thyroid aspiration in office

My general surgeon sees a patient in the office for an enlarged thyroid. He dictates a whole office visit including ROS, examination, history and then decides to do an aspiration in our office. Would you use modifier -25 w/ E & M code as well as aspiration code or use -57 for modifier?

i would use

modifier 25 on the e/m code.

thyroid aspiration in office

Thank you.