Priced under CLFS
36415 · PFS Q4 2020 · Historical
Status X is not separately payable under the PFS.
CMS RVU20DOctober 1 – December 31, 2020
PFS status evidence
Inspect PFS status evidence
- Code
- 36415
- Release
- Q4 2020, revision 1
- Result
- Priced under CLFS
Citations
-
Shows this code’s PFS status (X). Result: Priced under CLFS.
Physician relative value file (PPRRVU)CMS RVU20DOctober 1 – December 31, 2020
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU20_OCT.csv row 8,954 in rvu20d-updated-11232020.zip
In the CMS file
Loading rows 8,952–8,956 of PPRRVU20_OCT.csv…
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504fd19a9bc1d2eeebb290adac2d7de6c56d4e86cde7532df1862fe42494d319
CPT 36415 has no published national rate. It carries status X (statutory exclusion) in the Q4 2020 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.
Why is there no national PFS amount for 36415?
Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.
About this code
Also known as Blood draw, Complete blood count (CBC), Cholesterol test, Thyroid test
Taking a blood sample from a vein, usually at the inside of the elbow or the back of the hand, for laboratory testing. This covers the draw itself, not the tests run on the sample. Medicare reported 40.3 million services under this code in CY2024.
Plain-language context only—not the official CPT descriptor and not coding guidance
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (9)
Why would a Medicare claim for 36415 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
Which billing rules and modifiers apply? Copy link
Global period: what 36415's fee already covers Copy link
The global surgery concept does not apply to this code.
Can you bill it with another code? Copy link
Check a pair of codes Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.
Payment review for 36415 Copy link
The blood draw and the lab tests it supports are separate lines, sometimes paid under different Medicare fee schedules. Keep their units, sources, and billing settings apart when you review them.
What to check
- Don’t bill extra collection units just because one draw supplied several tests.
- Check the current MUE and how it’s applied before treating a unit reduction as a pricing error.
- Don’t add a CLFS test amount to the PFS collection amount unless both match how the service was actually billed.
Compare against 36416, 80053 and 85025: their amounts are in Related codes.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Clinical Laboratory Fee Schedule; CMS Medicare NCCI Policy Manual (2026).
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for 36415 across quarterly releases.
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 Oct 1, 2026 – present | X | — | — |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | X | — | — |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | X | — | — |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | X | — | — |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | X | — | — |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | X | — | — |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | X | — | — |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | X | — | — |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | X | — | — |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | X | — | — |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | X | — | — |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | X | — | — |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | X | — | — |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | X | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | X | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | X | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | X | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | X | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | X | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | X | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | X | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | X | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | X | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | X | — | — |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | X | — | — |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | X | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | X | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | X | — | — |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | X | — | — |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | X | — | — |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | X | — | — |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | X | — | — |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | X | — | — |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | X | — | — |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | X | — | — |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | X | — | — |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | X | — | — |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | X | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | X | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | X | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | X | — | — |
| Q4 2016 Oct 1, 2016 – Dec 31, 2016 | X | — | — |
| Q3 2016 Jul 1, 2016 – Sep 30, 2016 | X | — | — |
| Q2 2016 Apr 1, 2016 – Jun 30, 2016 | X | — | — |
| Q1 2016 Jan 1, 2016 – Mar 31, 2016 | X | — | — |
| Q4 2015 Oct 1, 2015 – Dec 31, 2015 | X | — | — |
| Q3 2015 Jul 1, 2015 – Sep 30, 2015 | X | — | — |
| Q2 2015 Apr 1, 2015 – Jun 30, 2015 | X | — | — |
| Q1 2015 Jan 1, 2015 – Mar 31, 2015 | X | — | — |
| Q4 2014 Oct 1, 2014 – Dec 31, 2014 | X | — | — |
| Q3 2014 Jul 1, 2014 – Sep 30, 2014 | X | — | — |
| Q2 2014 Apr 1, 2014 – Jun 30, 2014 | X | — | — |
| Q2 2013 Apr 1, 2013 – Jun 30, 2013 | X | — | — |
| Q1 2013 Jan 1, 2013 – Mar 31, 2013 | X | — | — |
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Usage and related codes Copy link
How often 36415 is billed Copy link
Across Original Medicare in CY2024, 36415 ranked #3 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 2.7 times on average that year.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2020 fee schedule above.
Who bills 36415 to Medicare
Observed CY2024 Medicare fee-for-service billing, by the rendering clinician's CMS specialty. Each share is that specialty's slice of all observed services for this code that year.
Setting split that year: 100% Office (non-facility) · 0% facility. CMS publishes only this facility vs non-facility split, never the exact place of service. The Office (non-facility) figure does not identify urgent care or any other specific setting.
CY2024 Medicare fee-for-service only, from the CMS Physician & Other Practitioners dataset, which suppresses rows under 11 beneficiaries. We omit specialty groups with fewer than 30 observed clinicians, so the shares can fall short of 100%. Specialty and practice-type pages linked elsewhere on this page are curated code lists, not utilization claims.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q4 2020 release (effective October 2020). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 36415 National PFS baseline: No national PFS rate (Q4 2020; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU20D, PPRRVU20_OCT.csv row 8,954. Localis. https://localishealth.com/cpt/36415/2020/D