CPT code 10009: FNA biopsy, CT guidance, first lesion2026 Medicare rate & RVUs in Montana

Reports CT-guided fine-needle aspiration of the initial lesion when a clinician uses imaging to direct needle sampling for cytologic evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality1.7K Medicare services in 2024

In Montana, Medicare pays $412.49 for 10009 in the office and $93.17 when it’s performed in a hospital or facility.

$412.49Office (non-facility)
$93.17Hospital or facility
−0.0%vs the national office rate ($412.50)

Check a contract rate as a % of Medicare · 10009 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 10009 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 10009 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 10009 covers

A clinician advances a fine needle into a lesion while using CT images to plan and guide sampling. The needle collects cells or fluid for cytologic evaluation rather than a core of tissue. Radiologists and interventional radiologists commonly perform this service for lesions that need image-guided access, such as a lung or deep soft-tissue mass, in an outpatient imaging department or hospital setting.

Report 10009 for the first lesion sampled with CT guidance. For another distinct lesion sampled during the same session with CT guidance, use the applicable additional-lesion code rather than reporting another first-lesion service. The record should identify the target lesion or site, CT guidance, and the aspiration sampling performed. CT guidance is part of this service; cytology interpretation is a separate service when performed and appropriately reported. Under the standard multiple procedure reduction, the highest-valued procedure in the same session is paid in full and other procedures are paid at 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 Montana compares for 10009

Across 109 of 109 payment localities, the office rate for 10009 runs from $362.06 in Arkansas to $563.47 in San Benito County, CA. Montana pays $412.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

10009 in Montana vs other payment areas
  1. Montana · this page$412.49
  2. Los Angeles, CA · California$473.57+$61.08
  3. Washington, DC area · District of Columbia$476.32+$63.83
  4. Miami, FL · Florida$437.83+$25.34
  5. Chicago, IL · Illinois$424.62+$12.13
  6. Manhattan, NY · New York$475.38+$62.89
  7. Alaska · Alaska$467.33+$54.84

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

Every other payment area

10009 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$367.75$88.35
ArkansasArkansas$362.06$87.77
ArizonaArizona$401.12$91.71
Bakersfield, CACalifornia$442.70$92.74
Chico, CACalifornia$441.99$92.03
El Centro, CACalifornia$442.03$92.07
Fresno, CACalifornia$441.99$92.03
Hanford, CACalifornia$441.99$92.03

10009 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.

$362.06

$502.73

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

View every state and territory as a table
10009 office rate range by state
State / territoryOffice rate rangeLocalities
AK$467.331
AL$367.751
AR$362.061
AZ$401.121
CA$441.99–$563.4729
CO$432.911
CT$441.101
DC$476.321
DE$408.121
FL$401.79–$437.833
GA$378.19–$419.572
GU$454.661
HI$454.661
IA$379.711
ID$381.951
IL$388.00–$427.894
IN$384.361
KS$376.881
KY$375.071
LA$374.07–$394.002
MA$429.68–$478.952
MD$416.58–$476.323
ME$383.09–$406.682
MI$384.67–$406.172
MN$416.701
MO$366.58–$396.613
MS$364.441
MT$412.491
NC$387.531
ND$407.941
NE$382.211
NH$425.131
NJ$446.67–$470.672
NM$386.541
NV$411.551
NY$393.65–$486.415
OH$383.741
OK$375.331
OR$408.89–$448.492
PA$384.91–$428.892
PR$416.031
RI$424.001
SC$386.171
SD$407.401
TN$378.791
TX$382.14–$430.998
UT$391.841
VA$404.61–$476.322
VI$416.031
VT$405.391
WA$429.18–$489.982
WI$393.271
WV$372.411
WY$410.501

See 10009 in every payment locality

How the 10009 rate is calculated

Each of 10009’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 · 10009

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.20

2.20 RVUs× 1.000 GPCI

Practice expense9.92

9.92 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

12.3500

Conversion factor

$33.4009

Medicare rate

$412.50

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

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,065

Code
10009
Physician work
2.20
Practice expense
9.92
Malpractice
0.23

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 10009 in Montana
ComponentRVULocality factorAdjusted
Physician work2.20× 1.0002.2000
Practice expense9.92× 1.0009.9200
Malpractice0.23× 0.9980.2295
Total RVUs12.3495
Conversion factor× 33.4009

Office rate, Montana$412.49

Office: (2.2 × 1 + 9.92 × 1 + 0.23 × 0.998) × $33.4009 = $412.49

Facility: (2.2 × 1 + 0.36 × 1 + 0.23 × 0.998) × $33.4009 = $93.17

Open 10009 in the RVU calculator

Payment rules and modifiers for 10009

The CMS indicators that decide how 10009 is paid alongside other services.

CMS payment indicators · 10009

FNA biopsy, CT guidance, 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

10009 without 51 · national office

$412.50

FNA biopsy, CT guidance, first lesion

10009-51 · Second procedure: 50%

$206.25

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 10009 has changed in Montana

10009 · Office / nonfacility

$412.49

Effective 2026-10-01

The base rate is $7.02 higher than on 2025-10-01, moving from $405.47 to $412.49 (1.7%).

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

    $405.47changed to$412.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.26 changed to 2.20
    • Practice expense RVU 10.06 changed to 9.92
    • Malpractice RVU 0.22 changed to 0.23
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $425.59changed to$405.47

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.31 changed to 10.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $418.64changed to$425.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $442.74changed to$418.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.59 changed to 10.31
  5. January 1, 2023

    RVU23A

    $469.43changed to$442.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.09 changed to 10.59
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $485.19changed to$469.43

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.44 changed to 11.09
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $483.13changed to$485.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.84 changed to 11.44
    • Malpractice RVU 0.22 changed to 0.21
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $482.16changed to$483.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.76 changed to 10.84
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$482.16

    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$412.49$93.17RVU26D
2026-07-01$412.49$93.17RVU26C
2026-04-01$412.49$93.17RVU26B
2026-01-01$412.49$93.17RVU26A
2025-10-01$405.47$103.68RVU25D
2025-07-01$405.47$103.68RVU25C
2025-04-01$405.47$103.68RVU25B
2025-01-01$405.47$103.68RVU25A
2024-10-01$425.59$106.36RVU24D
2024-07-01$425.59$106.36RVU24C
2024-04-01$425.59$106.36RVU24B
2024-03-09$425.59$106.36RVU24AR
2024-01-01$418.64$104.62RVU24A
2023-10-01$442.74$108.95RVU23D
2023-07-01$442.74$108.95RVU23C
2023-04-01$442.74$108.95RVU23B
2023-01-01$442.74$108.95RVU23A
2022-10-01$469.43$112.30RVU22D
2022-07-01$469.43$112.30RVU22C
2022-04-01$469.43$112.30RVU22B
2022-01-01$469.43$112.30RVU22A
2021-10-01$485.19$113.23RVU21D
2021-07-01$485.19$113.23RVU21C
2021-04-01$485.19$113.23RVU21B
2021-01-01$485.19$113.23RVU21A
2020-10-01$483.13$120.79RVU20D
2020-07-01$483.13$120.79RVU20C
2020-04-01$483.13$120.79RVU20B
2020-01-01$483.13$120.79RVU20A
2019-10-01$482.16$122.85RVU19D
2019-07-01$482.16$122.85RVU19C
2019-04-01$482.16$122.85RVU19B
2019-01-01$482.16$122.85RVU19A
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 10009 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

10009 billing questions

When should 10009 be selected instead of an unguided FNA code?

Use 10009 when CT images guide needle placement for the initial lesion. If the FNA is performed without imaging guidance, select the code for an unguided first-lesion FNA instead.

Does 10009 include the CT guidance?

Yes. The code represents the FNA biopsy with CT guidance, so the guidance for that sampling is included in the service.

How is a second lesion handled in the same session?

For another distinct lesion sampled with CT guidance during the session, report 10010 for the additional lesion rather than another 10009.

What documentation supports reporting 10009?

Document the target lesion or site, that CT was used to guide the needle, and that fine-needle aspiration sampling was performed.

How does the multiple procedure reduction affect payment?

When multiple procedures subject to the standard rule are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

Is cytology interpretation included in 10009?

10009 covers the CT-guided needle sampling, not interpretation of the specimen. Cytology may be reported separately when that service is performed and appropriately documented.

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 10009PPRRVU2026_Oct_nonQPP.csv, line 1,065 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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