CPT code 10009: FNA biopsy2026 Medicare rate & RVUs
Reports CT-guided fine-needle aspiration of the initial lesion when a clinician uses imaging to direct needle sampling for cytologic evaluation.
Medicare pays $412.50 for 10009 nationally in the office and $93.19 in a hospital or facility. Local office rates run $362.06–$563.47.
Medicare rate · 10009
FNA biopsy
- Work RVUs
- 2.2
- Total RVUs
- 12.35
- Global days
- XXX
National rate · 2026
$412.50
Office setting, before claim adjustments.
See every locality for 10009 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 10009 covers
A clinician advances a fine needle into a lesion while using CT images to plan and guide sampling. The needle collects cells or fluid for cytologic evaluation rather than a core of tissue. Radiologists and interventional radiologists commonly perform this service for lesions that need image-guided access, such as a lung or deep soft-tissue mass, in an outpatient imaging department or hospital setting.
Report 10009 for the first lesion sampled with CT guidance. For another distinct lesion sampled during the same session with CT guidance, use the applicable additional-lesion code rather than reporting another first-lesion service. The record should identify the target lesion or site, CT guidance, and the aspiration sampling performed. CT guidance is part of this service; cytology interpretation is a separate service when performed and appropriately reported. Under the standard multiple procedure reduction, the highest-valued procedure in the same session is paid in full and other procedures are paid 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.
Where 10009 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$362.06 to $563.47
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $367.75 | $88.35 |
| Alaska | $467.33 | $127.26 |
| Arizona | $401.12 | $91.71 |
| Arkansas | $362.06 | $87.77 |
| Atlanta, GA | $419.57 | $95.15 |
| Austin, TX | $430.99 | $93.16 |
| Bakersfield, CA | $442.70 | $92.74 |
| Baltimore area, MD | $439.69 | $97.06 |
| Beaumont, TX | $382.14 | $91.56 |
| Brazoria, TX | $408.42 | $91.98 |
| Chicago, IL | $424.62 | $103.71 |
| Chico, CA | $441.99 | $92.03 |
| Colorado | $432.91 | $93.16 |
| Connecticut | $441.10 | $97.20 |
| Dallas, TX | $410.75 | $92.71 |
| Delaware | $408.12 | $92.64 |
| Detroit, MI | $406.17 | $98.04 |
| East St. Louis, IL | $393.78 | $100.02 |
| El Centro, CA | $442.03 | $92.07 |
| Fort Lauderdale, FL | $423.02 | $99.55 |
| Fort Worth, TX | $407.53 | $92.69 |
| Fresno, CA | $441.99 | $92.03 |
| Galveston, TX | $409.45 | $92.37 |
| Hanford, CA | $441.99 | $92.03 |
| Hawaii, Guam, HI | $454.66 | $91.60 |
| Houston, TX | $413.66 | $96.58 |
| Idaho | $381.95 | $88.18 |
| Indiana | $384.36 | $88.36 |
| Iowa | $379.71 | $87.53 |
| Kansas | $376.88 | $88.22 |
| Kentucky | $375.07 | $91.20 |
| King County, WA | $489.98 | $98.19 |
| Los Angeles, CA | $473.57 | $95.82 |
| Madera, CA | $441.99 | $92.03 |
| Manhattan, NY | $475.38 | $104.34 |
| Marin County, CA | $551.17 | $100.94 |
| Merced, CA | $441.99 | $92.03 |
| Metropolitan Boston, MA | $478.95 | $97.69 |
| Metropolitan Kansas City, MO | $392.11 | $92.28 |
| Metropolitan Philadelphia, PA | $428.89 | $96.49 |
