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.
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 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 1 - modifier may bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 1 - modifier may bypass | Check pair |
10004 | Fna bx w/o img gdn ea addl | 1 - modifier may bypass | Check pair |
10006 | Fna bx w/us gdn ea addl | 1 - modifier may bypass | Check pair |
10008 | Fna bx w/fluor gdn ea addl | 1 - modifier may bypass | Check pair |
10010 | Fna bx w/ct gdn ea addl | 1 - modifier may bypass | Check pair |
10035 | Plmt sft tiss loclzj dev 1st | 1 - modifier may bypass | Check pair |
19281 | Perq device breast 1st imag | 1 - modifier may bypass | Check pair |
19283 | Perq dev breast 1st strtctc | 1 - modifier may bypass | Check pair |
19285 | Perq dev breast 1st us imag | 1 - modifier may bypass | Check pair |
19287 | Perq dev breast 1st mr guide | 1 - modifier may bypass | Check pair |
36000 | Place needle in vein | 1 - modifier may bypass | Check pair |
36410 | Vnpnxr 3yr/> phy/qhp dx/ther | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
61650 | Evasc prlng admn rx agnt 1st | 1 - modifier may bypass | Check pair |
62324 | Njx interlaminar crv/thrc | 1 - modifier may bypass | Check pair |
62325 | Njx interlaminar crv/thrc | 1 - modifier may bypass | Check pair |
62326 | Njx interlaminar lmbr/sac | 1 - modifier may bypass | Check pair |
62327 | Njx interlaminar lmbr/sac | 1 - modifier may bypass | Check pair |
64415 | Njx aa&/strd brch plxs img | 1 - modifier may bypass | Check pair |
64416 | Njx aa&/strd brch pl nfs img | 1 - modifier may bypass | Check pair |
64417 | Njx aa&/strd ax nerve img | 1 - modifier may bypass | Check pair |
64450 | Njx aa&/strd other pn/branch | 1 - modifier may bypass | Check pair |
64454 | Njx aa&/strd gnclr nrv brnch | 1 - modifier may bypass | Check pair |
64473 | Lwr xtr fscl pln blk uni njx | 1 - modifier may bypass | Check pair |
64474 | Lwr xtr fscl pln blk uni nfs | 1 - modifier may bypass | Check pair |
64486 | Tap block unil by injection | 1 - modifier may bypass | Check pair |
64487 | Tap block uni by infusion | 1 - modifier may bypass | Check pair |
64488 | Tap block bi injection | 1 - modifier may bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0200T | Perq sacral augmt unilat inj | 1 | Check pair |
0201T | Perq sacral augmt bilat inj | 1 | Check pair |
0653T | Egd flx transnasal bx 1/mlt | 1 | Check pair |
0673T | Abltj b9 thyr ndul perq lasr | 1 | Check pair |
0782T | Brnchsc rf dstrj plm nrv uni | 1 | Check pair |
10005 | Fna bx w/us gdn 1st les | 1 | Check pair |
10007 | Fna bx w/fluor gdn 1st les | 1 | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 | Check pair |
10021 | Fna bx w/o img gdn 1st les | 1 | Check pair |
11102 | Tangntl bx skin single les | 1 | Check pair |
11103 | Tangntl bx skin ea sep/addl | 1 | Check pair |
11104 | Punch bx skin single lesion | 1 | Check pair |
11105 | Punch bx skin ea sep/addl | 1 | Check pair |
11106 | Incal bx skn single les | 1 | Check pair |
11107 | Incal bx skn ea sep/addl | 1 | Check 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.