CPT code 10009: FNA biopsy, CT guidance, first lesion2026 Medicare rate & RVUs in South Dakota
Reports CT-guided fine-needle aspiration of the initial lesion when a clinician uses imaging to direct needle sampling for cytologic evaluation.
In South Dakota, Medicare pays $407.40 for 10009 in the office and $88.09 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $407.40. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$407.40
- Los Angeles, CA · California$473.57+$66.17
- Washington, DC area · District of Columbia$476.32+$68.92
- Miami, FL · Florida$437.83+$30.43
- Chicago, IL · Illinois$424.62+$17.22
- Manhattan, NY · New York$475.38+$67.98
- Alaska · Alaska$467.33+$59.93
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $441.99 | $92.03 |
| Merced, CACalifornia | $441.99 | $92.03 |
| Modesto, CACalifornia | $441.99 | $92.03 |
| Napa, CACalifornia | $518.72 | $97.86 |
| Oxnard, CACalifornia | $471.97 | $94.54 |
| Redding, CACalifornia | $441.99 | $92.03 |
| Rest of CaliforniaCalifornia | $441.99 | $92.03 |
| Riverside, CACalifornia | $444.50 | $94.54 |
| Sacramento, CACalifornia | $465.59 | $94.23 |
| Salinas, CACalifornia | $463.90 | $93.81 |
| San Diego, CACalifornia | $476.13 | $94.23 |
| Marin County, CACalifornia | $551.17 | $100.94 |
| San Francisco, CACalifornia | $550.91 | $100.68 |
| San Benito County, CACalifornia | $563.47 | $103.02 |
| Santa Clara County, CACalifornia | $562.40 | $101.95 |
| San Luis Obispo, CACalifornia | $456.24 | $92.54 |
| Santa Cruz, CACalifornia | $481.72 | $93.75 |
| Santa Maria, CACalifornia | $466.00 | $93.68 |
| Santa Rosa, CACalifornia | $486.69 | $94.57 |
| Stockton, CACalifornia | $441.99 | $92.03 |
| Vallejo, CACalifornia | $518.34 | $97.49 |
| Visalia, CACalifornia | $441.99 | $92.03 |
| Yuba City, CACalifornia | $441.99 | $92.03 |
| ColoradoColorado | $432.91 | $93.16 |
| ConnecticutConnecticut | $441.10 | $97.20 |
| DelawareDelaware | $408.12 | $92.64 |
| Fort Lauderdale, FLFlorida | $423.02 | $99.55 |
| Rest of FloridaFlorida | $401.79 | $96.52 |
| Atlanta, GAGeorgia | $419.57 | $95.15 |
| Rest of GeorgiaGeorgia | $378.19 | $93.36 |
| Hawaii, Guam, HIHawaii | $454.66 | $91.60 |
| IowaIowa | $379.71 | $87.53 |
| IdahoIdaho | $381.95 | $88.18 |
| East St. Louis, ILIllinois | $393.78 | $100.02 |
| Rest of IllinoisIllinois | $388.00 | $96.47 |
| Suburban Chicago, ILIllinois | $427.89 | $99.96 |
| IndianaIndiana | $384.36 | $88.36 |
| KansasKansas | $376.88 | $88.22 |
| KentuckyKentucky | $375.07 | $91.20 |
| New Orleans, LALouisiana | $394.00 | $93.52 |
| Rest of LouisianaLouisiana | $374.07 | $91.48 |
| Metropolitan Boston, MAMassachusetts | $478.95 | $97.69 |
| Rest of MassachusettsMassachusetts | $429.68 | $93.44 |
| Baltimore area, MDMaryland | $439.69 | $97.06 |
| Rest of MarylandMaryland | $416.58 | $93.44 |
| Rest of MaineMaine | $383.09 | $89.32 |
| Southern Maine, MEMaine | $406.68 | $90.25 |
| Detroit, MIMichigan | $406.17 | $98.04 |
| Rest of MichiganMichigan | $384.67 | $93.13 |
| MinnesotaMinnesota | $416.70 | $88.13 |
| Metropolitan Kansas City, MOMissouri | $392.11 | $92.28 |
| Metropolitan St. Louis, MOMissouri | $396.61 | $92.63 |
| Rest of MissouriMissouri | $366.58 | $91.33 |
| MississippiMississippi | $364.44 | $89.51 |
| MontanaMontana | $412.49 | $93.17 |
| North CarolinaNorth Carolina | $387.53 | $89.61 |
| North DakotaNorth Dakota | $407.94 | $88.63 |
| NebraskaNebraska | $382.21 | $87.48 |
