How much does Medicare pay for CPT 36012?

Medicare allowed an average of $468.62 per service and paid $373.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1930.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36012?

Insertion of tube into vein, second order branch. It was billed 3,864 times to 2,358 Medicare beneficiaries by 97 providers in 2024.

Does 36012 pay differently in an office than a hospital?

Yes. The allowed amount averaged $547.77 in an office setting and $99.36 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 36012 most?

Interventional Cardiology, with 1,006 services from 20 clinicians. Next are Cardiology, Vascular Surgery, Interventional Radiology.

CPT 36012

Insertion of tube into vein, second order branch

$468.62Medicare-allowed amount per service, averaged across 3,864 services

Providers submitted

$1930.44

Asking price, not received

Medicare allowed

$468.62

The fee schedule figure

Medicare paid

$373.15

Balance is patient coinsurance

Providers submitted an average of $1930.44 for this code and Medicare allowed $468.62 — 4.1× 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 $373.15 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $547.77
Hospital / facility: $99.36

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. 3,182 services were billed in an office setting and 682 in a facility.

Services: 3,864
Beneficiaries: 2,358
Providers billing it: 97
Total allowed: $1,810,748

What Medicare pays for CPT 36012

Across 3,864 services billed by 97 providers to 2,358 beneficiaries, Medicare allowed an average of $468.62 per service. That is 1.6 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 36012

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	1,006	504	$484.68	20
Cardiology	795	464	$433.14	17
Vascular Surgery	730	443	$545.05	19
Interventional Radiology	576	424	$474.73	20
Diagnostic Radiology	413	291	$411.60	11
Internal Medicine	98	58	$546.47	2
General Surgery	75	55	$416.85	3
Thoracic Surgery	67	38	$529.75	1
Neurology	45	37	$144.97	1
Neurosurgery	22	13	$77.00	1
General Practice	21	16	$98.92	1
Clinical Cardiac Electrophysiology	16	15	$431.13	1

36012 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
California	867	$458.09	$301.20	13
Florida	490	$373.13	$294.14	20
Texas	404	$444.34	$338.36	11
New York	390	$604.68	$401.06	7
New Jersey	328	$494.62	$323.26	7
Michigan	291	$509.77	$343.77	3
North Carolina	276	$469.85	$357.45	6
Arizona	125	$502.11	$439.10	2
Georgia	113	$701.94	$558.91	4
Minnesota	89	$269.17	$177.92	2
Illinois	71	$428.74	$323.78	3
Delaware	56	$455.72	$329.56	1
Louisiana	48	$547.12	$491.20	2
New Mexico	37	$995.47	$840.17	1
Mississippi	35	$83.94	$68.37	2
Nevada	34	$552.66	$441.93	1
Colorado	30	$473.18	$326.15	1
Oklahoma	28	$109.41	$91.76	2
Pennsylvania	28	$284.89	$233.51	2
Hawaii	27	$642.02	$461.85	1
Wisconsin	21	$81.51	$69.15	1
Alabama	17	$603.93	$470.06	1
Ohio	16	$523.52	$450.18	1
Indiana	16	$100.43	$86.33	1
Washington	15	$99.15	$76.08	1
Missouri	12	$193.74	$157.12	1

Related codes

36005Injection for x-ray imaging procedure into vein of arm or leg$134.97
36010Insertion of tube into vena cava$215.77
36011Insertion of tube into vein$425.13

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.