CPT 10009
Global XXX ActiveFna bx w/ct gdn 1st les
CPT 10009 Billing & Documentation Guide
CPT code 10009 (Fna bx w/ct gdn 1st les) is classified under Anesthesia with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.2, a non-facility practice expense RVU of 9.92, and a malpractice RVU of 0.23, a total non-facility RVU of 12.35 and facility RVU of 2.79. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $427.35, though rates vary from $362.06 to $563.47 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 10009, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 10009 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 10009 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 10009
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.2 | 2.2 |
| Practice Expense RVU | 9.92 | 0.36 |
| Malpractice RVU | 0.23 | 0.23 |
| Total RVU | 12.35 | 2.79 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 10009
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $472.34 | $94.51 | $441.99 - $563.47 | 29 |
| Florida | $420.88 | $100.5 | $401.79 - $437.83 | 3 |
| Georgia | $398.88 | $94.26 | $378.19 - $419.57 | 2 |
| Illinois | $408.57 | $100.04 | $388 - $427.89 | 4 |
| Michigan | $395.42 | $95.59 | $384.67 - $406.17 | 2 |
| North Carolina | $387.53 | $89.61 | $387.53 - $387.53 | 1 |
| New York | $457.05 | $100.83 | $393.65 - $486.41 | 5 |
| Ohio | $383.74 | $92.2 | $383.74 - $383.74 | 1 |
| Pennsylvania | $406.9 | $94.13 | $384.91 - $428.89 | 2 |
| Texas | $407.23 | $92.86 | $382.14 - $430.99 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 10009
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 10009 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10004 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 10005 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 10006 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10007 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 10008 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10011 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 10012 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10021 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 10009
What does CPT code 10009 mean? +
CPT code 10009 represents: Fna bx w/ct gdn 1st les. It's in the Anesthesia category with a global period of XXX.
What is the Medicare reimbursement for CPT 10009? +
The 2026 Medicare national average non-facility payment for CPT 10009 is $427.35. Rates range from $362.06 to $563.47 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 10009? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 10009? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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