How much does Medicare pay for CPT 36569?

Medicare allowed an average of $91.24 per service and paid $72.01 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $606.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36569?

Insertion of tube for infusion (5 years or older). It was billed 3,314 times to 2,954 Medicare beneficiaries by 78 providers in 2024.

Does 36569 pay differently in an office than a hospital?

Yes. The allowed amount averaged $92.24 in an office setting and $91.21 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 36569 most?

Physician Assistant, with 825 services from 30 clinicians. Next are Neurosurgery, Nurse Practitioner, Diagnostic Radiology.

CPT 36569

Insertion of tube for infusion (5 years or older)

$91.24Medicare-allowed amount per service, averaged across 3,314 services

Providers submitted

$606.76

Asking price, not received

Medicare allowed

$91.24

The fee schedule figure

Medicare paid

$72.01

Balance is patient coinsurance

Providers submitted an average of $606.76 for this code and Medicare allowed $91.24 — 6.7× 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 $72.01 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $92.24
Hospital / facility: $91.21

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. 101 services were billed in an office setting and 3,213 in a facility.

Services: 3,314
Beneficiaries: 2,954
Providers billing it: 78
Total allowed: $302,369

What Medicare pays for CPT 36569

Across 3,314 services billed by 78 providers to 2,954 beneficiaries, Medicare allowed an average of $91.24 per service. 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 36569

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physician Assistant	825	804	$85.29	30
Neurosurgery	708	550	$87.57	1
Nurse Practitioner	637	576	$83.23	7
Diagnostic Radiology	388	331	$100.61	8
Certified Registered Nurse Anesthetist (CRNA)	150	145	$87.64	7
Pulmonary Disease	118	110	$103.54	3
Vascular Surgery	88	85	$97.51	3
Family Practice	82	63	$88.43	2
General Surgery	74	68	$94.63	4
Critical Care (Intensivists)	58	54	$90.92	2
Interventional Radiology	52	51	$88.99	3
Emergency Medicine	29	25	$88.17	2
Internal Medicine	27	25	$88.01	2
Cardiology	25	24	$95.05	1
Medical Oncology	20	11	$97.85	1

36569 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	1,264	$85.07	$68.14	6
New York	663	$92.55	$62.26	25
Florida	360	$104.17	$72.49	5
Missouri	319	$77.52	$62.52	9
Oklahoma	131	$87.11	$71.46	6
Texas	106	$94.65	$71.86	3
New Jersey	67	$92.75	$70.13	3
Georgia	58	$87.92	$72.67	1
Virginia	52	$88.99	$72.70	3
New Mexico	51	$96.57	$67.12	3
Pennsylvania	49	$86.36	$69.16	3
Illinois	37	$92.10	$61.73	2
Louisiana	32	$88.08	$64.71	2
Kansas	31	$333.03	$291.17	2
South Carolina	27	$87.62	$72.55	1
Michigan	27	$83.42	$61.70	2
Indiana	24	$88.53	$73.43	1
Ohio	16	$89.14	$72.59	1

Related codes

36556Insertion of non-tunneled central venous tube for infusion (5 years or$81.86
36561Insertion of central venous tube$398.30
36558Insertion of tunneled central venous tube for infusion (5 years or old$285.71
36591Collection of blood sample from implanted device$27.38
36589Removal of tunneled central venous tube$161.38
36573Insertion of tube for infusion$94.78
36581Replacement of tunneled central venous tube$744.12
36590Removal of central venous tube$196.77
36514Mechanical separation of plasma from blood$92.43
36593Declotting of central venous tube$38.30
36500Insertion of tube into vein$91.52
36522Mechanical separation of white blood cells and platelets from blood$90.95

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.