CPT code 10011: MRI-guided FNA, first lesion2026 Medicare rate & RVUs in Missouri
Reports MRI-guided fine-needle aspiration biopsy of the first lesion when a physician samples a target for diagnostic evaluation.
CMS doesn’t publish an office rate for 10011 in Missouri.
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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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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
| 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
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%).
10011 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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.
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