CPT code 77021: MRI needle guidance2026 Medicare rate & RVUs in Florida

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, 20263 payment localities2.6K Medicare services in 2024

Medicare pays $411.69–$446.34 for 77021 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.

$411.69–$446.34Office (non-facility)
—Hospital or facility

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 9 sections
  1. Rate in Florida
  2. What 77021 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

Where 77021 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$411.69 to $446.34

$411.69$429.01$446.34
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
77021 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale$433.90Unavailable
Miami$446.34Unavailable
Rest Of Florida$411.69Unavailable

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

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

77021-26 · Professional component

$70.14

Pays only the interpretation and report.

When to use modifier 26

77021 compared with similar codes

Compare codes · National

4 codes, side by side

  • 77021

    MRI needle guidance1.46 wRVU

    $426.86

  • 77012

    CT guidance1.46 wRVU

    $122.92−$303.94

  • 77022

    Not on the physician fee schedule0 wRVU

    Not priced

  • 77002

    Fluoroscopy guidance0.53 wRVU

    $121.25−$305.61

How to choose

77012CT guidance
77021 reports MRI guidance for needle placement; 77012 is used when CT guides a needle biopsy.
77022Mri 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.
77002Fluoroscopy guidance
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
RVUs for 77021PPRRVU2026_Oct_nonQPP.csv, line 8,943 (RVU26D)

Open CMS sourceHow we calculate rates

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