CPT 10010 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 | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • UA • GC - Service performed by resident under supervision • RT - Right side of body • MG - The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional |
| Complexity Level | Moderate |
National average reimbursement for CPT 10010 by major payers:
$291.34
$363.69
$288.28
$441.85
| 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 10010 | ||||||
United | 10010 | $130.00 | 1588663512 - THOMAS EYE SURGERY CENTER LLC | 582464498 - (GA) THOMAS EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $70.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $152.00 | 1407251622 - MASSAC COUNTY SURGERY CENTER LLC, THE ORTHOPAEDIC INSTITUTE SURGERY CENTER | 464314954 - (IL) MASSAC COUNTY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $200.00 | 1568460889 - EYE ASSOCIATES OF MANATEE LLP, EYE ASSOCIATES SURGERY CENTER | 650105559 - (FL) THE EYE ASSOCIATES | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $1306.00 | 1992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER | 223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $82.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $574.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $164.00 | 1366181778 - AXION SPINE OUTPATIENT SURGERY CENTER | 881709019 - (GA) AXION SPINE OUTPATIENT SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $531.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $200.00 | 1326444688 - BRYAN COLLEGE STATION ASC, LP, THE HEART AND VASCULAR SURGERY CENTER | 471615354 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $126.00 | 1225286354 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $574.00 | 1427003052 - EYE SURGERY CENTER OF NASHVILLE LLC | 621872622 - (TN) EYE SURGERY CENTER OF NASHVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $1492.00 | 1255787867 - THE METROHEALTH SYSTEM, METROHEALTH SYSTEM PARMA AMBULATORY SURGERY CENTER | 346004382 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $574.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10010 | $150.00 | 1407202484 - SPORTSORTHO SURGERY CENTER LLC | 811465819 - (TX) SPORTSORTHO SURGERY CENTER LLC | TX | 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 10010 vs. Other General Surgical Procedures Codes
The CPT 10010 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 10010 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) |
| 10010-CPT | Moderate | Fine Needle Aspiration Biopsy Including Ct Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10010 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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