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CPT code 10021: Fine needle aspiration, first lesion, no imaging2026 Medicare rate & RVUs in Washington, DC area

Reports needle aspiration of a first lesion for cell or fluid sampling when the clinician performs the procedure without imaging guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality9.5K Medicare services in 2024

In Washington, DC area, Medicare pays $114.38 for 10021 in the office and $49.85 when it’s performed in a hospital or facility.

$114.38Office (non-facility)
$49.85Hospital or facility
+13.4%vs the national office rate ($100.87)

Check a contract rate as a % of Medicare · 10021 nationwide

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

We’ll open 10021 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 10021 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 10021 covers

A clinician uses a fine needle to withdraw cells or fluid from a lesion for diagnostic evaluation, without ultrasound, fluoroscopic, CT, or MR guidance. This may be performed in an office or procedure room when the target can be located clinically, such as a palpable thyroid nodule or superficial lymph node. The code represents sampling of the first lesion; cytologic examination of the specimen is a separate service when performed and appropriately reported.

Choose this code based on the absence of imaging guidance, not the lesion’s size or the number of needle passes. Document the target’s site and identity, the aspiration performed, and that no imaging guidance was used. For each additional distinct lesion sampled without imaging guidance, use 10004 rather than reporting another unit of 10021. When multiple procedures are performed in the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and the others 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 Washington, DC area compares for 10021

Across 109 of 109 payment localities, the office rate for 10021 runs from $89.75 in Arkansas to $130.13 in San Benito County, CA. Washington, DC area pays $114.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

10021 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$114.38
  2. Los Angeles, CA · California$112.16−$2.22
  3. Miami, FL · Florida$110.60−$3.78
  4. Chicago, IL · Illinois$107.47−$6.91
  5. Manhattan, NY · New York$115.92+$1.54
  6. Alaska · Alaska$119.55+$5.17
  7. Alabama · Alabama$90.99−$23.39

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

10021 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$89.75$42.70
ArizonaArizona$98.25$45.17
Bakersfield, CACalifornia$105.71$45.67
Chico, CACalifornia$105.30$45.26
El Centro, CACalifornia$105.32$45.28
Fresno, CACalifornia$105.30$45.26
Hanford, CACalifornia$105.30$45.26
Madera, CACalifornia$105.30$45.26

10021 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.

$89.75

$119.55

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
10021 office rate range by state
State / territoryOffice rate rangeLocalities
AK$119.551
AL$90.991
AR$89.751
AZ$98.251
CA$105.30–$130.1329
CO$104.271
CT$107.361
DC$114.381
DE$99.811
FL$100.46–$110.603
GA$94.99–$102.922
GU$107.501
HI$107.501
IA$92.711
ID$93.381
IL$98.04–$107.474
IN$93.881
KS$92.521
KY$93.501
LA$93.45–$97.802
MA$103.78–$113.912
MD$101.57–$114.383
ME$94.08–$98.582
MI$96.01–$101.882
MN$99.401
MO$92.08–$97.873
MS$90.921
MT$100.861
NC$94.981
ND$98.091
NE$93.131
NH$102.861
NJ$108.44–$113.342
NM$96.601
NV$100.151
NY$96.34–$118.885
OH$95.451
OK$93.111
OR$99.23–$107.182
PA$95.46–$104.952
PR$101.491
RI$103.071
SC$95.401
SD$97.771
TN$92.991
TX$94.89–$104.058
UT$96.631
VA$98.43–$114.382
VI$101.491
VT$97.931
WA$103.52–$115.942
WI$95.001
WV$94.661
WY$99.651

See 10021 in every payment locality

How the 10021 rate is calculated

Each of 10021’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 · 10021

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.00

1.00 RVUs× 1.000 GPCI

Practice expense1.88

1.88 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

3.0200

Conversion factor

$33.4009

Medicare rate

$100.87

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,072

Code
10021
Physician work
1.00
Practice expense
1.88
Malpractice
0.14

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 10021 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0541.0540
Practice expense1.88× 1.1782.2146
Malpractice0.14× 1.1130.1558
Total RVUs3.4245
Conversion factor× 33.4009

Office rate, Washington, DC area$114.38

Office: (1 × 1.054 + 1.88 × 1.178 + 0.14 × 1.113) × $33.4009 = $114.38

Facility: (1 × 1.054 + 0.24 × 1.178 + 0.14 × 1.113) × $33.4009 = $49.85

Open 10021 in the RVU calculator

Payment rules and modifiers for 10021

The CMS indicators that decide how 10021 is paid alongside other services.