| New HampshireNew Hampshire | $425.13 | $92.72 |
| Northern New JerseyNew Jersey | $470.67 | $100.26 |
| Rest of New JerseyNew Jersey | $446.67 | $97.98 |
| New MexicoNew Mexico | $386.54 | $93.73 |
| NevadaNevada | $411.55 | $91.92 |
| NYC suburbs and Long Island, NYNew York | $486.41 | $106.75 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $448.90 | $99.25 |
| Queens, NYNew York | $480.90 | $103.48 |
| Rest of New YorkNew York | $393.65 | $90.31 |
| OhioOhio | $383.74 | $92.20 |
| OklahomaOklahoma | $375.33 | $90.19 |
| Portland, OROregon | $448.49 | $93.73 |
| Rest of OregonOregon | $408.89 | $90.86 |
| Metropolitan Philadelphia, PAPennsylvania | $428.89 | $96.49 |
| Rest of PennsylvaniaPennsylvania | $384.91 | $91.78 |
| Puerto RicoPuerto Rico | $416.03 | $93.21 |
| Rhode IslandRhode Island | $424.00 | $94.15 |
| South CarolinaSouth Carolina | $386.17 | $91.12 |
| TennesseeTennessee | $378.79 | $88.54 |
| Austin, TXTexas | $430.99 | $93.16 |
| Beaumont, TXTexas | $382.14 | $91.56 |
| Brazoria, TXTexas | $408.42 | $91.98 |
| Dallas, TXTexas | $410.75 | $92.71 |
| Fort Worth, TXTexas | $407.53 | $92.69 |
| Galveston, TXTexas | $409.45 | $92.37 |
| Houston, TXTexas | $413.66 | $96.58 |
| Rest of TexasTexas | $394.86 | $91.83 |
| UtahUtah | $391.84 | $91.68 |
| VirginiaVirginia | $404.61 | $90.73 |
| Virgin Islands, VIUnited States Virgin Islands | $416.03 | $93.21 |
| VermontVermont | $405.39 | $89.27 |
| Rest of WashingtonWashington | $429.18 | $92.95 |
| King County, WAWashington | $489.98 | $98.19 |
| WisconsinWisconsin | $393.27 | $87.37 |
| West VirginiaWest Virginia | $372.41 | $94.92 |
| WyomingWyoming | $410.50 | $91.19 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $467.33 | 1 |
| AL | $367.75 | 1 |
| AR | $362.06 | 1 |
| AZ | $401.12 | 1 |
| CA | $441.99–$563.47 | 29 |
| CO | $432.91 | 1 |
| CT | $441.10 | 1 |
| DC | $476.32 | 1 |
| DE | $408.12 | 1 |
| FL | $401.79–$437.83 | 3 |
| GA | $378.19–$419.57 | 2 |
| GU | $454.66 | 1 |
| HI | $454.66 | 1 |
| IA | $379.71 | 1 |
| ID | $381.95 | 1 |
| IL | $388.00–$427.89 | 4 |
| IN | $384.36 | 1 |
| KS | $376.88 | 1 |
| KY | $375.07 | 1 |
| LA | $374.07–$394.00 | 2 |
| MA | $429.68–$478.95 | 2 |
| MD | $416.58–$476.32 | 3 |
| ME | $383.09–$406.68 | 2 |
| MI | $384.67–$406.17 | 2 |
| MN | $416.70 | 1 |
| MO | $366.58–$396.61 | 3 |
| MS | $364.44 | 1 |
| MT | $412.49 | 1 |
| NC | $387.53 | 1 |
| ND | $407.94 | 1 |
| NE | $382.21 | 1 |
| NH | $425.13 | 1 |
| NJ | $446.67–$470.67 | 2 |
| NM | $386.54 | 1 |
| NV | $411.55 | 1 |
| NY | $393.65–$486.41 | 5 |
| OH | $383.74 | 1 |
| OK | $375.33 | 1 |
| OR | $408.89–$448.49 | 2 |
| PA | $384.91–$428.89 | 2 |
| PR | $416.03 | 1 |
| RI | $424.00 | 1 |
| SC | $386.17 | 1 |
| SD | $407.40 | 1 |
| TN | $378.79 | 1 |
| TX | $382.14–$430.99 | 8 |
| UT | $391.84 | 1 |
| VA | $404.61–$476.32 | 2 |
| VI | $416.03 | 1 |
| VT | $405.39 | 1 |
| WA | $429.18–$489.98 | 2 |
| WI | $393.27 | 1 |
| WV | $372.41 | 1 |
| WY | $410.50 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.20 | × 1.000 | 2.2000 |
| Practice expense | 9.92 | × 1.000 | 9.9200 |
| Malpractice | 0.23 | × 0.336 | 0.0773 |
| Total RVUs | 12.1973 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$407.40
Office: (2.2 × 1 + 9.92 × 1 + 0.23 × 0.336) × $33.4009 = $407.40
Facility: (2.2 × 1 + 0.36 × 1 + 0.23 × 0.336) × $33.4009 = $88.09
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
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%).
