How much does Medicare pay for CPT 36215?

Medicare allowed an average of $311.96 per service and paid $248.62 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1778.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36215?

Insertion of tube into chest or arm artery, each first order branch. It was billed 17,154 times to 13,092 Medicare beneficiaries by 296 providers in 2024.

Does 36215 pay differently in an office than a hospital?

Yes. The allowed amount averaged $554.30 in an office setting and $111.96 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 36215 most?

Nephrology, with 8,290 services from 161 clinicians. Next are Interventional Radiology, Diagnostic Radiology, Vascular Surgery.

CPT 36215

Insertion of tube into chest or arm artery, each first order branch

$311.96Medicare-allowed amount per service, averaged across 17,154 services

Providers submitted

$1778.89

Asking price, not received

Medicare allowed

$311.96

The fee schedule figure

Medicare paid

$248.62

Balance is patient coinsurance

Providers submitted an average of $1778.89 for this code and Medicare allowed $311.96 — 5.7× 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 $248.62 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $554.30
Hospital / facility: $111.96

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. 7,756 services were billed in an office setting and 9,398 in a facility.

Services: 17,154
Beneficiaries: 13,092
Providers billing it: 296
Total allowed: $5,351,362

What Medicare pays for CPT 36215

Across 17,154 services billed by 296 providers to 13,092 beneficiaries, Medicare allowed an average of $311.96 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 36215

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nephrology	8,290	6,462	$329.33	161
Interventional Radiology	3,950	2,932	$272.13	42
Diagnostic Radiology	1,775	1,279	$266.31	11
Vascular Surgery	1,142	871	$366.05	32
Internal Medicine	1,120	787	$425.41	19
Cardiology	261	222	$198.69	11
General Surgery	215	195	$254.88	8
Hospitalist	77	69	$114.11	2
Interventional Cardiology	76	72	$177.13	4
Critical Care (Intensivists)	65	60	$259.81	2
Thoracic Surgery	65	52	$308.53	1
Emergency Medicine	58	45	$110.26	1
General Practice	33	23	$123.11	1
Neurosurgery	27	23	$101.54	1

36215 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
Texas	2,651	$340.19	$274.52	50
Illinois	2,409	$167.18	$125.08	21
California	1,924	$354.70	$249.96	26
New York	1,565	$549.09	$369.19	20
Georgia	1,229	$355.68	$307.26	22
Florida	1,026	$377.37	$308.32	20
North Carolina	710	$319.42	$269.47	15
New Jersey	706	$446.63	$320.60	8
Michigan	578	$336.56	$268.30	15
Nevada	513	$109.22	$88.08	12
Ohio	493	$131.00	$106.67	14
Arizona	441	$159.79	$131.90	7
Indiana	380	$196.33	$195.35	4
Virginia	335	$330.43	$253.23	9
Tennessee	284	$242.93	$201.32	4
Maryland	271	$308.75	$202.56	4
Pennsylvania	253	$131.47	$103.14	8
Arkansas	175	$191.80	$184.60	2
Massachusetts	174	$177.54	$130.35	3
South Carolina	170	$303.48	$256.67	5
Colorado	110	$508.29	$384.40	3
Kansas	93	$108.47	$87.59	3
Louisiana	77	$110.11	$85.51	3
Connecticut	77	$588.86	$418.51	1
Alabama	74	$362.52	$326.68	3
Washington	70	$118.55	$83.16	1
Kentucky	68	$499.75	$397.10	1
Missouri	62	$196.32	$160.22	3
Delaware	50	$101.33	$80.71	1
Oklahoma	40	$510.24	$407.39	1
Rhode Island	36	$140.60	$106.57	1
District of Columbia	30	$633.28	$449.82	1
New Hampshire	27	$101.54	$83.64	1
Puerto Rico	16	$107.53	$85.68	1
Minnesota	14	$594.82	$512.04	1
West Virginia	12	$99.00	$80.69	1
Mississippi	11	$96.06	$81.03	1

Related codes

36247Insertion of tube into abdominal$508.22
36248Insertion of tube into abdominal$94.94
36224Insertion of tube into internal neck artery for diagnosis or treatment$416.64
36226Insertion of tube into brain artery for diagnosis or treatment$286.02
36223Insertion of tube into intracranial artery for diagnosis or treatment$304.28
36227Insertion of tube into external neck artery for diagnosis or treatment$157.57
36245Insertion of tube into abdominal$406.16
36246Insertion of tube into abdominal$345.02
36225Insertion of tube into chest artery for diagnosis or treatment$253.70
36200Insertion of tube into aorta$221.32

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.