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See a sample rate comparisonCPT 10004 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Fine Needle Aspiration Biopsy, Fine Needle Aspiration Biopsy Without Imaging Guidance Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery General Surgical Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 10004 |
| Medicaid Fee Schedule | View Medicaid rates for 10004 |
National average reimbursement for CPT 10004 by major payers:
$64.55
$68.68
$61.09
$79.90
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CPT 10004
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc., Emory Aesthetic Center
Emory University
$1,250.00Published rateAesthetic & General Dermatology Of Seattle
Elie Levy, M.D., P.C. Dba Aesthetic & General Dermatology Of Seattle
$300.00Published rateHuron Gastro Endoscopy Center LLC, Huron Gastro Center For Digestive Care
Huron Gastro Endoscopy Center LLC
$143.00Published rateNational Surgical Centers Of America LLC, Nscoa The Villages
National Surgical Centers Of America LLC
$100.00Published rateEndoscopy Center Of North Carolina
$42.00Published rate
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See a sample payer proposalCPT 10004 vs. Other General Surgical Procedures Codes
The CPT 10004 code is part of the Surgery services used for General Surgical Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 10004 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 10004-CPT | Low | Fine Needle Aspiration Biopsy, Fine Needle Aspiration Biopsy Without Imaging Guidance Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10005-CPT | Low | Obtain Tissue Through A Needle, Biopsy In Which A Thin Hollow Needle Is Inserted Through The Skin Guided By Ultrasound Into A Mass Or Fluid To Collect A Sample. |
| 10006-CPT | Low | Fine Needle Aspiration Biopsy, Fine Needle Aspiration Biopsy Including Ultrasound Guidance Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10007-CPT | Moderate | Sample Tissue Using A Needle, Removal Of Body Fluid Or Tissue By Aspiration (Suction) Using A Fine Needle. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10004. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10004 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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