How much does Medicare pay for CPT 36478?

Medicare allowed an average of $907.22 per service and paid $715.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4022.16, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36478?

Laser destruction of incompetent vein of arm or leg using imaging guidance. It was billed 26,582 times to 13,947 Medicare beneficiaries by 430 providers in 2024.

Does 36478 pay differently in an office than a hospital?

Yes. The allowed amount averaged $930.56 in an office setting and $631.95 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 36478 most?

Vascular Surgery, with 7,263 services from 125 clinicians. Next are General Surgery, Cardiology, Diagnostic Radiology.

CPT 36478

Laser destruction of incompetent vein of arm or leg using imaging guidance

$907.22Medicare-allowed amount per service, averaged across 26,582 services

Providers submitted

$4022.16

Asking price, not received

Medicare allowed

$907.22

The fee schedule figure

Medicare paid

$715.64

Balance is patient coinsurance

Providers submitted an average of $4022.16 for this code and Medicare allowed $907.22 — 4.4× 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 $715.64 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $930.56
Hospital / facility: $631.95

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. 24,504 services were billed in an office setting and 2,078 in a facility.

Services: 26,582
Beneficiaries: 13,947
Providers billing it: 430
Total allowed: $24,115,722

What Medicare pays for CPT 36478

Across 26,582 services billed by 430 providers to 13,947 beneficiaries, Medicare allowed an average of $907.22 per service. That is 1.9 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 36478

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	7,263	3,740	$882.60	125
General Surgery	4,477	2,403	$868.28	60
Cardiology	3,204	1,737	$903.81	48
Diagnostic Radiology	1,983	1,142	$906.83	40
Family Practice	1,610	846	$919.97	21
Interventional Radiology	1,201	705	$908.33	31
Thoracic Surgery	1,169	489	$877.88	9
Internal Medicine	951	369	$1003.63	17
Anesthesiology	858	357	$837.90	5
Interventional Cardiology	769	435	$823.90	18
Ambulatory Surgical Center	627	352	$1491.08	10
Emergency Medicine	450	274	$1029.22	10
Cardiac Surgery	431	245	$839.63	4
Dermatology	385	161	$997.02	5
Obstetrics & Gynecology	235	131	$870.23	4

36478 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	4,672	$923.01	$741.38	55
Texas	3,363	$905.33	$751.53	47
California	2,512	$1054.96	$739.98	33
Arizona	1,916	$881.96	$730.33	13
Illinois	1,711	$914.05	$695.33	34
New York	1,489	$1093.08	$745.21	39
North Carolina	1,221	$866.78	$755.43	20
Missouri	1,141	$791.26	$700.57	12
Colorado	1,043	$935.09	$731.00	20
Mississippi	919	$777.63	$718.73	5
Ohio	912	$760.44	$662.57	16
Alabama	592	$792.97	$706.61	8
Pennsylvania	519	$892.60	$725.79	8
Tennessee	513	$852.32	$747.62	8
New Mexico	497	$781.84	$709.13	5
Maryland	461	$1071.91	$811.24	8
New Jersey	352	$1031.15	$703.35	13
Wisconsin	277	$858.58	$705.74	5
Arkansas	232	$630.21	$582.75	6
South Carolina	231	$848.12	$724.65	6
Georgia	230	$940.42	$755.58	7
Nevada	202	$941.86	$762.75	3
Michigan	192	$907.99	$745.69	7
Oklahoma	172	$718.06	$601.56	6
Indiana	161	$822.53	$752.14	3
Minnesota	148	$906.49	$705.65	4
Virginia	109	$976.17	$749.01	5
Kansas	103	$815.60	$723.32	4
Massachusetts	98	$497.85	$377.37	3
Kentucky	85	$796.24	$678.04	4
Maine	72	$979.03	$735.16	1
Connecticut	61	$1061.56	$747.60	3
Louisiana	52	$757.16	$725.44	3
Idaho	48	$242.27	$203.90	2
Montana	43	$514.79	$419.29	2
South Dakota	35	$236.37	$200.35	2
District of Columbia	33	$1102.82	$741.76	2
Iowa	30	$864.71	$737.81	1
West Virginia	24	$1045.14	$744.86	1
Rhode Island	22	$972.99	$740.59	1
Guam	22	$1033.26	$745.76	1
Nebraska	20	$1489.53	$1213.53	1
Wyoming	19	$777.88	$674.28	1
Oregon	14	$923.50	$745.12	1
North Dakota	14	$250.50	$199.01	1

Related codes

36415Insertion of needle into vein for collection of blood sample$8.49
36465Injection of chemical agent into single incompetent vein of leg$1256.40
36410Insertion of needle into vein (3 years or older)$16.89
36471Injection of chemical agent into multiple incompetent veins of leg$187.64
36475Destruction of first incompetent vein of arm or leg$1015.19
36482Chemical destruction of first incompetent vein of arm or leg$1603.82
36466Injection of chemical agent into multiple incompetent veins of same le$1330.00
36470Injection of chemical agent into single incompetent vein$103.15
36430Transfusion of blood or blood products$42.77
36479Laser destruction of incompetent veins of arm or leg$285.92
36476Destruction of subsequent incompetent veins of arm or leg$268.55

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.