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    v1.0.30
    OpenPayerBilling CodesFine Needle Aspiration Biopsy ProceduresCPT cpt-10008-fine-needle-aspiration-additional-lesion-fluoroscopic
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    CPT 10008: Fine Needle Aspiration, Additional Lesion

    Medicare pays $146 on average nationally for this procedure.

    CPT code 10008 describes a fine needle aspiration (FNA) performed to obtain a diagnostic specimen from an additional lesion, cyst, or mass when biopsied under fluoroscopic guidance; this is an add-on procedural code reported in conjunction with the primary FNA under fluoroscopy and represents an image-guided biopsy service. Service type: image-guided diagnostic procedure (fine needle aspiration). Typical site of service: outpatient radiology suite, ambulatory surgical center, or hospital imaging department during fluoroscopically guided biopsy procedures.

    For related coverage guidance, see recent payer policy updates: Destruction of Pre-Malignant Skin Lesions, Onychomycosis diagnostic testing and coverage, Treatment of Capillary Malformations (Port Wine Stains).

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient presents with a persistent, palpable thyroid nodule and ultrasound findings concerning for a solid, suspicious lesion. The interventional radiologist schedules a fluoroscopically guided fine needle aspiration (FNA) during the same visit to obtain cytologic material for diagnosis. The patient is positioned in the procedure suite, targeted lesion localization is performed using fluoroscopy, the skin is prepped and anesthetized, and a fine-gauge needle with syringe is advanced into the lesion under image guidance. Multiple passes are performed as needed. If more than one distinct lesion is biopsied under fluoroscopic guidance during the same session, the initial lesion is reported with the primary FNA- fluoroscopy code and each additional lesion is reported with 10008. The typical site of service is an outpatient ambulatory procedure suite, radiology or interventional radiology department, or hospital outpatient setting. Common clinical workflow includes pre-procedure consent, coagulation check, local anesthesia, image-guided needle aspiration, specimen labeling and submission to cytology, post-procedure monitoring, and documentation of lesions sampled and number of passes per lesion.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    10007Fine needle aspiration; with imaging guidance (e.g., ultrasound), first lesionPrimary imaging-guided FNA code; 10008 is reported for each additional lesion biopsied under fluoroscopic guidance in addition to 10007.
    76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretationOften used when ultrasound, rather than fluoroscopy, is used for needle localization during FNA; documents imaging guidance performed.
    77002Fluoroscopic guidance for needle placement (e.g., biopsy, aspiration, injection, localization), imaging supervision and interpretationUsed to report fluoroscopic imaging guidance associated with percutaneous needle placement; supports documentation when fluoroscopy is the modality used.
    88172Cytopathology, immediate cytologic evaluation; gross and microscopic examination during fine needle aspiration (e.g., ROSE)Reported when a cytopathologist or qualified practitioner performs immediate onsite evaluation of FNA specimens to assess specimen adequacy.
    19000Biopsy of breast; needle core, not vacuum assisted, single or multiple
    (Note: included as commonly associated when multiple sampling methods are used)
    Performed when core needle biopsy is used instead of or in addition to FNA for breast masses; may be part of the same diagnostic pathway.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207P00000X
    2084P0800X
    207L00000X
    363A00000X
    2251E1300X
    261QM1103X
    364SI0800X

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01
    Topical Acne-Non-Retinoid ProductsCigna2026-08-15
    Dermatology - Vtama Drug Quantity Management Policy - Per DaysCigna2026-08-15
    Medical Necessity Guidelines: Acne and Rosacea Medicationsharvard pilgrim health care2026-08-11
    Dermatology - Anzupgo Prior Authorization PolicyCigna2026-08-05
    Light Therapy for Dermatologic Conditionsbcbsvermont2026-08-01

    Related Codes

    CPT-10004-FINE-NEEDLE-ASPIRATION-ADDITIONAL-LESION

    CPT 10004: Fine Needle Aspiration, Additional Lesion

    CPT-10005-ULTRASOUND-GUIDED-FINE-NEEDLE-ASPIRATION-FIRST-LESION

    CPT 10005: Ultrasound-Guided Fine Needle Aspiration, First Lesion

    CPT-10006-ULTRASOUND-GUIDED-FNA-ADDITIONAL-LESION

    CPT 10006: Fine Needle Aspiration, Additional Lesion, Ultrasound-Guided

    CPT-10007-FINE-NEEDLE-ASPIRATION-FLUOROSCOPIC-GUIDANCE

    CPT 10007: Fluoroscopic Fine Needle Aspiration, First Lesion

    CPT-10009-CT-GUIDED-FINE-NEEDLE-ASPIRATION-FIRST-LESION

    CPT 10009: CT-Guided Fine Needle Aspiration, First Lesion

    CPT-10010-FINE-NEEDLE-ASPIRATION-ADDITIONAL-LESION-CT-GUIDANCE

    CPT 10010: Fine Needle Aspiration, Additional Lesion

    CPT-10011-MR-GUIDED-FNA-BIOPSY-FIRST-LESION

    CPT 10011: MR-Guided Fine Needle Aspiration, First Lesion

    CPT-10012-MR-GUIDED-FINE-NEEDLE-ASPIRATION-ADDITIONAL-LESION

    CPT 10012: Fine Needle Aspiration, Additional Lesion, MR Guidance

    CPT-10021-FINE-NEEDLE-ASPIRATION-FIRST-LESION-BIOPSY

    CPT 10021: Fine Needle Aspiration (First Lesion)

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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