Radiologic supervision and interpretation of CT used to guide a needle into position, most often for a biopsy, aspiration, or localization.
- Medicare
- $122.92
- Work RVU
- 1.46
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Primary procedure performed under CT guidance, such as a bone biopsy
- Target lesion location and reason CT was chosen over fluoroscopy or ultrasound
- Description of needle path and confirmation of final tip position
- Number of CT passes or image sets acquired during placement
- Physician interpretation of guidance images
- Complications or absence of complications
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
Use 77012 for the CT work when a physician uses cross-sectional images to place a needle. In orthopedics the common pairing is a deep bone biopsy (20225) for a lytic lesion, a suspected vertebral osteomyelitis, or a pelvic lesion that fluoroscopy cannot reach safely. The biopsy code and 77012 are billed together, each for its own work.
The trap is the same one that catches 77003. Many procedure codes now include CT guidance in the descriptor. Bone tumor ablation (20982, 20983), vertebral augmentation (22510-22515), and the spine injection families (64479-64484, 64490-64495, 62321, 62323, 62325, 62327) all bundle imaging. Adding 77012 to any of those draws an NCCI edit.
In a hospital or ASC the physician reports modifier 26. If the patient also gets a diagnostic CT of the same area that day, that scan needs a separate order and a separate report, and payers will ask for both.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.46) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.68) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.46 |
| Practice expense RVU | 2.12 |
| Malpractice RVU | 0.1 |
| Total RVU | 3.68 |
| Medicare national rate | $122.92 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $122.92 |
Common denial reasons
The recurring reasons claims for CPT 77012 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with a procedure whose descriptor already includes CT guidance, such as 20982 or 22511
- No primary procedure on the claim
- Diagnostic CT and guidance CT billed for the same imaging without separate documentation
- Missing modifier 26 for facility-based service
- Procedure note does not mention CT guidance
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can 77012 be billed with a bone biopsy 20225?
02Is 77012 bundled with kyphoplasty?
03Does 77012 need modifier 26?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the target, needle path, and confirmation of tip position in the procedure note, giving the coder clear support for CT guidance billed alongside the biopsy.
See how Mira captures CPT 77012 documentation