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CPT 77002: Fluoroscopic Guidance for Needle Placement

CPT code 77002 represents fluoroscopic guidance for initial needle placement or for the placement of a needle used in biopsy, aspiration, injection, or device localization for lesions anywhere in the body except the spine. Nationally, this code is important because it captures a common image-guidance service integral to many interventional procedures across radiology and procedural specialties, and it affects billing, coding compliance, and resource planning for facilities that perform image-guided procedures. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what CPT code 77002 covers clinically, which service settings commonly use it, and what to expect in payer coverage scope. The publication provides benchmarks and policy context relevant to billing and reimbursement for image-guided needle placement, summaries of payer coverage approaches, and clinical context that clarifies when this guidance code is applicable versus other image-guidance codes. Data not available in the input for associated taxonomies, ICD-10 diagnosis linkage, and related codes is noted as unavailable.

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Billing Code Overview

CPT code 77002 describes fluoroscopic guidance for placement of a needle used for biopsy, aspiration, injection, or localization of a device to detect lesions in any area of the body except the spine. The procedure also covers fluoroscopic guidance to identify the level and approach for initial needle placement prior to a diagnostic or therapeutic intervention.

Service type: Image-guided needle placement using fluoroscopy

Typical site of service: Interventional radiology suite, hospital outpatient department, ambulatory surgery center, or other procedural setting where fluoroscopic guidance is available

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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CPT 77002: Fluoroscopic Guidance for Needle Placement

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Billing Code Overview

Service type: Image-guided needle placement using fluoroscopy

Typical site of service: Interventional radiology suite, hospital outpatient department, ambulatory surgery center, or other procedural setting where fluoroscopic guidance is available

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient presents with a palpable soft-tissue mass in the right lateral thigh identified on clinical exam and ultrasound. The referring orthopedic surgeon requests tissue diagnosis to exclude malignancy. The interventional radiologist reviews prior imaging, obtains informed consent, and performs a fluoroscopically guided percutaneous needle biopsy using 77002 to localize the lesion and guide initial needle placement. The patient is positioned on the fluoroscopy table, sterile prep and local anesthesia are applied, and intermittent fluoroscopic images are used to identify the lesion and determine trajectory. After localization, the radiologist marks the skin entry site and documents the fluoroscopic guidance used to place the biopsy needle; the actual biopsy may be reported with a separate tissue sampling code. Post-procedure, the patient is observed for immediate complications and given discharge instructions. Typical sites of service include the hospital radiology department, ambulatory surgical center, or outpatient imaging center.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician's interpretation or professional portion of the procedure.
`50`	Bilateral procedure	Use when identical fluoroscopic localization is performed on bilateral lesions during the same encounter.
`52`	Reduced services	Use when the procedure was partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is terminated due to patient instability or other circumstances before completion.
`59`	Distinct procedural service	Use when another distinct procedure is performed on the same day at a separate site or session.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct parts of the procedure.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`79`	Unrelated procedure or service by same physician during postoperative period	Use when the fluoroscopic localization is unrelated to the prior procedure for which the patient is in the global period.
`25`	Significant, separately identifiable E/M service on the same day	Use when a separate evaluation and management visit is provided on the same day as the procedure.
`52`	Reduced services	Use when technical limitations reduce the scope of the fluoroscopic localization (note: listed above; include only once in billing).
`59`	Distinct procedural service	Use to indicate distinct and separate service when CINJ/needle placement is separate from another billed service (note: listed above; include only once in billing).

