36415 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for Coll venous bld venipuncture.
National Average Payment
Non-Facility (Private Office) Rate
36415 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
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Code Description
Collection of venous blood by venipuncture. The drawing of blood from a vein using a needle and syringe or evacuated tube system for diagnostic laboratory testing. This code covers the collection service only and does not include the cost of laboratory analysis.
Reimbursement Summary
CPT code 36415 (Collection of venous blood by venipuncture. The drawing of blood from a vein using a needle and syringe or evacuated tube system for diagnostic laboratory testing. This code covers the collection service only and does not include the cost of laboratory analysis.) does not currently have a published national facility or non-facility reimbursement rate in 2026.
36415 is a CPT code in the category “Physician Service.” Medicare does not publish a single national payment amount for this code in 2026 (Not Covered). This code is excluded/invalid for Medicare.
Because this code is not covered/invalid for Medicare, a reimbursement rate is not expected under Medicare rules. If you believe this should be payable, verify directly with CMS or your MAC.
36415 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Historical Medicare Reimbursement
| Quarter | Non-Facility Rate | Facility Rate | YoY % Change (Non-Fac) | YoY % Change (Fac) |
|---|---|---|---|---|
| 2026 Q2 | $0.00 | $0.00 | — | — |
| 2026 Q1 | $0.00 | $0.00 | — | — |
| 2025 Q4 | $0.00 | $0.00 | — | — |
| 2025 Q3 | $0.00 | $0.00 | — | — |
| 2025 Q2 | $0.00 | $0.00 | — | — |
| 2025 Q1 | $0.00 | $0.00 | — | — |
Commercial Payer Rates for 36415
Pro FeatureNational average reimbursement from major commercial payers based on CMS Transparency in Coverage machine-readable files.
| Modifier | Place of Service | Avg. Rate | vs Medicare | Percentile Range |
|---|---|---|---|---|
| NULL | Office (11) | $91.46 | -4.0% | $80 — $104 |
| NULL | Telehealth (02) | $88.20 | -7.4% | $76 — $102 |
| NULL | Facility (21) | $79.31 | -15.6% | $68 — $95 |
| NULL | Outpatient Hospital (22) | $84.92 | -10.2% | $71 — $99 |
| NULL | Home (12) | $96.14 | +1.0% | $84 — $113 |
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Source: CMS Transparency in Coverage machine-readable files (MRFs). Commercial rates reflect payer-published negotiated amounts and may not reflect individual contracted rates.
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Facility vs. Non-Facility (Office) Payment
Medicare often publishes two payment rates for the same code: a **non-facility** rate (typically used when the service is performed in a private office where the clinician bears more overhead) and a **facility** rate (typically used when performed in a hospital or facility where the facility bills separately for its costs).
Because the practice expense portion of RVUs differs by setting, the non-facility and facility payment amounts can be different. For locality-adjusted estimates in 2026, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
Q2 2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | 0 | 0 |
| Practice Expense (PE) | 0 | 0 |
| Malpractice (MP) | 0 | 0 |
| Total RVUs | 0.00 | 0.00 |
Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for 36415?
Medicare does not cover/recognize 36415 as payable under its rules (This code is excluded/invalid for Medicare.). A national reimbursement rate is not expected for 2026.
What is the description for code 36415?
Collection of venous blood by venipuncture. The drawing of blood from a vein using a needle and syringe or evacuated tube system for diagnostic laboratory testing. This code covers the collection service only and does not include the cost of laboratory analysis.
Why do facility and non-facility payments differ for 36415?
For many physician services, Medicare publishes different practice-expense RVUs by setting. In general, non-facility rates apply when services are performed in a private office, while facility rates apply when performed in a hospital or facility where the facility bills separately.
How can I find my local Medicare rate for 36415?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is 36415 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.
