CPT 10010Surgery

Fna bx w/ct gdn ea addl

CPT code 10010 covers each additional site when a doctor uses CT scan guidance to perform a fine needle aspiration biopsy, which is a procedure to remove tissue or fluid samples using a thin needle for testing.

Showing rates for

National Average

Base Medicare rate

$227.72

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.65

PE RVU (NF)

5.18

MP RVU

0.21

Total RVU

7.04

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always bill 10010 as an add-on code with the primary CT-guided FNA code (such as 10009); never bill 10010 alone or as the first unit
Impact: Prevents automatic denial; 10010 cannot be paid without a primary procedure code, resulting in $0 reimbursement if billed incorrectly
Verify facility versus non-facility place of service coding, as the reimbursement difference is $158.18 per additional site (70% higher for non-facility)
Impact: Incorrect POS coding costs $158.18 per additional site; billing non-facility when performed in hospital results in overpayment and potential audit liability
Document each additional anatomic site with specific location, imaging coordinates, and separate pathology specimen labeling to support multiple unit billing
Impact: Prevents bundling denials and supports payment for each additional site; missing documentation commonly results in payment for only one unit regardless of sites biopsied
Report the exact number of additional lesions biopsied as units of 10010; if three total lesions are biopsied, bill the primary code once and 10010 x 2 units
Impact: Each correctly billed unit adds $227.72 (non-facility) or $69.54 (facility) to reimbursement; undercoding by one unit loses this revenue per case
Ensure CT imaging documentation shows separate targeting and needle guidance for each additional site, not just multiple passes at the same location
Impact: Multiple passes at one site do not qualify for additional 10010 billing; improper billing risks recoupment of $227.72+ per incorrectly billed unit during audits
Coordinate coding with pathology to ensure separate specimen containers and pathology reports for each site, with distinct anatomic labels matching procedure documentation

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Frequently asked questions

What is CPT code 10010 used for?

CPT code 10010 is an add-on code used to bill for each additional lesion or anatomic site when performing fine needle aspiration (FNA) biopsy under CT guidance beyond the first site. It must be billed with a primary CT-guided FNA code and represents the additional work of targeting, imaging, and sampling each subsequent lesion during the same procedure session.

How much does Medicare pay for CPT 10010 in 2025?

Medicare pays $227.72 for CPT 10010 in non-facility settings and $69.54 in facility settings for 2025 based on the national average rates. The non-facility rate applies when performed in physician offices or independent imaging centers, while the facility rate applies in hospital outpatient departments or ambulatory surgical centers.

Can CPT 10010 be billed alone without another code?

No, CPT 10010 cannot be billed alone. It is an add-on code that must be reported with a primary CT-guided fine needle aspiration code such as 10009. Billing 10010 without the appropriate primary procedure code will result in automatic denial as it only covers additional sites beyond the first.

How many times can you bill CPT 10010 for one procedure session?

You can bill CPT 10010 for each additional anatomic site biopsied beyond the first during one session, with no specific Medicare limit on units. However, each unit must represent a truly distinct lesion or anatomic site with separate imaging guidance, separate needle targeting, and separate pathology specimens. Billing for multiple units requires detailed documentation of medical necessity and distinct anatomic locations.

What is the difference between CPT 10009 and 10010?

CPT 10009 is the primary code for the first fine needle aspiration biopsy performed with CT guidance, while CPT 10010 is the add-on code for each additional site biopsied during the same session. For example, if three lesions are biopsied under CT guidance, you would bill 10009 once for the first lesion and 10010 twice for the second and third lesions.

What documentation is required to bill multiple units of CPT 10010?

Documentation must include specific anatomic descriptions of each separate biopsy site with imaging coordinates, CT images showing distinct locations, separate pathology specimen labels for each site, procedure notes describing individual targeting and sampling of each lesion, and medical necessity justification for sampling multiple sites. Each additional site must be clearly distinguishable as a separate anatomic location, not just multiple passes at the same site.

What modifiers are commonly used with CPT 10010?

Common modifiers include 59 or XS for distinct procedural services when billing multiple separate sites that might appear bundled, RT/LT for laterality when biopsying bilateral structures, 76 for repeat procedures by the same physician, and 52 for reduced services if the additional biopsy is discontinued. Modifier selection depends on the specific clinical scenario and payer requirements, with XS increasingly preferred over 59 for NCCI edits.