CPT code 10010: Fine needle aspiration, additional lesion, CT-guided2026 Medicare rate & RVUs in Puerto Rico
Reports CT-guided fine needle aspiration of each additional distinct lesion sampled after the first lesion during the same procedure.
In Puerto Rico, Medicare pays $236.96 for 10010 in the office and $65.75 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 10010 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 10010 covers
A clinician uses CT to localize and guide a fine needle into an additional distinct lesion, aspirating cells or fluid for cytologic evaluation. The service is typically performed by an interventional radiologist or another physician performing image-guided sampling, often in a hospital or outpatient procedure suite. CT can help target lesions that are deep or difficult to access by palpation or other imaging methods.
Report one unit for each additional lesion sampled after the first CT-guided lesion, which is reported with 10009. Additional needle passes into the same lesion do not constitute additional lesions. The procedure note should identify each target separately and document CT guidance and sampling. CMS classifies 10010 as an add-on code: report it only with its primary procedure, 10009, and payment falls 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.
How Puerto Rico compares for 10010
Across 109 of 109 payment localities, the office rate for 10010 runs from $207.16 in Arkansas to $314.87 in San Benito County, CA. Puerto Rico pays $236.96. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$236.96
- Los Angeles, CA · California$266.90+$29.94
- Washington, DC area · District of Columbia$269.87+$32.91
- Miami, FL · Florida$253.02+$16.06
- Chicago, IL · Illinois$245.47+$8.51
- Manhattan, NY · New York$270.94+$33.98
- Alaska · Alaska$270.21+$33.25
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $210.30 | $62.13 |
| ArkansasArkansas | $207.16 | $61.69 |
| ArizonaArizona | $228.73 | $64.63 |
| Bakersfield, CACalifornia | $250.16 | $64.56 |
| Chico, CACalifornia | $249.54 | $63.94 |
| El Centro, CACalifornia | $249.57 | $63.98 |
| Fresno, CACalifornia | $249.54 | $63.94 |
| Hanford, CACalifornia | $249.54 | $63.94 |
| Madera, CACalifornia | $249.54 | $63.94 |
| Merced, CACalifornia | $249.54 | $63.94 |
| Modesto, CACalifornia | $249.54 | $63.94 |
| Napa, CACalifornia | $290.52 | $67.33 |
| Oxnard, CACalifornia | $265.74 | $65.57 |
| Redding, CACalifornia | $249.54 | $63.94 |
| Rest of CaliforniaCalifornia | $249.54 | $63.94 |
| Riverside, CACalifornia | $251.82 | $66.22 |
| Sacramento, CACalifornia | $262.24 | $65.30 |
| Salinas, CACalifornia | $261.28 | $65.01 |
| San Diego, CACalifornia | $267.72 | $65.18 |
| Marin County, CACalifornia | $307.94 | $69.17 |
| San Francisco, CACalifornia | $307.70 | $68.93 |
| San Benito County, CACalifornia | $314.87 | $70.67 |
| Santa Clara County, CACalifornia | $313.89 | $69.70 |
| San Luis Obispo, CACalifornia | $257.04 | $64.16 |
| Santa Cruz, CACalifornia | $270.50 | $64.75 |
| Santa Maria, CACalifornia | $262.34 | $64.88 |
| Santa Rosa, CACalifornia | $273.25 | $65.30 |
| Stockton, CACalifornia | $249.54 | $63.94 |
| Vallejo, CACalifornia | $290.18 | $66.99 |
| Visalia, CACalifornia | $249.54 | $63.94 |
| Yuba City, CACalifornia | $249.54 | $63.94 |
