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10005 Fna bx w/us gdn 1st les

What 10005 is

CMS fee schedule short descriptor: Fna bx w/us gdn 1st les.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 10005 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.422.370.173.96$132.27
Facility (hospital, ASC)1.420.280.171.87$62.46

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

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Medically Unlikely Edit (MUE)

Medicare caps 10005 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 10005? These codes are bundled into it

10005 is a Column 1 code in 57 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0213TNjx paravert w/us cer/thor1 - modifier may bypassCheck pair
0216TNjx paravert w/us lumb/sac1 - modifier may bypassCheck pair
10004Fna bx w/o img gdn ea addl1 - modifier may bypassCheck pair
10008Fna bx w/fluor gdn ea addl1 - modifier may bypassCheck pair
10010Fna bx w/ct gdn ea addl1 - modifier may bypassCheck pair
10011Fna bx w/mr gdn 1st les1 - modifier may bypassCheck pair
10012Fna bx w/mr gdn ea addl1 - modifier may bypassCheck pair
10021Fna bx w/o img gdn 1st les1 - modifier may bypassCheck pair
10035Plmt sft tiss loclzj dev 1st1 - modifier may bypassCheck pair
11102Tangntl bx skin single les1 - modifier may bypassCheck pair
11103Tangntl bx skin ea sep/addl1 - modifier may bypassCheck pair
11104Punch bx skin single lesion1 - modifier may bypassCheck pair
11105Punch bx skin ea sep/addl1 - modifier may bypassCheck pair
11106Incal bx skn single les1 - modifier may bypassCheck pair
11107Incal bx skn ea sep/addl1 - modifier may bypassCheck pair
19281Perq device breast 1st imag1 - modifier may bypassCheck pair
19283Perq dev breast 1st strtctc1 - modifier may bypassCheck pair
19285Perq dev breast 1st us imag1 - modifier may bypassCheck pair
19287Perq dev breast 1st mr guide1 - modifier may bypassCheck pair
36000Place needle in vein1 - modifier may bypassCheck pair
36410Vnpnxr 3yr/> phy/qhp dx/ther1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
61650Evasc prlng admn rx agnt 1st1 - modifier may bypassCheck pair
62324Njx interlaminar crv/thrc1 - modifier may bypassCheck pair
62325Njx interlaminar crv/thrc1 - modifier may bypassCheck pair
62326Njx interlaminar lmbr/sac1 - modifier may bypassCheck pair
62327Njx interlaminar lmbr/sac1 - modifier may bypassCheck pair
64415Njx aa&/strd brch plxs img1 - modifier may bypassCheck pair
64416Njx aa&/strd brch pl nfs img1 - modifier may bypassCheck pair

Showing 30 of 57 column 2 codes. Use the pair checker for any specific combination.

10005 is bundled into these codes

10005 appears as a Column 2 code in 366 active edits. Reported with one of these Column 1 codes on the same date of service, 10005 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0200TPerq sacral augmt unilat inj1Check pair
0201TPerq sacral augmt bilat inj1Check pair
0653TEgd flx transnasal bx 1/mlt1Check pair
0673TAbltj b9 thyr ndul perq lasr1Check pair
0782TBrnchsc rf dstrj plm nrv uni1Check pair
10007Fna bx w/fluor gdn 1st les1Check pair
10009Fna bx w/ct gdn 1st les1Check pair
11755Biopsy nail unit1Check pair
19081Bx breast 1st lesion strtctc1Check pair
19082Bx breast add lesion strtctc1Check pair
19083Bx breast 1st lesion us imag1Check pair
19084Bx breast add lesion us imag1Check pair
19085Bx breast 1st lesion mr imag1Check pair
19086Bx breast add lesion mr imag1Check pair
19100Bx breast percut w/o image1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.