Flying into Rome and have a car service that wants to be paid in cash.
Planning to arrive w/o euros and using ATM at arrival.

1. Are there multiple options in FCO gate area/baggage?
2. Same transaction fees/exhange rate as ATM's in the city?

Yes, there are ATMs there, and there are no transaction fees at any ATMs in Italy. The only fees you might incur come from YOUR bank.

I was just in Rome (FCO) last month, but I was leaving, so didn't need an ATM. However, having said that, I would expect that you could find an ATM. It is a full service, busy, international airport with a myriad of services. I have gotten euros before at other airports, and all the fees were the same as in the city.

Besides, in the event that you couldn't find an ATM, they are ubiquitous throughout Rome, and your driver would most likely be willing to stop, since apparently his fee depends on it! Good luck; Rome is a fascinating city.

By the way, an ATM is called a bancomat. (bahnco-maht.)

There's an ATM as you exit baggage claim right by the door to outside. It usually has a line. I usually turn right after exiting baggage claim and there is another one down the hallway (right after the floor slopes up on the right) in the direction of the train.