localis

Describe a service in plain words, or type a CPT/HCPCS code.

CPT 36415

Blood Draw

Priced under CLFS

36415 · PFS Q1 2026 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules

CPT 36415 has no published national rate. It carries status X (statutory exclusion) in the Q1 2026 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

PFS status evidence

Inspect PFS status evidence
Code
36415
Release
Q1 2026, revision 1
Result
Priced under CLFS

Citations

  • Shows this code’s PFS status (X). Result: Priced under CLFS.

    Physician relative value file (PPRRVU)

    Q1 2026 · revision 1

    Latest revision of this release

    Release period: January 1 – March 31, 2026

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    Record details PPRRVU2026_Jan_nonQPP.csv in rvu26a-updated-12-29-2025.zip (row 4,371)
    hcpcs (col 1)
    36415
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: 9a15cb9cc117f079f5bbd41819bcad7c9ebf71fa8836ee186e079bc15b3269de

    Original source file

Plain-text summary

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)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.

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.

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.

Codes to compare

National Q1 2026 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code Office Facility
36416 Capillary (fingerstick) collection — —
80053 Common lab panel, priced separately — —
85025 Common blood count, priced separately — —

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Clinical Laboratory Fee Schedule; CMS Medicare NCCI Policy Manual (2026).

Which billing rules and modifiers apply? Copy link

Global period: what 36415's fee already covers Copy link

XXX Does not apply

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.

See every current NCCI pair for 36415 →

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 takes effect Oct 1, 2026 X — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 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.

Beneficiaries
14.9M
Office + facility beneficiaries combined
Services
40.3M
Times it was billed
Allowed
$341.9M
Total Medicare allowed dollars
Compare: ↑ #2 more popular · 99213 ↓ #4 less popular · 99233

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 Q1 2026 fee schedule above.

Did this answer your question about CPT 36415?

We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.

Did this page answer your question?

Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2026 release (effective January 2026). 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.

Use the (i) buttons next to each amount above for the exact row, columns, and math.

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 (Q1 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/36415/2026/A