| ColoradoColorado | $245.41 | $65.23 |
| ConnecticutConnecticut | $251.12 | $68.73 |
| DelawareDelaware | $232.61 | $65.30 |
| Fort Lauderdale, FLFlorida | $243.08 | $71.53 |
| Rest of FloridaFlorida | $231.00 | $69.11 |
| Atlanta, GAGeorgia | $239.50 | $67.45 |
| Rest of GeorgiaGeorgia | $217.66 | $66.61 |
| Hawaii, Guam, HIHawaii | $256.08 | $63.53 |
| IowaIowa | $216.09 | $61.14 |
| IdahoIdaho | $217.50 | $61.70 |
| East St. Louis, ILIllinois | $228.31 | $72.51 |
| Rest of IllinoisIllinois | $223.92 | $69.31 |
| Suburban Chicago, ILIllinois | $245.64 | $71.73 |
| IndianaIndiana | $218.81 | $61.83 |
| KansasKansas | $214.93 | $61.84 |
| KentuckyKentucky | $215.19 | $64.65 |
| New Orleans, LALouisiana | $225.81 | $66.46 |
| Rest of LouisianaLouisiana | $214.80 | $64.93 |
| Metropolitan Boston, MAMassachusetts | $270.40 | $68.20 |
| Rest of MassachusettsMassachusetts | $243.82 | $65.50 |
| Baltimore area, MDMaryland | $250.39 | $68.69 |
| Rest of MarylandMaryland | $237.20 | $65.82 |
| Rest of MaineMaine | $218.54 | $62.75 |
| Southern Maine, MEMaine | $230.98 | $63.17 |
| Detroit, MIMichigan | $233.85 | $70.44 |
| Rest of MichiganMichigan | $220.88 | $66.27 |
| MinnesotaMinnesota | $235.26 | $61.01 |
| Metropolitan Kansas City, MOMissouri | $224.35 | $65.33 |
| Metropolitan St. Louis, MOMissouri | $226.79 | $65.57 |
| Rest of MissouriMissouri | $210.90 | $64.93 |
| MississippiMississippi | $209.08 | $63.27 |
| MontanaMontana | $235.13 | $65.79 |
| North CarolinaNorth Carolina | $220.93 | $62.93 |
| North DakotaNorth Dakota | $230.98 | $61.63 |
| NebraskaNebraska | $217.35 | $61.05 |
| New HampshireNew Hampshire | $241.41 | $65.13 |
| Northern New JerseyNew Jersey | $266.90 | $70.47 |
| Rest of New JerseyNew Jersey | $254.01 | $69.09 |
| New MexicoNew Mexico | $222.08 | $66.79 |
| NevadaNevada | $234.15 | $64.63 |
| NYC suburbs and Long Island, NYNew York | $277.55 | $76.20 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $255.60 | $70.17 |
| Queens, NYNew York | $273.42 | $73.25 |
| Rest of New YorkNew York | $224.34 | $63.47 |
| OhioOhio | $220.03 | $65.42 |
| OklahomaOklahoma | $214.92 | $63.70 |
| Portland, OROregon | $253.56 | $65.42 |
| Rest of OregonOregon | $232.36 | $63.70 |
| Metropolitan Philadelphia, PAPennsylvania | $244.61 | $68.33 |
| Rest of PennsylvaniaPennsylvania | $220.46 | $65.00 |
| Rhode IslandRhode Island | $241.16 | $66.23 |
| South CarolinaSouth Carolina | $220.84 | $64.37 |
| South DakotaSouth Dakota | $230.48 | $61.14 |
| TennesseeTennessee | $216.03 | $62.10 |
| Austin, TXTexas | $244.56 | $65.40 |
| Beaumont, TXTexas | $218.95 | $64.85 |
| Brazoria, TXTexas | $232.46 | $64.64 |
| Dallas, TXTexas | $233.93 | $65.27 |
| Fort Worth, TXTexas | $232.28 | $65.31 |
| Galveston, TXTexas | $233.15 | $64.99 |
| Houston, TXTexas | $236.99 | $68.83 |
| Rest of TexasTexas | $225.57 | $64.86 |
| UtahUtah | $223.97 | $64.78 |
| VirginiaVirginia | $230.12 | $63.65 |
| Virgin Islands, VIUnited States Virgin Islands | $236.96 | $65.75 |
| VermontVermont | $229.93 | $62.28 |
| Rest of WashingtonWashington | $243.41 | $65.09 |
| King County, WAWashington | $276.13 | $68.34 |
| WisconsinWisconsin | $222.97 | $60.74 |
| West VirginiaWest Virginia | $215.33 | $68.17 |
| WyomingWyoming | $233.32 | $63.98 |
10010 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.
