How much does Medicare pay for CPT 36901?

Medicare allowed an average of $388.29 per service and paid $305.62 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1396.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36901?

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist. It was billed 23,388 times to 20,188 Medicare beneficiaries by 709 providers in 2024.

Does 36901 pay differently in an office than a hospital?

Yes. The allowed amount averaged $641.92 in an office setting and $279.03 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 36901 most?

Nephrology, with 7,373 services from 233 clinicians. Next are Ambulatory Surgical Center, Vascular Surgery, Interventional Radiology.

CPT 36901

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist

$388.29Medicare-allowed amount per service, averaged across 23,388 services

Providers submitted

$1396.17

Asking price, not received

Medicare allowed

$388.29

The fee schedule figure

Medicare paid

$305.62

Balance is patient coinsurance

Providers submitted an average of $1396.17 for this code and Medicare allowed $388.29 — 3.6× 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 $305.62 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $641.92
Hospital / facility: $279.03

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. 7,042 services were billed in an office setting and 16,346 in a facility.

Services: 23,388
Beneficiaries: 20,188
Providers billing it: 709
Total allowed: $9,081,327

What Medicare pays for CPT 36901

Across 23,388 services billed by 709 providers to 20,188 beneficiaries, Medicare allowed an average of $388.29 per service. That is 1.2 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 36901

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nephrology	7,373	6,518	$338.75	233
Ambulatory Surgical Center	5,571	4,804	$527.23	107
Vascular Surgery	3,484	2,912	$403.07	141
Interventional Radiology	2,921	2,455	$326.59	87
Diagnostic Radiology	2,198	1,853	$341.34	78
General Surgery	842	761	$255.53	31
Internal Medicine	606	542	$399.70	20
Critical Care (Intensivists)	97	82	$167.83	1
Physician Assistant	74	66	$439.08	2
Hospitalist	73	59	$124.35	1
Cardiac Surgery	60	52	$147.54	2
Cardiology	29	29	$146.16	2
Thoracic Surgery	26	23	$162.57	2
Interventional Cardiology	18	18	$156.83	1
Emergency Medicine	16	14	$166.61	1

36901 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	3,014	$407.51	$328.42	81
California	2,646	$402.59	$279.74	68
New York	1,629	$447.87	$301.01	44
Florida	1,249	$403.62	$323.72	37
Illinois	1,203	$485.17	$371.01	43
North Carolina	1,168	$375.57	$310.91	25
Georgia	1,119	$415.48	$334.82	38
New Jersey	1,020	$427.89	$301.67	29
Virginia	841	$379.85	$295.51	22
Michigan	795	$526.82	$420.36	32
Ohio	792	$309.12	$257.49	26
Arizona	719	$371.16	$306.32	17
Nevada	557	$293.02	$226.03	15
South Carolina	491	$286.28	$239.77	13
Pennsylvania	481	$387.41	$310.55	15
Maryland	477	$441.41	$312.73	13
Mississippi	452	$261.74	$234.74	11
Tennessee	391	$323.38	$277.66	14
Indiana	369	$280.58	$227.24	13
Louisiana	364	$249.86	$207.19	14
Minnesota	348	$321.90	$253.21	12
Missouri	325	$247.36	$207.76	14
Kansas	321	$283.88	$241.92	11
Alabama	280	$367.09	$326.01	13
Arkansas	251	$287.95	$261.06	7
Oklahoma	215	$259.41	$207.26	6
Massachusetts	195	$298.73	$222.75	7
Connecticut	195	$622.35	$449.94	8
New Mexico	185	$409.96	$348.29	6
Wisconsin	157	$240.77	$195.22	9
Kentucky	146	$338.63	$284.88	6
Oregon	138	$378.24	$271.75	4
Rhode Island	136	$299.32	$232.75	2
Utah	125	$308.51	$248.38	5
Delaware	120	$648.77	$521.54	4
District of Columbia	83	$375.21	$265.97	2
Alaska	82	$364.86	$221.91	5
Colorado	68	$371.31	$271.30	4
Iowa	64	$267.11	$225.43	4
Washington	46	$340.46	$241.98	2
Guam	44	$741.33	$521.73	2
South Dakota	33	$435.82	$345.96	2
West Virginia	24	$155.83	$114.24	2
Idaho	17	$142.16	$119.28	1
Maine	13	$157.01	$122.39	1

Related codes

36902Insertion of needle and/or tube into hemodialysis circuit and balloon$1145.95
36907Balloon dilation of dialysis segment$366.37
36905Removal and/or dissolving of blood clot in hemodialysis circuit and ba$2871.34
36903Insertion of needle and/or tube into hemodialysis circuit and insertio$3750.51
36906Removal and/or dissolving of blood clot in hemodialysis circuit and ba$5934.78

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.