CPT code 10005: Ultrasound-guided FNA, first lesion2026 Medicare rate & RVUs in South Carolina

Ultrasound-guided fine-needle aspiration biopsy of the first lesion, commonly used to sample a thyroid nodule, lymph node, or other accessible target.

CMS RVU26DEffective Oct 1, 2026One payment locality132.9K Medicare services in 2024

In South Carolina, Medicare pays $125.40 for 10005 in the office and $60.90 when it’s performed in a hospital or facility.

$125.40Office (non-facility)
$60.90Hospital or facility
−5.2%vs the national office rate ($132.27)

Check a contract rate as a % of Medicare · 10005 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 10005 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 10005 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 10005 covers

A clinician uses ultrasound to guide a fine needle into a lesion and aspirate cells or fluid for diagnostic evaluation. Common targets include thyroid nodules and enlarged lymph nodes; radiologists, endocrinologists, surgeons, and other clinicians may perform the procedure in an office or hospital setting. The code represents the first lesion sampled with ultrasound guidance, not a core-needle tissue biopsy.

Report 10005 for the first lesion and 10006 for each additional lesion sampled using ultrasound guidance during the session. The record should support the target lesion, ultrasound guidance, and performance of the aspiration. Ultrasound guidance is included in this service. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces payment for the others by 50%.

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.

How South Carolina compares for 10005

Across 109 of 109 payment localities, the office rate for 10005 runs from $118.35 in Arkansas to $169.84 in San Benito County, CA. South Carolina pays $125.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

10005 in South Carolina vs other payment areas
  1. South Carolina · this page$125.40
  2. Los Angeles, CA · California$146.79+$21.39
  3. Washington, DC area · District of Columbia$149.56+$24.16
  4. Miami, FL · Florida$144.20+$18.80
  5. Chicago, IL · Illinois$140.35+$14.95
  6. Manhattan, NY · New York$151.45+$26.05
  7. Alaska · Alaska$158.58+$33.18

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

10005 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$119.91$58.83
ArkansasArkansas$118.35$58.39
ArizonaArizona$129.00$61.35
Bakersfield, CACalifornia$138.55$62.04
Chico, CACalifornia$138.04$61.53
El Centro, CACalifornia$138.07$61.56
Fresno, CACalifornia$138.04$61.53
Hanford, CACalifornia$138.04$61.53

10005 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$118.35

$158.58

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
10005 office rate range by state
State / territoryOffice rate rangeLocalities
AK$158.581
AL$119.911
AR$118.351
AZ$129.001
CA$138.04–$169.8429
CO$136.661
CT$140.501
DC$149.561
DE$130.981
FL$131.64–$144.203
GA$124.81–$134.822
GU$140.721
HI$140.721
IA$122.121
ID$122.941
IL$128.58–$140.354
IN$123.571
KS$121.851
KY$123.001
LA$122.93–$128.372
MA$136.07–$148.942
MD$133.23–$149.563
ME$123.79–$129.462
MI$126.11–$133.392
MN$130.571
MO$121.20–$128.483
MS$119.781
MT$132.261
NC$124.911
ND$128.891
NE$122.641
NH$134.801
NJ$142.00–$148.312
NM$126.841
NV$131.401
NY$126.62–$155.135
OH$125.431
OK$122.531
OR$130.26–$140.362
PA$125.46–$137.462
PR$133.051
RI$135.171
SC$125.401
SD$128.501
TN$122.441
TX$124.74–$136.318
UT$126.941
VA$129.25–$149.562
VI$133.051
VT$128.671
WA$135.72–$151.572
WI$125.011
WV$124.341
WY$130.791

See 10005 in every payment locality

How the 10005 rate is calculated

Each of 10005’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 10005

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.42

1.42 RVUs× 1.000 GPCI

Practice expense2.37

2.37 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

3.9600

Conversion factor

$33.4009

Medicare rate

$132.27

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,061

Code
10005
Physician work
1.42
Practice expense
2.37
Malpractice
0.17

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 10005 in South Carolina
ComponentRVULocality factorAdjusted
Physician work1.42× 1.0001.4200
Practice expense2.37× 0.9242.1899
Malpractice0.17× 0.8500.1445
Total RVUs3.7544
Conversion factor× 33.4009

Office rate, South Carolina$125.40

Office: (1.42 × 1 + 2.37 × 0.924 + 0.17 × 0.85) × $33.4009 = $125.40

Facility: (1.42 × 1 + 0.28 × 0.924 + 0.17 × 0.85) × $33.4009 = $60.90

Open 10005 in the RVU calculator

Payment rules and modifiers for 10005

The CMS indicators that decide how 10005 is paid alongside other services.

