RxDoctor Payments Data

CPT 36415

Insertion of needle into vein for collection of blood sample

$8.49Medicare-allowed amount per service, averaged across 39,989,147 services
Providers submitted
$21.83

Asking price, not received

Medicare allowed
$8.49

The fee schedule figure

Medicare paid
$8.49

Balance is patient coinsurance

Providers submitted an average of $21.83 for this code and Medicare allowed $8.492.6× 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 $8.49 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$8.49
Hospital / facility
$8.63

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 39,914,807 services were billed in an office setting and 74,340 in a facility.

Services
39,989,147

Medicare Part B, 2024

Beneficiaries
20,204,443
Providers billing it
85,982
Total allowed
$339,507,858

Services × allowed amount

What Medicare pays for CPT 36415

Across 39,989,147 services billed by 85,982 providers to 20,204,443 beneficiaries, Medicare allowed an average of $8.49 per service. That is 2.0 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 36415

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory21,495,50010,074,114$8.531,228
Family Practice4,685,4562,719,751$8.3821,932
Internal Medicine4,381,8782,388,849$8.4315,504
Hematology-Oncology2,221,587731,047$8.542,610
Nurse Practitioner1,813,2431,175,707$8.4218,397
Pathology1,090,618556,881$8.62134
Urology674,281493,510$8.392,728
Physician Assistant672,617462,593$8.437,626
Medical Oncology558,997187,546$8.58783
Rheumatology457,192235,389$8.381,317
Endocrinology435,975256,366$8.391,394
Cardiology355,070229,191$8.402,317
Nephrology298,768145,172$8.361,080
General Practice113,16466,739$8.20719
Gastroenterology83,13557,909$8.481,087

36415 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.

StateServicesAllowedStandardized pmtProviders
California4,104,766$8.56$8.654,538
Florida3,619,481$8.47$8.656,039
Texas3,416,811$8.52$8.656,275
New Jersey3,204,336$8.35$8.652,129
North Carolina2,710,718$8.60$8.653,385
New York2,224,135$8.47$8.658,138
Arizona1,509,950$8.47$8.651,489
Illinois1,362,855$8.55$8.654,267
Tennessee1,263,007$8.56$8.653,234
Ohio1,230,939$8.53$8.651,887
Massachusetts1,171,172$8.62$8.652,134
Georgia1,153,436$8.58$8.653,020
Virginia953,611$8.22$8.652,577
Alabama923,893$8.42$8.651,493
Pennsylvania901,177$8.50$8.652,342
Kansas793,928$8.50$8.651,075
Washington750,576$8.50$8.651,899
South Carolina704,388$8.50$8.652,143
Maryland648,252$8.54$8.651,460
Wisconsin631,457$8.59$8.652,182
Minnesota600,266$8.58$8.653,452
Mississippi461,545$8.45$8.651,601
Oklahoma442,646$8.17$8.651,020
Indiana437,470$8.55$8.651,676
Iowa410,183$8.56$8.651,412
Arkansas402,061$8.47$8.651,367
Colorado364,673$8.40$8.651,044
Missouri352,851$8.56$8.651,418
Michigan350,822$8.31$8.651,751
Louisiana344,921$8.34$8.65867
Oregon344,831$8.58$8.651,063
Nevada303,662$8.58$8.65330
Nebraska288,497$8.08$8.651,158
Kentucky250,741$8.58$8.651,045
Hawaii229,214$8.58$8.6531
Utah173,717$8.31$8.65860
New Mexico133,283$8.61$8.65357
Connecticut102,522$8.50$8.65530
South Dakota88,505$7.89$8.65285
Idaho75,018$8.47$8.65487
Puerto Rico69,935$7.15$8.65384
Maine63,693$8.36$8.65259
North Dakota63,558$8.61$8.65226
Montana55,946$8.58$8.65260
Rhode Island53,796$8.65$8.6549
West Virginia50,730$8.50$8.65293
Wyoming40,360$8.45$8.65210
New Hampshire36,645$7.92$8.65212
Alaska33,851$8.52$8.65285
Vermont25,738$8.59$8.65148
Delaware23,898$8.59$8.6532
District of Columbia16,517$8.31$8.65116
U.S. Virgin Islands13,287$7.77$8.6523
Guam2,387$8.58$8.6513
XX1,973$8.58$8.653
AP229$8.65$8.653

Related codes

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.