CPT 10007 Fee Schedule
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.
| 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 | Moderate |
National average reimbursement for CPT 10007 by major payers:
$319.47
$378.97
$327.74
$510.05
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 10007 | ||||||
United | 10007 | $1817.00 | 1295748531 - THE EMORY CLINIC INC, EMORY CLINIC AMBULATORY SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $443.00 | 1073593109 - MARYVILLE ASC, TENNESSEE ENDOSCOPY CENTER | 621587667 - (TN) MARYVILLE ASC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $889.00 | 1093960700 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE HIGHLANDS SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $967.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $636.00 | 1215990247 - SOUTHERN HILLS SURGERY CENTER LP, SOUTHERN HILLS SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $503.00 | 1457331274 - MONTGOMERY EYE SURGERY CENTER LLC, THE MONTGOMERY EYE SURGERY CENTER | 621607284 - (AL) MONTGOMERY EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $1005.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $525.00 | 1841256302 - NEW ENGLAND PAIN CARE | 760718172 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $893.00 | 1306843222 - ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC | 562332449 - (AZ) ST JOSEPHS OUTPATIENT SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $957.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $245.00 | 1164597761 - OUTPATIENT EYE SURGERY CENTER | 721098835 - (LA) OUTPATIENT EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $392.00 | 1477633071 - SURGERY CENTER OF EYE SPECIALISTS OF INDIANA, PC, SURGERY CENTER | 351938206 - (IN) SURGERY CENTER OF EYE SPECIALISTS OF INDIANA PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $726.00 | 1689633588 - SOUTH JERSEY ENDOSCOPY LLC, DIMARINO-KROOP-PRIETO GI ASSOC | 200478348 - (NJ) SOUTH JERSEY ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $341.00 | 1053058255 - INDIANA VASCULAR SURGERY CENTER LLC | 871608290 - (IN) INDIANA VASCULAR SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10007 | $420.00 | 1467472688 - WEST CLINIC ASTC, WEST CLINIC, PC | 621526296 - THE WEST CLINIC, PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 10007 vs. Other General Surgical Procedures Codes
The CPT 10007 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 10007 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, Without Imaging Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10005-CPT | Low | Fine Needle Aspiration Biopsy Including Ultrasound Guidance; First Lesion |
| 10006-CPT | Low | Fine Needle Aspiration Biopsy Including Ultrasound Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10007-CPT | Moderate | Fine Needle Aspiration Biopsy Including Fluoro- Scopic Guidance; First Lesion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10007. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10007 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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