$255.10
This code describes a lumbar or sacral epidural injection that includes imaging guidance. Do not separately report 77003 for guidance already included in that service.
On this page
CMS RVU26D · Effective 2026-10-01
77003 Fluoroscopic guidance Medicare reimbursement rates in Ohio
Reports fluoroscopic needle guidance for a spinal or paraspinal injection when the primary procedure does not already include imaging guidance. Compare 77003 office and facility rates across CMS payment localities in Ohio.
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 77003 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$97.32
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
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.
Radiology
About 77003: Fluoroscopic guidance for spinal injection
Reports fluoroscopic needle guidance for a spinal or paraspinal injection when the primary procedure does not already include imaging guidance.
This service uses fluoroscopy to guide a needle or catheter during a spinal or paraspinal injection, helping the practitioner advance and position it at the intended site. It is commonly performed by pain medicine physicians, anesthesiologists, radiologists, and other clinicians performing image-guided spine procedures in office or facility settings. Examples include guidance for an epidural injection or an injection near spinal structures when the associated procedure code does not include imaging guidance.
Report 77003 only as an add-on to an eligible primary procedure; CMS places its payment within that procedure’s global period. The primary code must describe the injection, and its coding rules must permit separate reporting of guidance. Documentation should identify the spinal or paraspinal target, the fluoroscopic guidance performed, and support the service with saved images and a written report. CMS separately prices professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 77003
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- 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 RVU0.59 · 19%
- Practice expense (office) RVU2.49 · 80%
- Malpractice RVU0.05 · 2%
22.1K
Medicare services in 2024 · #1109 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.
77003 compared with similar codes
Office rates for Ohio, from the same CMS release.
$112.36
77002 is fluoroscopic needle guidance for targets outside the spine and paraspinal region; 77003 is specific to spinal or paraspinal injection guidance.
$116.78
77012 reports CT guidance for needle placement. Use 77003 when fluoroscopy guides the spinal or paraspinal injection instead.
Compare 77003 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.
1 of 1 payment localities
Ohio →
Office / nonfacility
$97.32
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 77003 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
8,931
- Code
- 77003
- Physician work
- 0.59
- Practice expense
- 2.49
- Malpractice
- 0.05
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 2.49 | × 0.913 | 2.2734 |
| Malpractice | 0.05 | × 1.008 | 0.0504 |
| Total RVUs | 2.9138 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$97.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1 |
| Practice expense | 2.49 | 0.913 |
| Malpractice | 0.05 | 1.008 |
(0.59 × 1 + 2.49 × 0.913 + 0.05 × 1.008) × $33.4009 = $97.32
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
77003 billing questions
Can 77003 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary procedure. CMS places payment within the primary procedure’s global period.
When should 77003 be distinguished from 62323?
Use 77003 for spinal or paraspinal fluoroscopic guidance when the primary procedure does not include guidance. Code 62323 describes a lumbar or sacral epidural injection that includes imaging guidance, so separate reporting of 77003 is not appropriate for that service.
Which modifiers identify the components?
Modifier 26 reports the professional interpretation, and modifier TC reports the technical component, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 77003?
Document the spinal or paraspinal target and the fluoroscopic guidance used to position the needle or catheter. Retain supporting images and a written report.
Can 77003 accompany an injection code that says without imaging guidance?
It may be reported when fluoroscopy was performed and the primary code permits separate reporting of guidance. For example, 62322 describes a lumbar or sacral epidural injection without imaging guidance.
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.
8,92877002,,Needle localization by xray,A,,0.53,3.06,,3.06,NA,0.04,3.63,3.63,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,92977002,26,Needle localization by xray,A,,0.53,0.25,,0.25,,0.03,0.81,0.81,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,93077002,TC,Needle localization by xray,A,,0.00,2.81,,2.81,NA,0.01,2.82,2.82,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
8,93177003,,Fluoroguide for spine inject,A,,0.59,2.49,,2.49,NA,0.05,3.13,3.13,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,93277003,26,Fluoroguide for spine inject,A,,0.59,0.22,,0.22,,0.04,0.85,0.85,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,93377003,TC,Fluoroguide for spine inject,A,,0.00,2.27,,2.27,NA,0.01,2.28,2.28,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
8,93477011,,Ct scan for localization,A,,1.18,5.37,,5.37,NA,0.08,6.63,6.63,1,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703