How much does Medicare pay for CPT 10006?

Medicare allowed an average of $56.90 per service and paid $44.60 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $260.32, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 10006?

Fine needle aspiration biopsy using ultrasound guidance, each additional growth. It was billed 11,480 times to 8,799 Medicare beneficiaries by 386 providers in 2024.

Does 10006 pay differently in an office than a hospital?

Yes. The allowed amount averaged $60.12 in an office setting and $46.38 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 10006 most?

Pathology, with 3,154 services from 26 clinicians. Next are Endocrinology, Diagnostic Radiology, Physician Assistant.

CPT 10006

Fine needle aspiration biopsy using ultrasound guidance, each additional growth

$56.90Medicare-allowed amount per service, averaged across 11,480 services

Providers submitted

$260.32

Asking price, not received

Medicare allowed

$56.90

The fee schedule figure

Medicare paid

$44.60

Balance is patient coinsurance

Providers submitted an average of $260.32 for this code and Medicare allowed $56.90 — 4.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $44.60 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $60.12
Hospital / facility: $46.38

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 8,786 services were billed in an office setting and 2,694 in a facility.

Services: 11,480
Beneficiaries: 8,799
Providers billing it: 386
Total allowed: $653,212

What Medicare pays for CPT 10006

Across 11,480 services billed by 386 providers to 8,799 beneficiaries, Medicare allowed an average of $56.90 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 10006

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	3,154	2,079	$59.78	26
Endocrinology	2,560	1,969	$58.33	107
Diagnostic Radiology	2,189	1,856	$57.84	93
Physician Assistant	904	784	$41.40	48
General Surgery	596	472	$61.15	21
Otolaryngology	499	420	$57.60	26
Internal Medicine	441	339	$59.24	18
Interventional Radiology	434	367	$52.63	23
Clinical Laboratory	284	191	$55.98	2
Nurse Practitioner	226	201	$42.51	14
Urology	104	43	$62.84	3
Surgical Oncology	51	47	$54.27	3
General Practice	22	16	$54.03	1
Nuclear Medicine	16	15	$68.58	1

10006 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	3,017	$63.37	$45.73	45
California	1,081	$60.29	$44.43	33
Texas	821	$53.98	$43.38	35
Florida	782	$57.53	$43.56	39
New Jersey	603	$59.66	$43.12	21
Tennessee	555	$54.31	$46.33	8
Georgia	415	$55.01	$42.87	15
Arizona	348	$54.75	$43.03	10
Pennsylvania	335	$47.05	$37.23	17
Illinois	314	$54.29	$39.34	16
Maryland	283	$53.26	$40.47	17
Indiana	273	$53.57	$44.94	6
South Carolina	213	$45.42	$35.42	12
Virginia	212	$54.15	$42.83	11
Ohio	188	$51.20	$43.13	8
Arkansas	182	$51.11	$43.87	7
Delaware	177	$55.08	$43.80	4
Massachusetts	167	$56.19	$40.85	8
Oklahoma	156	$52.07	$41.65	6
Nevada	126	$54.74	$44.04	6
North Carolina	124	$53.80	$43.67	5
Utah	114	$53.42	$44.69	5
Michigan	103	$58.02	$45.05	5
Louisiana	77	$54.80	$45.39	4
Wisconsin	73	$53.34	$43.03	4
Missouri	64	$47.34	$37.65	4
Connecticut	63	$48.00	$35.94	2
Colorado	62	$42.86	$34.03	4
Iowa	57	$41.84	$34.66	2
Kentucky	56	$54.98	$47.29	2
North Dakota	53	$46.97	$37.91	2
Nebraska	45	$45.15	$38.59	3
Oregon	39	$57.91	$43.70	2
District of Columbia	34	$53.15	$38.54	2
New Hampshire	28	$54.05	$42.46	2
Puerto Rico	27	$47.82	$36.12	1
Minnesota	25	$47.93	$38.45	1
Kansas	24	$51.32	$42.37	2
South Dakota	23	$39.38	$32.74	1
Mississippi	21	$52.03	$47.39	1
Maine	21	$47.27	$36.93	1
Alabama	17	$56.46	$42.57	1
Alaska	16	$41.58	$32.83	1
New Mexico	16	$47.86	$33.90	1
Wyoming	14	$57.97	$46.87	1
West Virginia	13	$47.63	$34.22	1
Vermont	12	$46.81	$38.63	1
Montana	11	$48.50	$32.13	1

Related codes

10060Simple or single drainage of skin abscess$124.11
10005Fine needle aspiration biopsy$99.08
10061Complicated or multiple drainage of skin abscess$210.58
10040Acne surgery$109.41
10021Fine needle aspiration biopsy$74.12

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.