CPT code 10008: FNA biopsy, each additional lesion2026 Medicare rate & RVUs in California
Report this add-on for each additional lesion sampled by fine-needle aspiration biopsy with fluoroscopic guidance after the first lesion.
Medicare pays $149.01–$186.44 for 10008 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 10008 covers
A clinician uses fluoroscopic imaging to guide a needle to an additional lesion and aspirates material for examination, commonly cytology. Interventional radiologists and other physicians who perform image-guided biopsies may report the service in an imaging or procedure suite. This code represents an additional target after the first lesion sampled with fluoroscopic guidance; it is not the code for the initial lesion.
Report 10008 with 10007 for the first lesion, and document the additional lesion sampled and the use of fluoroscopic guidance. The record should distinguish each target lesion from repeated needle passes or additional samples from the same lesion. CMS treats 10008 as an add-on code: it must be billed with its primary procedure, and payment is within that procedure’s global period.
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.
Where 10008 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$149.01 to $186.44
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $149.45 | $46.22 |
| Chico, CA | $149.01 | $45.78 |
| El Centro, CA | $149.03 | $45.80 |
| Fresno, CA | $149.01 | $45.78 |
| Hanford, CA | $149.01 | $45.78 |
| Los Angeles, CA | $159.09 | $47.66 |
| Madera, CA | $149.01 | $45.78 |
| Marin County, CA | $182.35 | $49.54 |
| Merced, CA | $149.01 | $45.78 |
| Modesto, CA | $149.01 | $45.78 |
| Napa, CA | $172.36 | $48.22 |
| Oxnard, CA | $158.28 | $46.95 |
| Redding, CA | $149.01 | $45.78 |
| Rest of California | $149.01 | $45.78 |
| Riverside, CA | $150.64 | $47.40 |
| Sacramento, CA | $156.30 | $46.75 |
| Salinas, CA | $155.71 | $46.55 |
| San Benito County, CA | $186.44 | $50.62 |
| San Diego, CA | $159.32 | $46.67 |
| San Francisco, CA | $182.18 | $49.37 |
| San Luis Obispo, CA | $153.22 | $45.93 |
| Santa Clara County, CA | $185.75 | $49.92 |
| Santa Cruz, CA | $160.81 | $46.37 |
| Santa Maria, CA | $156.28 | $46.46 |
| Santa Rosa, CA | $162.43 | $46.76 |
| Stockton, CA | $149.01 | $45.78 |
| Vallejo, CA | $172.12 | $47.97 |
| Visalia, CA | $149.01 | $45.78 |
| Yuba City, CA | $149.01 | $45.78 |
How the 10008 rate is calculated
Each of 10008’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 · 10008
RVUs × geographic indexes × conversion factor
Work1.15
1.15 RVUs× 1.000 GPCI
Practice expense2.93
2.93 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
4.2300
Conversion factor
$33.4009
Medicare rate
$141.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 10008
The CMS indicators that decide how 10008 is paid alongside other services.
CMS payment indicators · 10008
FNA biopsy, each additional lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
10008 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 10007Fine needle aspirationFluoroscopy, first lesion
- 10007 covers the first lesion sampled with fluoroscopic guidance. Use 10008 only for an additional lesion.
- 10006FNA biopsyEach additional lesion
- Both codes cover an additional lesion, but 10006 uses ultrasound guidance instead of fluoroscopy.
- 10010Fine needle aspirationAdditional lesion, CT-guided
- 10010 is for an additional lesion sampled with CT guidance; 10008 is for fluoroscopic guidance.
- 10004Fine needle aspirationEach additional lesion
- 10004 covers an additional lesion sampled without imaging guidance. Choose 10008 when fluoroscopy guides the biopsy.
10008 billing questions
When should 10008 be reported instead of 10007?
Use 10007 for the first lesion sampled with fluoroscopic guidance. Report 10008 for each additional lesion sampled during the service.
Can 10008 be billed by itself?
No. It is an add-on code and must be reported with the primary fluoroscopy-guided aspiration biopsy code, 10007.
Does each needle pass support another unit of 10008?
No. The add-on represents an additional lesion, not another pass or specimen from the same lesion.
What documentation supports reporting 10008?
Document the additional lesion sampled, the aspiration biopsy performed, and fluoroscopic guidance. The record should make the separate lesion distinguishable from the first target.
How does 10008 differ from 10006?
Both represent an additional lesion, but 10008 is for fluoroscopic guidance and 10006 is for ultrasound guidance.
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
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