Billing code 10021: Fine needle aspirationMedicare rate & RVUs in Utah
Reports needle aspiration of a first lesion for cell or fluid sampling when the clinician performs the procedure without imaging guidance.
Medicare pays $96.63 for 10021 in the office in Utah (Utah). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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.
10021 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $96.63 | $45.14 |
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
Swap in your local Medicare rate.
Work 1.00Practice expense 1.88Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| 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
10021 without 51 · national office
$100.87
Fine needle aspiration
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%).
10021 compared with similar codes
Compare codes
10021 vs 10004 vs 10005 vs 10007: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 10004Fine needle aspiration
- 10021 represents the first lesion sampled without imaging guidance; 10004 represents each additional distinct lesion sampled that way.
- 10005Ultrasound-guided FNA
- Both report FNA of a first lesion, but 10005 includes ultrasound guidance and 10021 is performed without imaging guidance.
- 10007Fine needle aspiration
- Use 10007 when fluoroscopy guides the FNA of the first lesion; use 10021 when the aspiration is not image guided.
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
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