CPT 10021
Global XXX ActiveFna bx w/o img gdn 1st les
CPT 10021 Billing & Documentation Guide
CPT code 10021 (Fna bx w/o img 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 1, a non-facility practice expense RVU of 1.88, and a malpractice RVU of 0.14, a total non-facility RVU of 3.02 and facility RVU of 1.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $103.62, though rates vary from $89.75 to $130.13 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 10021, 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 10021 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 10021 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 10021
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1 | 1 |
| Practice Expense RVU | 1.88 | 0.24 |
| Malpractice RVU | 0.14 | 0.14 |
| Total RVU | 3.02 | 1.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 10021
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 | $111.44 | $46.62 | $105.3 - $130.13 | 29 |
| Florida | $105.51 | $50.55 | $100.46 - $110.6 | 3 |
| Georgia | $98.96 | $46.7 | $94.99 - $102.92 | 2 |
| Illinois | $103.13 | $50.2 | $98.04 - $107.47 | 4 |
| Michigan | $98.95 | $47.51 | $96.01 - $101.88 | 2 |
| North Carolina | $94.98 | $43.87 | $94.98 - $94.98 | 1 |
| New York | $111.39 | $50.28 | $96.34 - $118.88 | 5 |
| Ohio | $95.45 | $45.43 | $95.45 - $95.45 | 1 |
| Pennsylvania | $100.21 | $46.56 | $95.46 - $104.95 | 2 |
| Texas | $99.75 | $45.82 | $94.89 - $104.05 | 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 10021
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 10021 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 |
| 10006 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 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 | CPT Manual or CMS manual coding instruction |
| 10035 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11102 | Column 1 (primary), can be billed with modifier | Yes | Sequential procedure |
| 11103 | Column 1 (primary), can be billed with modifier | Yes | Sequential procedure |
| 11104 | Column 1 (primary), can be billed with modifier | Yes | Sequential procedure |
| 11105 | Column 1 (primary), can be billed with modifier | Yes | Sequential procedure |
Frequently Asked Questions, CPT 10021
What does CPT code 10021 mean? +
CPT code 10021 represents: Fna bx w/o img gdn 1st les. It's in the Anesthesia category with a global period of XXX.
What is the Medicare reimbursement for CPT 10021? +
The 2026 Medicare national average non-facility payment for CPT 10021 is $103.62. Rates range from $89.75 to $130.13 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 10021? +
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 10021? +
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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