$56.84–$58.55
10005 covers the first lesion sampled with ultrasound guidance. Use 10006 for each additional lesion sampled with that guidance.
On this page
CMS RVU26D · Effective 2026-10-01
10005 Ultrasound-guided FNA Medicare reimbursement rates in Maine
Ultrasound-guided fine-needle aspiration biopsy of the first lesion, commonly used to sample a thyroid nodule, lymph node, or other accessible target. Compare 10005 office and facility rates across CMS payment localities in Maine.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 10005 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$123.79–$129.46
2 of 2 localities have a supported rate.
Facility setting
$59.57–$60.28
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Image-guided biopsy
About 10005: Ultrasound-guided fine-needle aspiration biopsy
Ultrasound-guided fine-needle aspiration biopsy of the first lesion, commonly used to sample a thyroid nodule, lymph node, or other accessible target.
A clinician uses ultrasound to guide a fine needle into a lesion and aspirate cells or fluid for diagnostic evaluation. Common targets include thyroid nodules and enlarged lymph nodes; radiologists, endocrinologists, surgeons, and other clinicians may perform the procedure in an office or hospital setting. The code represents the first lesion sampled with ultrasound guidance, not a core-needle tissue biopsy.
Report 10005 for the first lesion and 10006 for each additional lesion sampled using ultrasound guidance during the session. The record should support the target lesion, ultrasound guidance, and performance of the aspiration. Ultrasound guidance is included in this service. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces payment for the others by 50%.
CMS billing rules for 10005
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU1.42 · 36%
- Practice expense (office) RVU2.37 · 60%
- Malpractice RVU0.17 · 4%
132.9K
Medicare services in 2024 · #484 by national volume
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.
10005 compared with similar codes
Office rates for Maine, from the same CMS release.
$94.08–$98.58
10021 is for fine-needle aspiration biopsy without imaging guidance; 10005 includes ultrasound guidance.
$318.83–$338.55
Both cover the first lesion, but 10007 uses fluoroscopic guidance rather than ultrasound.
$383.09–$406.68
Both cover the first lesion, but 10009 uses CT guidance rather than ultrasound.
Compare 10005 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$123.79
Facility
$59.57
Southern Maine →
Office / nonfacility
$129.46
Facility
$60.28
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
10005 billing questions
When should 10005 be used instead of 10021?
Use 10005 when ultrasound guides the aspiration. Code 10021 describes fine-needle aspiration biopsy without imaging guidance.
How are additional lesions reported?
Report 10005 for the first lesion and 10006 for each additional lesion sampled with ultrasound guidance in the session. Count distinct lesions, not needle passes.
Can ultrasound guidance be billed separately?
No. Ultrasound guidance is included in 10005 for the aspiration it guides.
Does a core-needle biopsy qualify for 10005?
No. This code is for fine-needle aspiration, which collects cells or fluid; it does not describe a core-needle tissue biopsy.
What documentation supports reporting 10005?
Document the lesion sampled, the fine-needle aspiration, and use of ultrasound guidance. The record should distinguish the first lesion from any additional lesions reported with 10006.
How does CMS handle multiple procedures in the same session?
CMS pays the highest-valued procedure in full and reduces payment for the other procedures by 50% when multiple procedures are performed in the same session.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,0580998T,,Precuneus mag stimj tx dlvr,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,0590999T,,Autol musc cell therapy hrvg,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,06010004,,Fna bx w/o img gdn ea addl,A,,0.78,0.68,,0.19,,0.13,1.59,1.10,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,06110005,,Fna bx w/us gdn 1st les,A,,1.42,2.37,,0.28,,0.17,3.96,1.87,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,06210006,,Fna bx w/us gdn ea addl,A,,0.98,0.71,,0.20,,0.11,1.80,1.29,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,06310007,,Fna bx w/fluor gdn 1st les,A,,1.76,8.28,,0.37,,0.27,10.31,2.40,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,06410008,,Fna bx w/fluor gdn ea addl,A,,1.15,2.93,,0.11,,0.15,4.23,1.41,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00