FeeBase
Log inGet started
Menu

CPT code 10021: Fine needle aspiration, first lesion, no imaging2026 Medicare rate & RVUs in Hawaii, Guam, HI

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 Hawaii, Guam, HI, Medicare pays $107.50 for 10021 in the office and $45.22 when it’s performed in a hospital or facility.

$107.50Office (non-facility)
$45.22Hospital or facility
+6.6%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 Hawaii, Guam, HI
  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 Hawaii, Guam, HI 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. Hawaii, Guam, HI pays $107.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

10021 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$107.50
  2. Los Angeles, CA · California$112.16+$4.66
  3. Washington, DC area · District of Columbia$114.38+$6.88
  4. Miami, FL · Florida$110.60+$3.10
  5. Chicago, IL · Illinois$107.47−$0.03
  6. Manhattan, NY · New York$115.92+$8.42
  7. Alaska · Alaska$119.55+$12.05

Other areas in Hawaii first, then benchmark localities. Bars start at $0.

Every other payment area

10021 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$90.99$43.06
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

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 Hawaii, Guam, HI 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

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 10021 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0001.0000
Practice expense1.88× 1.1372.1376
Malpractice0.14× 0.5790.0811
Total RVUs3.2186
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$107.50

Office: (1 × 1 + 1.88 × 1.137 + 0.14 × 0.579) × $33.4009 = $107.50

Facility: (1 × 1 + 0.24 × 1.137 + 0.14 × 0.579) × $33.4009 = $45.22

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, Hawaii, Guam, HI
Add-on codes
10004Fine needle aspiration, each additional lesionAdd-on code for each additional lesion aspirated without imaging guidance.$54.39
Used instead
10005Ultrasound-guided FNA, first lesionFirst-lesion FNA when ultrasound guidance is used.$140.72
10007Fine needle aspiration, fluoroscopy, first lesionFirst-lesion FNA when fluoroscopic guidance is used.$378.46
Often billed with
88173FNA cytology, final interpretation and reportCytopathology evaluation of an FNA specimen may be separately reported when performed.$182.35

How 10021 has changed in Hawaii, Guam, HI

10021 · Office / nonfacility

$107.50

Effective 2026-10-01

The base rate is $3.08 higher than on 2025-10-01, moving from $104.42 to $107.50 (2.9%).

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

    $104.42changed to$107.50

    • 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
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $108.42changed to$104.42

    • 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

    $106.65changed to$108.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $110.95changed to$106.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.88 changed to 1.87
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $112.77changed to$110.95

    • 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 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.38changed to$112.77

    • 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

    $108.13changed to$113.38

    • 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 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $106.75changed to$108.13

    • 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 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $133.27changed to$106.75

    • 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

    $133.50changed to$133.27

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $134.66changed to$133.50

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.05 changed to 2.03
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $165.85changed to$134.66

    • 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

    $165.02changed to$165.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $163.38changed to$165.02

    • 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 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $167.81changed to$163.38

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$167.81

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$107.50$45.22RVU26D
2026-07-01$107.50$45.22RVU26C
2026-04-01$107.50$45.22RVU26B
2026-01-01$107.50$45.22RVU26A
2025-10-01$104.42$53.51RVU25D
2025-07-01$104.42$53.51RVU25C
2025-04-01$104.42$53.51RVU25B
2025-01-01$104.42$53.51RVU25A
2024-10-01$108.42$54.49RVU24D
2024-07-01$108.42$54.49RVU24C
2024-04-01$108.42$54.49RVU24B
2024-03-09$108.42$54.49RVU24AR
2024-01-01$106.65$53.60RVU24A
2023-10-01$110.95$55.80RVU23D
2023-07-01$110.95$55.80RVU23C
2023-04-01$110.95$55.80RVU23B
2023-01-01$110.95$55.80RVU23A
2022-10-01$112.77$56.60RVU22D
2022-07-01$112.77$56.60RVU22C
2022-04-01$112.77$56.60RVU22B
2022-01-01$112.77$56.60RVU22A
2021-10-01$113.38$57.15RVU21D
2021-07-01$113.38$57.15RVU21C
2021-04-01$113.38$57.15RVU21B
2021-01-01$113.38$57.15RVU21A
2020-10-01$108.13$58.58RVU20D
2020-07-01$108.13$58.58RVU20C
2020-04-01$108.13$58.58RVU20B
2020-01-01$108.13$58.58RVU20A
2019-10-01$106.75$58.43RVU19D
2019-07-01$106.75$58.43RVU19C
2019-04-01$106.75$58.43RVU19B
2019-01-01$106.75$58.43RVU19A
2018-10-01$133.27$72.21RVU18D
2018-07-01$133.27$72.21RVU18C
2018-04-01$133.27$72.21RVU18B
2018-01-01$133.27$72.21RVU18AR1
2017-10-01$133.50$72.62RVU17D
2017-07-01$133.50$72.62RVU17C
2017-04-01$133.50$72.62RVU17B
2017-01-01$133.50$72.62RVU17A
2016-10-01$134.66$72.67RVU16D
2016-07-01$134.66$72.67RVU16C
2016-04-01$134.66$72.67RVU16B
2016-01-01$134.66$72.67RVU16A
2015-10-01$165.85$72.73RVU15D
2015-07-01$165.85$72.73RVU15C
2015-04-01$165.02$72.37RVU15B
2015-01-01$165.02$72.37RVU15A
2014-10-01$163.38$73.36RVU14D
2014-07-01$163.38$73.36RVU14C
2014-04-01$163.38$73.36RVU14B
2014-01-01$163.38$73.36RVU14A
2013-10-01$167.81$71.61RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 10021 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

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 Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 10021 pays in Hawaii, Guam, HI?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 10021 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist