10021 Fna bx w/o img gdn 1st les
What 10021 is
CMS fee schedule short descriptor: Fna bx w/o img 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 10021 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.00 | 1.88 | 0.14 | 3.02 | $100.87 |
| Facility (hospital, ASC) | 1.00 | 0.24 | 0.14 | 1.38 | $46.09 |
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.
Medically Unlikely Edit (MUE)
Medicare caps 10021 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 10021? These codes are bundled into it
10021 is a Column 1 code in 53 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 |
10006 | Fna bx w/us gdn ea addl | 1 - modifier may bypass | Check pair |
10011 | Fna bx w/mr gdn 1st les | 1 - modifier may bypass | Check pair |
10012 | Fna bx w/mr gdn ea addl | 1 - modifier may bypass | Check pair |
10035 | Plmt sft tiss loclzj dev 1st | 1 - modifier may bypass | Check pair |
11102 | Tangntl bx skin single les | 1 - modifier may bypass | Check pair |
11103 | Tangntl bx skin ea sep/addl | 1 - modifier may bypass | Check pair |
11104 | Punch bx skin single lesion | 1 - modifier may bypass | Check pair |
11105 | Punch bx skin ea sep/addl | 1 - modifier may bypass | Check pair |
11107 | Incal bx skn ea sep/addl | 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 |
Showing 30 of 53 column 2 codes. Use the pair checker for any specific combination.
10021 is bundled into these codes
10021 appears as a Column 2 code in 371 active edits. Reported with one of these Column 1 codes on the same date of service, 10021 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 |
10008 | Fna bx w/fluor gdn ea addl | 1 | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 | Check pair |
10010 | Fna bx w/ct gdn ea addl | 1 | Check pair |
11106 | Incal bx skn single les | 1 | Check pair |
11755 | Biopsy nail unit | 1 | Check pair |
19081 | Bx breast 1st lesion strtctc | 1 | Check pair |
19082 | Bx breast add lesion strtctc | 1 | Check pair |
19083 | Bx breast 1st lesion us imag | 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.