| Metropolitan St. Louis, MO | $396.61 | $92.63 |
| Miami, FL | $437.83 | $105.43 |
| Minnesota | $416.70 | $88.13 |
| Mississippi | $364.44 | $89.51 |
| Modesto, CA | $441.99 | $92.03 |
| Montana | $412.49 | $93.17 |
| Napa, CA | $518.72 | $97.86 |
| Nebraska | $382.21 | $87.48 |
| Nevada | $411.55 | $91.92 |
| New Hampshire | $425.13 | $92.72 |
| New Mexico | $386.54 | $93.73 |
| New Orleans, LA | $394.00 | $93.52 |
| North Carolina | $387.53 | $89.61 |
| North Dakota | $407.94 | $88.63 |
| Northern New Jersey | $470.67 | $100.26 |
| NYC suburbs and Long Island, NY | $486.41 | $106.75 |
| Ohio | $383.74 | $92.20 |
| Oklahoma | $375.33 | $90.19 |
| Oxnard, CA | $471.97 | $94.54 |
| Portland, OR | $448.49 | $93.73 |
| Poughkeepsie and northern NYC suburbs, NY | $448.90 | $99.25 |
| Puerto Rico | $416.03 | $93.21 |
| Queens, NY | $480.90 | $103.48 |
| Redding, CA | $441.99 | $92.03 |
| Rest of California | $441.99 | $92.03 |
| Rest of Florida | $401.79 | $96.52 |
| Rest of Georgia | $378.19 | $93.36 |
| Rest of Illinois | $388.00 | $96.47 |
| Rest of Louisiana | $374.07 | $91.48 |
| Rest of Maine | $383.09 | $89.32 |
| Rest of Maryland | $416.58 | $93.44 |
| Rest of Massachusetts | $429.68 | $93.44 |
| Rest of Michigan | $384.67 | $93.13 |
| Rest of Missouri | $366.58 | $91.33 |
| Rest of New Jersey | $446.67 | $97.98 |
| Rest of New York | $393.65 | $90.31 |
| Rest of Oregon | $408.89 | $90.86 |
| Rest of Pennsylvania | $384.91 | $91.78 |
| Rest of Texas | $394.86 | $91.83 |
| Rest of Washington | $429.18 | $92.95 |
| Rhode Island | $424.00 | $94.15 |
| Riverside, CA | $444.50 | $94.54 |
| Sacramento, CA | $465.59 | $94.23 |
| Salinas, CA | $463.90 | $93.81 |
| San Benito County, CA | $563.47 | $103.02 |
| San Diego, CA | $476.13 | $94.23 |
| San Francisco, CA | $550.91 | $100.68 |
| San Luis Obispo, CA | $456.24 | $92.54 |
| Santa Clara County, CA | $562.40 | $101.95 |
| Santa Cruz, CA | $481.72 | $93.75 |
| Santa Maria, CA | $466.00 | $93.68 |
| Santa Rosa, CA | $486.69 | $94.57 |
| South Carolina | $386.17 | $91.12 |
| South Dakota | $407.40 | $88.09 |
| Southern Maine, ME | $406.68 | $90.25 |
| Stockton, CA | $441.99 | $92.03 |
| Suburban Chicago, IL | $427.89 | $99.96 |
| Tennessee | $378.79 | $88.54 |
| Utah | $391.84 | $91.68 |
| Vallejo, CA | $518.34 | $97.49 |
| Vermont | $405.39 | $89.27 |
| Virgin Islands, VI | $416.03 | $93.21 |
| Virginia | $404.61 | $90.73 |
| Visalia, CA | $441.99 | $92.03 |
| Washington, DC area | $476.32 | $100.16 |
| West Virginia | $372.41 | $94.92 |
| Wisconsin | $393.27 | $87.37 |
| Wyoming | $410.50 | $91.19 |
| Yuba City, CA | $441.99 | $92.03 |
10009 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$362.06
$502.73
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $467.33 | 1 |
| AL | $367.75 | 1 |
| AR | $362.06 | 1 |
| AZ | $401.12 | 1 |
| CA | $441.99–$563.47 | 29 |
| CO | $432.91 | 1 |
| CT | $441.10 | 1 |
| DC | $476.32 | 1 |
| DE | $408.12 | 1 |
| FL | $401.79–$437.83 | 3 |
| GA | $378.19–$419.57 | 2 |
| GU | $454.66 | 1 |
| HI | $454.66 | 1 |
| IA | $379.71 | 1 |
| ID | $381.95 | 1 |
| IL | $388.00–$427.89 | 4 |
| IN | $384.36 | 1 |
| KS | $376.88 | 1 |
| KY | $375.07 | 1 |
| LA | $374.07–$394.00 | 2 |
| MA | $429.68–$478.95 | 2 |
| MD | $416.58–$476.32 | 3 |
