CPT 10012 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 • 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 |
National average reimbursement for CPT 10012 by major payers:
$246.63
$296.66
$217.20
$347.97
| 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 10012 | ||||||
United | 10012 | $254.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $1029.00 | 1770145351 - TEXAS HEALTH SPINE SURGERY CENTER ALLIANCE LLC | 320571301 - (TX) TEXAS HEALTH SPINE SURGERY CENTER ALLIANCE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $1551.00 | 1538292990 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $1029.00 | 1841295425 - CROSS TIMBERS SURGERY CENTER, LLC, NORTH TEXAS GI CENTER | 752862780 - (TX) CROSS TIMBERS SURGERY CENTER, LP DBA NORTH TEXAS GI CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $92.00 | 1780865634 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND TERAPEUTIC CENTER | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $702.00 | 1639804248 - WILLIS SURGICENTER, LLC | 842342776 - (TX) WILLIS SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $179.00 | 1639476377 - LIVONIA OUTPATIENT SURGERY CENTER, LLC | 261322609 - (MI) LIVONIA OUTPATIENT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $949.84 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $45.00 | 1346308962 - PODIATRY ASSOCIATES AMBULATORY SURGICAL CENTERS LLC | 522210174 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $531.00 | 1245263292 - CHATTANOOGA PAIN MANAGEMENT CENTER LLC, CHATTANOOGA PAIN SURGERY CENTER | 320121593 - (TN) CHATTANOOGA PAIN MANAGEMENT | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $176.00 | 1518373695 - HOLLYWOOD SURGICAL CENTER, LLC | 462573171 - (FL) HOLLYWOOD SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $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 | 10012 | $500.00 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $555.00 | 1215116611 - UPPER BAY SURGERY CENTER, LLC | 205547410 - (MD) UPPER BAY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10012 | $175.00 | 1487014361 - GRIFFIN CENTER FOR PAIN AND SPINE | 814348805 | GA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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, 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) |
| 10012-CPT | Moderate | 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 10012) and we'll show you how you compare in 15 minutes or less.