CMS payment indicators · 10021

Fine needle aspiration, first lesion, no imaging

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

10021 without 51 · national office

$100.87

Fine needle aspiration, first lesion, no imaging

10021-51 · Second procedure: 50%

$50.44

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

Codes related to 10021

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

Codes related to 10021
CodeHow it relatesOffice range, Washington, DC area
Add-on codes
10004Fine needle aspiration, each additional lesionAdd-on code for each additional lesion aspirated without imaging guidance.$59.05
Used instead
10005Ultrasound-guided FNA, first lesionFirst-lesion FNA when ultrasound guidance is used.$149.56
10007Fine needle aspiration, fluoroscopy, first lesionFirst-lesion FNA when fluoroscopic guidance is used.$397.78
Often billed with
88173FNA cytology, final interpretation and reportCytopathology evaluation of an FNA specimen may be separately reported when performed.$190.60

How 10021 has changed in Washington, DC area

10021 · Office / nonfacility

$114.38

Effective 2026-10-01

The base rate is $2.55 higher than on 2025-10-01, moving from $111.83 to $114.38 (2.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $111.83changed to$114.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.03 changed to 1.00
    • Practice expense RVU 1.84 changed to 1.88
    • Malpractice RVU 0.15 changed to 0.14
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $115.88changed to$111.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.87 changed to 1.84
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $113.99changed to$115.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $120.04changed to$113.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.88 changed to 1.87
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $122.93changed to$120.04

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.87 changed to 1.88
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $123.99changed to$122.93

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.85 changed to 1.87
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $117.25changed to$123.99

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.64 changed to 1.85
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $115.07changed to$117.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.61 changed to 1.64
    • Malpractice RVU 0.14 changed to 0.13
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $143.55changed to$115.07

    • Conversion factor 35.9996 changed to 36.0391
    • Work RVU 1.27 changed to 1.03
    • Practice expense RVU 2.03 changed to 1.61
    • Malpractice RVU 0.17 changed to 0.14

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $143.31changed to$143.55

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $144.03changed to$143.31

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.05 changed to 2.03
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $176.62changed to$144.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.78 changed to 2.05
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $175.74changed to$176.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $173.96changed to$175.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.72 changed to 2.78
    • Malpractice RVU 0.21 changed to 0.18
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $177.69changed to$173.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.04 changed to 2.72
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $177.69

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$114.38$49.85RVU26D
2026-07-01$114.38$49.85RVU26C
2026-04-01$114.38$49.85RVU26B
2026-01-01$114.38$49.85RVU26A
2025-10-01$111.83$59.00RVU25D
2025-07-01$111.83$59.00RVU25C
2025-04-01$111.83$59.00RVU25B
2025-01-01$111.83$59.00RVU25A
2024-10-01$115.88$59.94RVU24D
2024-07-01$115.88$59.94RVU24C
2024-04-01$115.88$59.94RVU24B
2024-03-09$115.88$59.94RVU24AR
2024-01-01$113.99$58.96RVU24A
2023-10-01$120.04$61.62RVU23D
2023-07-01$120.04$61.62RVU23C
2023-04-01$120.04$61.62RVU23B
2023-01-01$120.04$61.62RVU23A
2022-10-01$122.93$62.19RVU22D
2022-07-01$122.93$62.19RVU22C
2022-04-01$122.93$62.19RVU22B
2022-01-01$122.93$62.19RVU22A
2021-10-01$123.99$63.18RVU21D
2021-07-01$123.99$63.18RVU21C
2021-04-01$123.99$63.18RVU21B
2021-01-01$123.99$63.18RVU21A
2020-10-01$117.25$64.37RVU20D
2020-07-01$117.25$64.37RVU20C
2020-04-01$117.25$64.37RVU20B
2020-01-01$117.25$64.37RVU20A
2019-10-01$115.07$64.26RVU19D
2019-07-01$115.07$64.26RVU19C
2019-04-01$115.07$64.26RVU19B
2019-01-01$115.07$64.26RVU19A
2018-10-01$143.55$79.35RVU18D
2018-07-01$143.55$79.35RVU18C
2018-04-01$143.55$79.35RVU18B
2018-01-01$143.55$79.35RVU18AR1
2017-10-01$143.31$79.74RVU17D
2017-07-01$143.31$79.74RVU17C
2017-04-01$143.31$79.74RVU17B
2017-01-01$143.31$79.74RVU17A
2016-10-01$144.03$79.74RVU16D
2016-07-01$144.03$79.74RVU16C
2016-04-01$144.03$79.74RVU16B
2016-01-01$144.03$79.74RVU16A
2015-10-01$176.62$80.06RVU15D
2015-07-01$176.62$80.06RVU15C
2015-04-01$175.74$79.66RVU15B
2015-01-01$175.74$79.66RVU15A
2014-10-01$173.96$80.52RVU14D
2014-07-01$173.96$80.52RVU14C
2014-04-01$173.96$80.52RVU14B
2014-01-01$173.96$80.52RVU14A
2013-10-01$177.69$77.83RVU13D
2013-07-01$177.69$77.83RVU13C
2013-04-01$177.69$77.83RVU13B
2013-01-01$177.69$77.83RVU13AR

Price 10021 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

10021 billing questions

When should 10021 be used instead of 10005?

Use 10021 for aspiration of the first lesion without imaging guidance. Use 10005 when ultrasound guidance is used for the first lesion.

How are additional lesions reported?

Report 10021 for the first lesion and 10004 for each additional distinct lesion sampled without imaging guidance. Repeated needle passes into the same lesion do not make it an additional lesion.

Does 10021 include cytology interpretation?

It reports the aspiration procedure, not the separate cytologic examination. The examination may be reported separately when performed and supported.

What documentation supports 10021?

Identify the lesion and its site, document the aspiration and specimen obtained, and make clear that imaging guidance was not used. Distinguish each separately sampled lesion.

How does the multiple procedure reduction affect 10021?

When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%. The payment order depends on the relative values of the procedures performed.

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
RVUs for 10021PPRRVU2026_Oct_nonQPP.csv, line 1,072 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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