CPT 10009 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 10009 by major payers:
$496.59
$605.65
$541.52
$762.74
| 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 10009 | ||||||
United | 10009 | $950.00 | 1689635757 - ATLANTICARE SURGERY CENTER LLC | 223491867 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $953.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $587.00 | 1376507194 - COLUMBIA EYE AND SPECIALTY SURGERY CENTER LTD | 752528760 - (FL) COLUMBIA EYE AND SPECIALTY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $425.00 | 1528197191 - RWMC AMBULATORY SURGERY CENTER, LLC, SCOTTSBLUFF SURGERY CENTER | 205026191 - (NE) RWMC AMBULATORY SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $515.00 | 1174850176 - SOUTHWEST OHIO PAIN MANAGEMENT LLC | 300571536 - (OH) SOUTHWEST OHIO PAIN MANAGEMENT | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $950.00 | 1164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $217.00 | 1275574154 - DOCTORS SURGERY CENTER OF TEXARKANA, DOCTOR'S SURGERY CENTER | 710796220 - (AR) DOCTORS SURGERY CENTER OF TEXARKANA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $325.00 | 1528501939 - AMERICAN ACCESS CARE OF FLORIDA ASC LLC, AZURA SURGERY CENTER PLANTATION | 814131878 - (FL) AMERICAN ACCESS CARE OF FLORIDA ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $962.00 | 1619149960 - THE VANCOUVER CLINIC INC PS, THE VANCOUVER CLINIC, AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $661.00 | 1225452303 - MARTHA JEFFERSON HOSPITAL, MARTHA JEFFERSON OUTPATIENT SURGERY CENTER | 540261840 - (VA) MARTHA JEFFERSON HOSPITAL | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $325.00 | 1306892609 - THE CLEARWATER ORTHOPAEDIC ASC LLC, C MED AMBULATORY SURGERY CENTER | 331011433 - (FL) THE CLEARWATER ORTHOPAEDIC ASS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $1418.00 | 1861743601 - FLUSHING ENDOSCOPY CENTER, LLC | 274675522 - (NY) FLUSHING ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $618.00 | 1437101433 - TRI CITY SURGERY CENTER LLC | 201504745 - (AZ) TRI-CITY SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $205.00 | 1699429415 - ST LUKE'S SURGERY CENTER, LLC | 873243012 - A POSITIVE FOCUS COUNSELING LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10009 | $325.00 | 1396277208 - ELITE SURGERY CENTER, LLC | 820836081 - (CA) ELITE SURGERY CENTER LLC | CA | 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 10009 vs. Other General Surgical Procedures Codes
The CPT 10009 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 10009 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) |
| 10009-CPT | Moderate | Fine Needle Aspiration Biopsy Of Growth Using Ct Guidance, First Growth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10009 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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