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See a sample rate comparisonCPT 10012 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 Including Mr 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 23 - Emergency Room |
| Common Modifiers | None 26 - Professional component 95 - Telemedicine - audio and video 62 - Co-Surgeons 52 - Reduced Services RT - Right side of body XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 10012 |
| Medicaid Fee Schedule | View Medicaid rates for 10012 |
National average reimbursement for CPT 10012 by major payers:
$246.63
$296.66
$217.20
$326.00
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CPT 10012
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Fort Worth
Texas Health Harris Methodist Hospital Southwest Fort Worth
$1,551.00Published rateGa Endoscopy Center, LLC
Ga Endoscopy Center LLC
$566.00Published rateDermatology Associates Of Kentucky, Psc
Dermatology Associates Of Kentucky, P.S.C.
$475.55Published rateLivonia Outpatient Surgery Center, LLC
Livonia Outpatient Surgery Center LLC
$179.00Published ratePodiatry Associates Ambulatory Surgical Centers LLC
$45.00Published rate
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See a sample payer proposalCPT 10012 vs. Other General Surgical Procedures Codes
The CPT 10012 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 10012 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) |
| 10012-CPT | Moderate | Fine Needle Aspiration Biopsy, Fine Needle Aspiration Biopsy Including Mr 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 10012. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10012 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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