unavailable |
| Wisconsin | Office $409.25 | Facility Unavailable |
| Wyoming** | Office $426.17 | Facility Unavailable |
| Yuba City | Office $462.49 | Facility Unavailable |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,94077013,,Ct guide for tissue ablation,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,94177013,26,Ct guide for tissue ablation,A,,3.89,1.14,,1.14,,0.27,5.30,5.30,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,94277013,TC,Ct guide for tissue ablation,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,94377021,,Mri guidance ndl plmt rs&i,A,,1.46,11.24,,11.24,NA,0.08,12.78,12.78,1,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,94477021,26,Mri guidance ndl plmt rs&i,A,,1.46,0.58,,0.58,,0.06,2.10,2.10,1,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,94577021,TC,Mri guidance ndl plmt rs&i,A,,0.00,10.66,,10.66,NA,0.02,10.68,10.68,1,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
8,94677022,,Mri gdn parnchyma tiss abltj,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00