$207.16
$282.21
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 | $270.21 | 1 |
| AL | $210.30 | 1 |
| AR | $207.16 | 1 |
| AZ | $228.73 | 1 |
| CA | $249.54–$314.87 | 29 |
| CO | $245.41 | 1 |
| CT | $251.12 | 1 |
| DC | $269.87 | 1 |
| DE | $232.61 | 1 |
| FL | $231.00–$253.02 | 3 |
| GA | $217.66–$239.50 | 2 |
| GU | $256.08 | 1 |
| HI | $256.08 | 1 |
| IA | $216.09 | 1 |
| ID | $217.50 | 1 |
| IL | $223.92–$245.64 | 4 |
| IN | $218.81 | 1 |
| KS | $214.93 | 1 |
| KY | $215.19 | 1 |
| LA | $214.80–$225.81 | 2 |
| MA | $243.82–$270.40 | 2 |
| MD | $237.20–$269.87 | 3 |
| ME | $218.54–$230.98 | 2 |
| MI | $220.88–$233.85 | 2 |
| MN | $235.26 | 1 |
| MO | $210.90–$226.79 | 3 |
| MS | $209.08 | 1 |
| MT | $235.13 | 1 |
| NC | $220.93 | 1 |
| ND | $230.98 | 1 |
| NE | $217.35 | 1 |
| NH | $241.41 | 1 |
| NJ | $254.01–$266.90 | 2 |
| NM | $222.08 | 1 |
| NV | $234.15 | 1 |
| NY | $224.34–$277.55 | 5 |
| OH | $220.03 | 1 |
| OK | $214.92 | 1 |
| OR | $232.36–$253.56 | 2 |
| PA | $220.46–$244.61 | 2 |
| PR | $236.96 | 1 |
| RI | $241.16 | 1 |
| SC | $220.84 | 1 |
| SD | $230.48 | 1 |
| TN | $216.03 | 1 |
| TX | $218.95–$244.56 | 8 |
| UT | $223.97 | 1 |
| VA | $230.12–$269.87 | 2 |
| VI | $236.96 | 1 |
| VT | $229.93 | 1 |
| WA | $243.41–$276.13 | 2 |
| WI | $222.97 | 1 |
| WV | $215.33 | 1 |
| WY | $233.32 | 1 |
How the 10010 rate is calculated
Each of 10010’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 · 10010
RVUs × geographic indexes × conversion factor
Work1.61
1.61 RVUs× 1.000 GPCI
Practice expense5.22
5.22 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
7.0400
Conversion factor
$33.4009
Medicare rate
$235.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,068
- Code
- 10010
- Physician work
- 1.61
- Practice expense
- 5.22
- Malpractice
- 0.21
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.61 | × 1.000 | 1.6100 |
| Practice expense | 5.22 | × 1.011 | 5.2774 |
| Malpractice | 0.21 | × 0.985 | 0.2068 |
| Total RVUs | 7.0943 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$236.96
Office: (1.61 × 1 + 5.22 × 1.011 + 0.21 × 0.985) × $33.4009 = $236.96
Facility: (1.61 × 1 + 0.15 × 1.011 + 0.21 × 0.985) × $33.4009 = $65.75
Payment rules and modifiers for 10010
The CMS indicators that decide how 10010 is paid alongside other services.
CMS payment indicators · 10010
Fine needle aspiration, additional lesion, CT-guided
| 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. |
How 10010 has changed in Puerto Rico
10010 · Office / nonfacility
$236.96
Effective 2026-10-01
The base rate is $8.19 higher than on 2025-10-01, moving from $228.77 to $236.96 (3.6%).
