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10011 Fna bx w/mr gdn 1st les

What 10011 is

CMS fee schedule short descriptor: Fna bx w/mr 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 10011 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 10011 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 10011? These codes are bundled into it

10011 is a Column 1 code in 49 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
10006Fna bx w/us 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
10035Plmt sft tiss loclzj dev 1st1 - 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
64417Njx aa&/strd ax nerve img1 - modifier may bypassCheck pair
64450Njx aa&/strd other pn/branch1 - modifier may bypassCheck pair
64454Njx aa&/strd gnclr nrv brnch1 - modifier may bypassCheck pair
64473Lwr xtr fscl pln blk uni njx1 - modifier may bypassCheck pair
64474Lwr xtr fscl pln blk uni nfs1 - modifier may bypassCheck pair
64486Tap block unil by injection1 - modifier may bypassCheck pair
64487Tap block uni by infusion1 - modifier may bypassCheck pair
64488Tap block bi injection1 - modifier may bypassCheck pair

Showing 30 of 49 column 2 codes. Use the pair checker for any specific combination.

10011 is bundled into these codes

10011 appears as a Column 2 code in 374 active edits. Reported with one of these Column 1 codes on the same date of service, 10011 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
10005Fna bx w/us gdn 1st les1Check pair
10007Fna bx w/fluor gdn 1st les1Check pair
10009Fna bx w/ct gdn 1st les1Check pair
10021Fna bx w/o img gdn 1st les1Check pair
11102Tangntl bx skin single les1Check pair
11103Tangntl bx skin ea sep/addl1Check pair
11104Punch bx skin single lesion1Check pair
11105Punch bx skin ea sep/addl1Check pair
11106Incal bx skn single les1Check pair
11107Incal bx skn ea sep/addl1Check 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.