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

CMS doesn’t publish a rate for 10011 in Puerto Rico.

Check a contract rate as a % of Medicare · 10011 nationwide

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

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.

How Puerto Rico compares for 10011

Every other payment area

10011 rates by state

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

See 10011 in every payment locality

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.

Payment rules and modifiers for 10011

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

What modifiers do to the payment

When to use modifier 51

Codes related to 10011

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

How 10011 has changed in Puerto Rico

Price 10011 for an earlier date of service

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

Browse all communities in Puerto Rico

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