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CPT code 10021: Fine needle aspiration, first lesion, no imaging2026 Medicare rate & RVUs in Virgin Islands, VI

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 Virgin Islands, VI, Medicare pays $101.49 for 10021 in the office and $46.11 when it’s performed in a hospital or facility.

$101.49Office (non-facility)
$46.11Hospital or facility
+0.6%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 Virgin Islands, VI
  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 Virgin Islands, VI 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. Virgin Islands, VI pays $101.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

10021 in Virgin Islands, VI vs other payment areas
  1. Virgin Islands, VI · this page$101.49
  2. Los Angeles, CA · California$112.16+$10.67
  3. Washington, DC area · District of Columbia$114.38+$12.89
  4. Miami, FL · Florida$110.60+$9.11
  5. Chicago, IL · Illinois$107.47+$5.98
  6. Manhattan, NY · New York$115.92+$14.43
  7. Alaska · Alaska$119.55+$18.06

Other areas in United States Virgin Islands 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 Virgin Islands, VI 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

107

Locality
Virgin Islands, VI
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 10021 in Virgin Islands, VI
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0001.0000
Practice expense1.88× 1.0111.9007
Malpractice0.14× 0.9850.1379
Total RVUs3.0386
Conversion factor× 33.4009

Office rate, Virgin Islands, VI$101.49

Office: (1 × 1 + 1.88 × 1.011 + 0.14 × 0.985) × $33.4009 = $101.49

Facility: (1 × 1 + 0.24 × 1.011 + 0.14 × 0.985) × $33.4009 = $46.11

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, Virgin Islands, VI
Add-on codes
10004Fine needle aspiration, each additional lesionAdd-on code for each additional lesion aspirated without imaging guidance.$53.29
Used instead
10005Ultrasound-guided FNA, first lesionFirst-lesion FNA when ultrasound guidance is used.$133.05
10007Fine needle aspiration, fluoroscopy, first lesionFirst-lesion FNA when fluoroscopic guidance is used.$347.27
Often billed with
88173FNA cytology, final interpretation and reportCytopathology evaluation of an FNA specimen may be separately reported when performed.$167.96

How 10021 has changed in Virgin Islands, VI

10021 · Office / nonfacility

$101.49

Effective 2026-10-01

The base rate is $3.47 higher than on 2025-10-01, moving from $98.02 to $101.49 (3.5%).

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

    $98.02changed to$101.49

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $101.55changed to$98.02

    • 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

    $99.89changed to$101.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $103.79changed to$99.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.88 changed to 1.87
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $103.36changed to$103.79

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $104.97changed to$103.36

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $105.83changed to$104.97

    • 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.

  8. January 1, 2021

    RVU21A

    $101.47changed to$105.83

    • 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
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $100.54changed to$101.47

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $125.37changed to$100.54

    • 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.

  11. January 1, 2018

    RVU18AR1

    $124.93changed to$125.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.006 changed to 1.007
    • Malpractice GPCI 0.993 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $122.00changed to$124.93

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.05 changed to 2.03
    • Practice expense GPCI 0.960 changed to 1.006
    • Malpractice GPCI 0.996 changed to 0.993

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $147.98changed to$122.00

    • 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.

  14. July 1, 2015

    RVU15C

    $147.24changed to$147.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $150.87changed to$147.24

    • 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
    • Practice expense GPCI 1.004 changed to 0.960
    • Malpractice GPCI 1.003 changed to 0.996

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $154.41changed to$150.87

    • 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
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 1.010 changed to 1.003

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $154.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$101.49$46.11RVU26D
2026-07-01$101.49$46.11RVU26C
2026-04-01$101.49$46.11RVU26B
2026-01-01$101.49$46.11RVU26A
2025-10-01$98.02$53.39RVU25D
2025-07-01$98.02$53.39RVU25C
2025-04-01$98.02$53.39RVU25B
2025-01-01$98.02$53.39RVU25A
2024-10-01$101.55$54.28RVU24D
2024-07-01$101.55$54.28RVU24C
2024-04-01$101.55$54.28RVU24B
2024-03-09$101.55$54.28RVU24AR
2024-01-01$99.89$53.40RVU24A
2023-10-01$103.79$55.28RVU23D
2023-07-01$103.36$55.24RVU23C
2023-04-01$103.36$55.24RVU23B
2023-01-01$103.36$55.24RVU23A
2022-10-01$104.97$55.44RVU22D
2022-07-01$104.97$55.44RVU22C
2022-04-01$104.97$55.44RVU22B
2022-01-01$104.97$55.44RVU22A
2021-10-01$105.83$56.23RVU21D
2021-07-01$105.83$56.23RVU21C
2021-04-01$105.83$56.23RVU21B
2021-01-01$105.83$56.23RVU21A
2020-10-01$101.47$57.81RVU20D
2020-07-01$101.47$57.81RVU20C
2020-04-01$101.47$57.81RVU20B
2020-01-01$101.47$57.81RVU20A
2019-10-01$100.54$58.08RVU19D
2019-07-01$100.54$58.08RVU19C
2019-04-01$100.54$58.08RVU19B
2019-01-01$100.54$58.08RVU19A
2018-10-01$125.37$71.72RVU18D
2018-07-01$125.37$71.72RVU18C
2018-04-01$125.37$71.72RVU18B
2018-01-01$125.37$71.72RVU18AR1
2017-10-01$124.93$71.86RVU17D
2017-07-01$124.93$71.86RVU17C
2017-04-01$124.93$71.86RVU17B
2017-01-01$124.93$71.86RVU17A
2016-10-01$122.00$70.78RVU16D
2016-07-01$122.00$70.78RVU16C
2016-04-01$122.00$70.78RVU16B
2016-01-01$122.00$70.78RVU16A
2015-10-01$147.98$71.05RVU15D
2015-07-01$147.98$71.05RVU15C
2015-04-01$147.24$70.70RVU15B
2015-01-01$147.24$70.70RVU15A
2014-10-01$150.87$72.82RVU14D
2014-07-01$150.87$72.82RVU14C
2014-04-01$150.87$72.82RVU14B
2014-01-01$150.87$72.82RVU14A
2013-10-01$154.41$70.88RVU13D
2013-07-01$154.41$70.88RVU13C
2013-04-01$154.41$70.88RVU13B
2013-01-01$154.41$70.88RVU13AR

Price 10021 for an earlier date of service

Where the Virgin Islands, VI rate applies

Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.

  • Charlotte Amalie
  • Charlotte Amalie East
  • Charlotte Amalie West
  • Christiansted
  • Coral Bay
  • Cruz Bay
  • Frederiksted
  • Frederiksted Southeast

Browse all communities in United States Virgin Islands

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 Virgin Islands, VIGPCI2026.csv, line 107 (RVU26D)

Open CMS sourceHow we calculate rates

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