How 10009 has changed in South Dakota
10009 · Office / nonfacility
$407.40
Effective 2026-10-01
The base rate is $6.17 higher than on 2025-10-01, moving from $401.23 to $407.40 (1.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$401.23changed to$407.40
- 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 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$421.22changed to$401.23
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 10.31 changed to 10.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$414.35changed to$421.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$438.16changed to$414.35
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 10.59 changed to 10.31
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$464.63changed to$438.16
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 11.09 changed to 10.59
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$480.58changed to$464.63
- 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.
January 1, 2021
RVU21A
$475.70changed to$480.58
- 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 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$472.31changed to$475.70
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 10.76 changed to 10.84
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$472.31
Held through RVU19B, RVU19C, RVU19D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $407.40 | $88.09 | RVU26D |
| 2026-07-01 | $407.40 | $88.09 | RVU26C |
| 2026-04-01 | $407.40 | $88.09 | RVU26B |
| 2026-01-01 | $407.40 | $88.09 | RVU26A |
| 2025-10-01 | $401.23 | $99.43 | RVU25D |
| 2025-07-01 | $401.23 | $99.43 | RVU25C |
| 2025-04-01 | $401.23 | $99.43 | RVU25B |
| 2025-01-01 | $401.23 | $99.43 | RVU25A |
| 2024-10-01 | $421.22 | $101.99 | RVU24D |
| 2024-07-01 | $421.22 | $101.99 | RVU24C |
| 2024-04-01 | $421.22 | $101.99 | RVU24B |
| 2024-03-09 | $421.22 | $101.99 | RVU24AR |
| 2024-01-01 | $414.35 | $100.33 | RVU24A |
| 2023-10-01 | $438.16 | $104.38 | RVU23D |
| 2023-07-01 | $438.16 | $104.38 | RVU23C |
| 2023-04-01 | $438.16 | $104.38 | RVU23B |
| 2023-01-01 | $438.16 | $104.38 | RVU23A |
| 2022-10-01 | $464.63 | $107.50 | RVU22D |
| 2022-07-01 | $464.63 | $107.50 | RVU22C |
| 2022-04-01 | $464.63 | $107.50 | RVU22B |
| 2022-01-01 | $464.63 | $107.50 | RVU22A |
| 2021-10-01 | $480.58 | $108.62 | RVU21D |
| 2021-07-01 | $480.58 | $108.62 | RVU21C |
| 2021-04-01 | $480.58 | $108.62 | RVU21B |
| 2021-01-01 | $480.58 | $108.62 | RVU21A |
| 2020-10-01 | $475.70 | $113.36 | RVU20D |
| 2020-07-01 | $475.70 | $113.36 | RVU20C |
| 2020-04-01 | $475.70 | $113.36 | RVU20B |
| 2020-01-01 | $475.70 | $113.36 | RVU20A |
| 2019-10-01 | $472.31 | $113.00 | RVU19D |
| 2019-07-01 | $472.31 | $113.00 | RVU19C |
| 2019-04-01 | $472.31 | $113.00 | RVU19B |
| 2019-01-01 | $472.31 | $113.00 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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