Taxonomy Code	Specialty	Notes
207X00000X	Interventional Radiology	Primary specialty performing image-guided needle localization and biopsies.
2080S0123X	Diagnostic Radiology	Radiologists frequently perform fluoroscopic guidance and localization.
2084P0800X	Orthopedic Surgery	Orthopedic surgeons may request localization guidance for musculoskeletal lesions.
363L00000X	Pain Medicine	Pain specialists perform fluoroscopically guided needle placements for diagnostic/therapeutic aspirations or injections.
208600000X	General Surgery	General surgeons may perform or coordinate image-guided localization for lesions in soft tissues or superficial organs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77012`	Fluoroscopic guidance for needle placement (radiological supervision and interpretation)	Often used for subsequent fluoroscopic guidance and continuous imaging during the actual needle placement and sampling; may be reported when full imaging guidance is provided.
`32905`	Thoracentesis, needle drainage, aspiration of pleural space	May follow fluoroscopic localization when aspiration of pleural collections requires image guidance.
`19081`	Percutaneous needle core biopsy of breast with imaging guidance	For breast lesions, `77002` may be used to localize and identify approach prior to performing a core biopsy coded with `19081`.
`38500`	Biopsy or excision of lymph node; superficial	Following fluoroscopic localization, surgical biopsy codes like this may be used when tissue sampling is performed surgically.
`76942`	Ultrasonic guidance for needle placement	Alternative or adjunct to fluoroscopic guidance; used when ultrasound guidance is employed instead of or in addition to fluoroscopy.

CPT 77001: Radiologic Supervision and Interpretation for CVAD Catheter Position

CPT-77003-FLUOROSCOPIC-SPINAL-GUIDANCE-NEEDLE-CATHETER-LOCALIZATION

CPT 77003: Fluoroscopic Spinal Needle/Catheter Localization

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician's interpretation or professional portion of the procedure.
`50`	Bilateral procedure	Use when identical fluoroscopic localization is performed on bilateral lesions during the same encounter.
`52`	Reduced services	Use when the procedure was partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is terminated due to patient instability or other circumstances before completion.
`59`	Distinct procedural service	Use when another distinct procedure is performed on the same day at a separate site or session.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct parts of the procedure.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`79`	Unrelated procedure or service by same physician during postoperative period	Use when the fluoroscopic localization is unrelated to the prior procedure for which the patient is in the global period.
`25`	Significant, separately identifiable E/M service on the same day	Use when a separate evaluation and management visit is provided on the same day as the procedure.
`52`	Reduced services	Use when technical limitations reduce the scope of the fluoroscopic localization (note: listed above; include only once in billing).
`59`	Distinct procedural service	Use to indicate distinct and separate service when CINJ/needle placement is separate from another billed service (note: listed above; include only once in billing).

Taxonomy Code	Specialty	Notes
207X00000X	Interventional Radiology	Primary specialty performing image-guided needle localization and biopsies.
2080S0123X	Diagnostic Radiology	Radiologists frequently perform fluoroscopic guidance and localization.
2084P0800X	Orthopedic Surgery	Orthopedic surgeons may request localization guidance for musculoskeletal lesions.
363L00000X	Pain Medicine	Pain specialists perform fluoroscopically guided needle placements for diagnostic/therapeutic aspirations or injections.
208600000X	General Surgery	General surgeons may perform or coordinate image-guided localization for lesions in soft tissues or superficial organs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77012`	Fluoroscopic guidance for needle placement (radiological supervision and interpretation)	Often used for subsequent fluoroscopic guidance and continuous imaging during the actual needle placement and sampling; may be reported when full imaging guidance is provided.
`32905`	Thoracentesis, needle drainage, aspiration of pleural space	May follow fluoroscopic localization when aspiration of pleural collections requires image guidance.
`19081`	Percutaneous needle core biopsy of breast with imaging guidance	For breast lesions, `77002` may be used to localize and identify approach prior to performing a core biopsy coded with `19081`.
`38500`	Biopsy or excision of lymph node; superficial	Following fluoroscopic localization, surgical biopsy codes like this may be used when tissue sampling is performed surgically.
`76942`	Ultrasonic guidance for needle placement	Alternative or adjunct to fluoroscopic guidance; used when ultrasound guidance is employed instead of or in addition to fluoroscopy.

CPT 77001: Radiologic Supervision and Interpretation for CVAD Catheter Position

CPT-77003-FLUOROSCOPIC-SPINAL-GUIDANCE-NEEDLE-CATHETER-LOCALIZATION

CPT 77003: Fluoroscopic Spinal Needle/Catheter Localization

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 77002: Fluoroscopic Guidance for Needle Placement

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Billing Code Overview

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CPT 77002: Fluoroscopic Guidance for Needle Placement

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References