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
$228.77changed to$236.96
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.65 changed to 1.61
- Practice expense RVU 5.18 changed to 5.22
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$235.76changed to$228.77
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.19 changed to 5.18
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$231.91changed to$235.76
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$243.97changed to$231.91
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.32 changed to 5.19
- Malpractice RVU 0.19 changed to 0.21
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$242.63changed to$243.97
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$277.11changed to$242.63
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 6.17 changed to 5.32
- Malpractice RVU 0.14 changed to 0.19
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$288.54changed to$277.11
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 6.42 changed to 6.17
- Malpractice RVU 0.15 changed to 0.14
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$291.17changed to$288.54
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.22 changed to 6.42
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$289.09changed to$291.17
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.17 changed to 6.22
- Malpractice RVU 0.16 changed to 0.15
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$289.09
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 | $236.96 | $65.75 | RVU26D |
| 2026-07-01 | $236.96 | $65.75 | RVU26C |
| 2026-04-01 | $236.96 | $65.75 | RVU26B |
| 2026-01-01 | $236.96 | $65.75 | RVU26A |
| 2025-10-01 | $228.77 | $69.49 | RVU25D |
| 2025-07-01 | $228.77 | $69.49 | RVU25C |
| 2025-04-01 | $228.77 | $69.49 | RVU25B |
| 2025-01-01 | $228.77 | $69.49 | RVU25A |
| 2024-10-01 | $235.76 | $70.84 | RVU24D |
| 2024-07-01 | $235.76 | $70.84 | RVU24C |
| 2024-04-01 | $235.76 | $70.84 | RVU24B |
| 2024-03-09 | $235.76 | $70.84 | RVU24AR |
| 2024-01-01 | $231.91 | $69.68 | RVU24A |
| 2023-10-01 | $243.97 | $71.81 | RVU23D |
| 2023-07-01 | $242.63 | $71.84 | RVU23C |
| 2023-04-01 | $242.63 | $71.84 | RVU23B |
| 2023-01-01 | $242.63 | $71.84 | RVU23A |
| 2022-10-01 | $277.11 | $80.71 | RVU22D |
| 2022-07-01 | $277.11 | $80.71 | RVU22C |
| 2022-04-01 | $277.11 | $80.71 | RVU22B |
| 2022-01-01 | $277.11 | $80.71 | RVU22A |
| 2021-10-01 | $288.54 | $82.43 | RVU21D |
| 2021-07-01 | $288.54 | $82.43 | RVU21C |
| 2021-04-01 | $288.54 | $82.43 | RVU21B |
| 2021-01-01 | $288.54 | $82.43 | RVU21A |
| 2020-10-01 | $291.17 | $86.00 | RVU20D |
| 2020-07-01 | $291.17 | $86.00 | RVU20C |
| 2020-04-01 | $291.17 | $86.00 | RVU20B |
| 2020-01-01 | $291.17 | $86.00 | RVU20A |
| 2019-10-01 | $289.09 | $86.22 | RVU19D |
| 2019-07-01 | $289.09 | $86.22 | RVU19C |
| 2019-04-01 | $289.09 | $86.22 | RVU19B |
| 2019-01-01 | $289.09 | $86.22 | 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 Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
10010 billing questions
When is 10010 reported instead of 10009?
Use 10009 for the first lesion sampled with CT guidance. Report 10010 for each additional distinct lesion sampled during the procedure.
Can 10010 be billed by itself?
No. CMS identifies it as an add-on code, so report it with the primary procedure, 10009.
Do multiple needle passes into one lesion support multiple units?
No. Units represent additional distinct lesions, not additional passes into the same target.
Is CT guidance separately reported for the additional target?
The CT-guided aspiration service is represented by 10010 for the additional lesion; do not report a separate guidance code for that same target.
What documentation supports an additional-lesion unit?
Document the additional target as a distinct lesion and record its CT-guided sampling. The record should distinguish it from the first lesion and from repeat passes at one site.
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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