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CPT code 10011: MRI-guided FNA, first lesion2026 Medicare rate & RVUs

Reports MRI-guided fine-needle aspiration biopsy of the first lesion when a physician samples a target for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026109 payment localities73 Medicare services in 2024

Medicare rate · 10011

MRI-guided FNA, first lesion

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 10011 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 10011 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 10011 covers

Code 10011 reports fine-needle aspiration biopsy of one lesion performed with MRI guidance. MRI directs the needle to the target while the physician obtains a sample for diagnostic evaluation. Radiologists and other physicians performing image-guided procedures may report it in a setting equipped for MRI-guided intervention.

Medicare lists this CPT code with physician fee schedule status C (carrier priced): the Medicare Administrative Contractor sets payment for each claim, rather than CMS publishing a national payment amount. Use 10011 for the first lesion sampled with MRI guidance; 10012 identifies each additional lesion in the same session. Codes 10005, 10007, and 10009 identify first-lesion FNA with ultrasound, fluoroscopic, and CT guidance, respectively; 10021 is first-lesion FNA without imaging guidance.

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 10011 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

10011 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

10011 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
10011 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 10011 rate is calculated

Each of 10011’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 · 10011

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 10011

The CMS indicators that decide how 10011 is paid alongside other services.

CMS payment indicators · 10011

MRI-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

10011 without 51 · national facility

$0.00

MRI-guided FNA, first lesion

10011-51 · Second procedure: 50%

$0.00

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

10011 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 10011

    MRI-guided FNA, first lesion0 wRVU

    Not priced

  • 10012

    MR-guided FNA, each additional lesion0 wRVU

    Not priced

  • 10005

    Ultrasound-guided FNA, first lesion1.42 wRVU

    $132.27

  • 10009

    FNA biopsy, CT guidance, first lesion2.2 wRVU

    $412.50

  • 10021

    Fine needle aspiration, first lesion, no imaging1 wRVU

    $100.87

How to choose

10012MR-guided FNAEach additional lesion
10011 is for the first lesion sampled with MRI guidance; 10012 is used for each additional lesion in the same session.
10005Ultrasound-guided FNAFirst lesion
Both report image-guided FNA of the first lesion, but 10005 identifies ultrasound guidance rather than MRI guidance.
10009FNA biopsyCT guidance, first lesion
Both report image-guided FNA of the first lesion, but 10009 identifies CT guidance rather than MRI guidance.
10021Fine needle aspirationFirst lesion, no imaging
10011 identifies MRI-guided FNA; 10021 identifies first-lesion FNA performed without imaging guidance.

Codes related to 10011

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 10011
CodeHow it relatesNational office range
Add-on codes
10012MR-guided FNA, each additional lesionAdd-on code for each additional lesion sampled with MRI guidance.No office rate
Used instead
10005Ultrasound-guided FNA, first lesionFirst-lesion FNA with ultrasound guidance instead of MRI guidance.$118.35–$169.84
10007Fine needle aspiration, fluoroscopy, first lesionFirst-lesion FNA with fluoroscopic guidance instead of MRI guidance.$300.99–$468.88
10009FNA biopsy, CT guidance, first lesionFirst-lesion FNA with CT guidance instead of MRI guidance.$362.06–$563.47
10021Fine needle aspiration, first lesion, no imagingFirst-lesion FNA performed without imaging guidance.$89.75–$130.13

10011 billing questions

When should 10011 be chosen over 10012?

Use 10011 for the first lesion sampled with MRI guidance in the session. Use 10012 for each additional lesion sampled with that guidance.

Which code applies to an unguided aspiration?

Code 10021 identifies first-lesion FNA performed without imaging guidance.

What does one unit of 10011 represent?

It represents the first lesion sampled with MRI guidance. Each additional lesion in the same session is identified by 10012.

How does Medicare price 10011?

Its physician fee schedule status is C, carrier priced. The Medicare Administrative Contractor sets payment for each claim; CMS publishes no national payment.

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

Open CMS sourceHow we calculate rates

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