How much does Medicare pay for CPT 36011?

Medicare allowed an average of $425.13 per service and paid $338.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1918.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36011?

Insertion of tube into vein, first order branch. It was billed 2,759 times to 1,665 Medicare beneficiaries by 67 providers in 2024.

Does 36011 pay differently in an office than a hospital?

Yes. The allowed amount averaged $523.46 in an office setting and $82.35 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 36011 most?

General Surgery, with 597 services from 6 clinicians. Next are Vascular Surgery, Cardiology, Interventional Cardiology.

CPT 36011

Insertion of tube into vein, first order branch

$425.13Medicare-allowed amount per service, averaged across 2,759 services

Providers submitted

$1918.58

Asking price, not received

Medicare allowed

$425.13

The fee schedule figure

Medicare paid

$338.81

Balance is patient coinsurance

Providers submitted an average of $1918.58 for this code and Medicare allowed $425.13 — 4.5× 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 $338.81 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $523.46
Hospital / facility: $82.35

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. 2,144 services were billed in an office setting and 615 in a facility.

Services: 2,759
Beneficiaries: 1,665
Providers billing it: 67
Total allowed: $1,172,934

What Medicare pays for CPT 36011

Across 2,759 services billed by 67 providers to 1,665 beneficiaries, Medicare allowed an average of $425.13 per service. That is 1.7 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 36011

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	597	230	$486.17	6
Vascular Surgery	581	213	$482.19	5
Cardiology	527	372	$550.23	12
Interventional Cardiology	251	209	$416.22	6
Interventional Radiology	247	233	$136.82	17
Diagnostic Radiology	231	215	$109.59	14
Emergency Medicine	85	20	$610.46	1
Cardiac Surgery	85	70	$405.42	2
Physician Assistant	58	22	$625.64	1
Clinical Cardiac Electrophysiology	50	50	$89.89	1
Peripheral Vascular Disease	32	18	$507.20	1
Thoracic Surgery	15	13	$375.59	1

36011 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
Florida	1,407	$519.71	$413.40	18
California	373	$417.59	$284.03	9
Illinois	299	$273.33	$220.04	11
New York	97	$459.88	$305.93	1
Texas	91	$128.77	$106.67	5
Michigan	77	$454.59	$310.05	1
Arizona	66	$300.66	$253.67	3
Virginia	62	$74.40	$60.17	5
Mississippi	53	$71.25	$58.73	2
Nevada	45	$387.02	$309.43	1
New Mexico	32	$519.71	$445.97	1
Georgia	25	$400.32	$309.12	1
Kentucky	20	$801.75	$665.64	1
North Carolina	19	$583.63	$499.96	1
Colorado	18	$399.92	$305.80	1
Minnesota	14	$72.24	$59.23	1
New Jersey	14	$95.33	$71.81	1
Connecticut	13	$78.24	$59.30	1
South Carolina	12	$99.16	$79.08	1
Kansas	11	$78.29	$64.78	1
Maryland	11	$78.96	$53.71	1

Related codes

36005Injection for x-ray imaging procedure into vein of arm or leg$134.97
36012Insertion of tube into vein$468.62
36010Insertion of tube into vena cava$215.77

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.