CMS payment indicators · 10005

Ultrasound-guided FNA, first lesion

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

10005 without 51 · national office

$132.27

Ultrasound-guided FNA, first lesion

10005-51 · Second procedure: 50%

$66.14

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 10005 has changed in South Carolina

10005 · Office / nonfacility

$125.40

Effective 2026-10-01

The base rate is $3.95 higher than on 2025-10-01, moving from $121.45 to $125.40 (3.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $121.45changed to$125.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.46 changed to 1.42
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $126.19changed to$121.45

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.41 changed to 2.37

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $124.13changed to$126.19

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $128.91changed to$124.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.44 changed to 2.41
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817
  5. January 1, 2023

    RVU23A

    $132.11changed to$128.91

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.48 changed to 2.44
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $129.57changed to$132.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.38 changed to 2.48
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $123.70changed to$129.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.08 changed to 2.38
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $120.68changed to$123.70

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.98 changed to 2.08
    • Malpractice RVU 0.15 changed to 0.13
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$120.68

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$125.40$60.90RVU26D
2026-07-01$125.40$60.90RVU26C
2026-04-01$125.40$60.90RVU26B
2026-01-01$125.40$60.90RVU26A
2025-10-01$121.45$67.70RVU25D
2025-07-01$121.45$67.70RVU25C
2025-04-01$121.45$67.70RVU25B
2025-01-01$121.45$67.70RVU25A
2024-10-01$126.19$69.36RVU24D
2024-07-01$126.19$69.36RVU24C
2024-04-01$126.19$69.36RVU24B
2024-03-09$126.19$69.36RVU24AR
2024-01-01$124.13$68.23RVU24A
2023-10-01$128.91$70.75RVU23D
2023-07-01$128.91$70.75RVU23C
2023-04-01$128.91$70.75RVU23B
2023-01-01$128.91$70.75RVU23A
2022-10-01$132.11$71.49RVU22D
2022-07-01$132.11$71.49RVU22C
2022-04-01$132.11$71.49RVU22B
2022-01-01$132.11$71.49RVU22A
2021-10-01$129.57$70.34RVU21D
2021-07-01$129.57$70.34RVU21C
2021-04-01$129.57$70.34RVU21B
2021-01-01$129.57$70.34RVU21A
2020-10-01$123.70$71.33RVU20D
2020-07-01$123.70$71.33RVU20C
2020-04-01$123.70$71.33RVU20B
2020-01-01$123.70$71.33RVU20A
2019-10-01$120.68$71.71RVU19D
2019-07-01$120.68$71.71RVU19C
2019-04-01$120.68$71.71RVU19B
2019-01-01$120.68$71.71RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 10005 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

10005 billing questions

When should 10005 be used instead of 10021?

Use 10005 when ultrasound guides the aspiration. Code 10021 describes fine-needle aspiration biopsy without imaging guidance.

How are additional lesions reported?

Report 10005 for the first lesion and 10006 for each additional lesion sampled with ultrasound guidance in the session. Count distinct lesions, not needle passes.

Can ultrasound guidance be billed separately?

No. Ultrasound guidance is included in 10005 for the aspiration it guides.

Does a core-needle biopsy qualify for 10005?

No. This code is for fine-needle aspiration, which collects cells or fluid; it does not describe a core-needle tissue biopsy.

What documentation supports reporting 10005?

Document the lesion sampled, the fine-needle aspiration, and use of ultrasound guidance. The record should distinguish the first lesion from any additional lesions reported with 10006.

How does CMS handle multiple procedures in the same session?

CMS pays the highest-valued procedure in full and reduces payment for the other procedures by 50% when multiple procedures are performed in the same session.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 10005PPRRVU2026_Oct_nonQPP.csv, line 1,061 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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