| ME | $383.09–$406.68 | 2 |
| MI | $384.67–$406.17 | 2 |
| MN | $416.70 | 1 |
| MO | $366.58–$396.61 | 3 |
| MS | $364.44 | 1 |
| MT | $412.49 | 1 |
| NC | $387.53 | 1 |
| ND | $407.94 | 1 |
| NE | $382.21 | 1 |
| NH | $425.13 | 1 |
| NJ | $446.67–$470.67 | 2 |
| NM | $386.54 | 1 |
| NV | $411.55 | 1 |
| NY | $393.65–$486.41 | 5 |
| OH | $383.74 | 1 |
| OK | $375.33 | 1 |
| OR | $408.89–$448.49 | 2 |
| PA | $384.91–$428.89 | 2 |
| PR | $416.03 | 1 |
| RI | $424.00 | 1 |
| SC | $386.17 | 1 |
| SD | $407.40 | 1 |
| TN | $378.79 | 1 |
| TX | $382.14–$430.99 | 8 |
| UT | $391.84 | 1 |
| VA | $404.61–$476.32 | 2 |
| VI | $416.03 | 1 |
| VT | $405.39 | 1 |
| WA | $429.18–$489.98 | 2 |
| WI | $393.27 | 1 |
| WV | $372.41 | 1 |
| WY | $410.50 | 1 |
How the 10009 rate is calculated
Each of 10009’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 · 10009
RVUs × geographic indexes × conversion factor
Work2.20
2.20 RVUs× 1.000 GPCI
Practice expense9.92
9.92 RVUs× 1.000 GPCI
Malpractice0.23
0.23 RVUs× 1.000 GPCI
Adjusted RVUs
12.3500
Conversion factor
$33.4009
Medicare rate
$412.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 10009
The CMS indicators that decide how 10009 is paid alongside other services.
CMS payment indicators · 10009
FNA biopsy
| 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
10009 without 51 · national office
$412.50
FNA biopsy
10009-51 · Second procedure: 50%
$206.25
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%).
10009 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 10010Fine needle aspiration
- 10009 is for the initial lesion sampled with CT guidance; 10010 is for each additional lesion sampled with CT guidance during the session.
- 10005Ultrasound-guided FNA
- Both report image-guided FNA of the first lesion, but 10005 uses ultrasound guidance and 10009 uses CT guidance.
- 10021Fine needle aspiration
- 10021 is for first-lesion FNA without imaging guidance. Use 10009 when CT guides needle placement.
10009 billing questions
When should 10009 be selected instead of an unguided FNA code?
Use 10009 when CT images guide needle placement for the initial lesion. If the FNA is performed without imaging guidance, select the code for an unguided first-lesion FNA instead.
Does 10009 include the CT guidance?
Yes. The code represents the FNA biopsy with CT guidance, so the guidance for that sampling is included in the service.
How is a second lesion handled in the same session?
For another distinct lesion sampled with CT guidance during the session, report 10010 for the additional lesion rather than another 10009.
What documentation supports reporting 10009?
Document the target lesion or site, that CT was used to guide the needle, and that fine-needle aspiration sampling was performed.
How does the multiple procedure reduction affect payment?
When multiple procedures subject to the standard rule are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
Is cytology interpretation included in 10009?
10009 covers the CT-guided needle sampling, not interpretation of the specimen. Cytology may be reported separately when that service is performed and appropriately documented.
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
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