How much does Medicare pay for CPT 36907?

Medicare allowed an average of $366.37 per service and paid $292.48 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1187.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36907?

Balloon dilation of dialysis segment with review by radiologist. It was billed 24,464 times to 17,147 Medicare beneficiaries by 528 providers in 2024.

Does 36907 pay differently in an office than a hospital?

Yes. The allowed amount averaged $601.64 in an office setting and $143.60 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 36907 most?

Nephrology, with 9,590 services from 191 clinicians. Next are Interventional Radiology, Vascular Surgery, Diagnostic Radiology.

CPT 36907

Balloon dilation of dialysis segment with review by radiologist

$366.37Medicare-allowed amount per service, averaged across 24,464 services

Providers submitted

$1187.12

Asking price, not received

Medicare allowed

$366.37

The fee schedule figure

Medicare paid

$292.48

Balance is patient coinsurance

Providers submitted an average of $1187.12 for this code and Medicare allowed $366.37 — 3.2× 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 $292.48 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $601.64
Hospital / facility: $143.60

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. 11,898 services were billed in an office setting and 12,566 in a facility.

Services: 24,464
Beneficiaries: 17,147
Providers billing it: 528
Total allowed: $8,962,876

What Medicare pays for CPT 36907

Across 24,464 services billed by 528 providers to 17,147 beneficiaries, Medicare allowed an average of $366.37 per service. That is 1.4 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 36907

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nephrology	9,590	6,730	$354.11	191
Interventional Radiology	4,972	3,647	$320.86	79
Vascular Surgery	4,902	3,334	$451.62	153
Diagnostic Radiology	2,294	1,573	$404.88	39
General Surgery	1,138	789	$238.81	30
Internal Medicine	1,071	704	$417.06	23
Critical Care (Intensivists)	212	149	$165.02	1
Hospitalist	78	58	$295.95	2
General Practice	50	40	$156.38	2
Interventional Cardiology	36	23	$143.98	2
Physician Assistant	33	31	$507.96	2
Thoracic Surgery	32	26	$309.89	1
Emergency Medicine	25	18	$149.52	1
Cardiac Surgery	17	13	$138.58	1
Nurse Practitioner	14	12	$476.12	1

36907 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	4,341	$387.79	$275.80	79
New York	3,296	$535.91	$360.00	53
Florida	2,105	$426.09	$342.66	31
Texas	1,838	$365.57	$294.56	45
New Jersey	1,207	$340.79	$241.39	26
Virginia	1,011	$395.44	$290.61	15
Illinois	941	$305.69	$234.61	18
Michigan	919	$478.47	$388.81	27
Georgia	887	$330.25	$274.16	24
Maryland	886	$369.67	$256.19	16
Arizona	729	$226.41	$187.81	15
Indiana	671	$146.50	$120.05	10
North Carolina	661	$313.89	$264.03	17
Nevada	525	$149.73	$120.47	12
Ohio	461	$171.86	$141.58	14
South Carolina	446	$265.03	$222.55	11
Pennsylvania	414	$251.99	$197.30	8
Connecticut	348	$606.33	$436.09	9
Tennessee	284	$293.41	$249.09	9
Missouri	268	$234.86	$191.25	10
Massachusetts	262	$318.27	$240.81	6
Louisiana	186	$208.20	$171.14	9
Kansas	173	$129.67	$110.42	7
New Mexico	146	$504.49	$450.64	2
Alabama	137	$130.65	$110.41	5
Alaska	132	$394.24	$264.94	5
Kentucky	131	$177.87	$144.27	5
Arkansas	127	$229.76	$214.99	2
Rhode Island	123	$149.31	$110.63	1
Mississippi	118	$131.84	$110.94	6
Delaware	108	$562.69	$451.11	3
Oklahoma	108	$274.29	$215.70	6
District of Columbia	95	$266.21	$191.89	2
Wisconsin	77	$127.88	$108.33	3
Nebraska	73	$129.37	$110.35	4
Minnesota	69	$205.43	$174.82	5
Washington	64	$156.14	$110.52	1
Utah	31	$136.48	$110.79	2
Colorado	27	$594.22	$451.18	2
Guam	25	$623.17	$451.08	2
Iowa	14	$519.47	$451.73	1

Related codes

36902Insertion of needle and/or tube into hemodialysis circuit and balloon$1145.95
36901Insertion of needle and/or tube into hemodialysis circuit$388.29
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.