HCPCS 36415

Procedure (ClaimLight category; the code descriptor is not shown)

Procedures Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

90,924
100th percentile among 6,116 codes billed · 2020
$122M
98th percentile among 6,116 codes billed · 2020
41.1M
100th percentile among 6,116 codes billed · 2020
94
87th percentile among 6,116 codes billed · 2020
851
87th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M2020: $122M paid20202021: $126M paid20212022: $120M paid20222023: $329M paid20232024: $340M paid2024$340M$0$200M2020: $122M paid20202021: $126M paid20212022: $120M paid20222023: $329M paid20232024: $340M paid2024$340M$0$200M2020: $122M paid20202021: $126M paid20212022: $120M paid20222023: $329M paid20232024: $340M paid2024$340M$0$200M2020: $122M paid20202021: $126M paid20212022: $120M paid20222023: $329M paid20232024: $340M paid2024$340M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

050K100K2020: 91K providers20202021: 88K providers20212022: 87K providers20222023: 86K providers20232024: 86K providers202486K050K100K2020: 91K providers20202021: 88K providers20212022: 87K providers20222023: 86K providers20232024: 86K providers202486K050K100K2020: 91K providers20202021: 88K providers20212022: 87K providers20222023: 86K providers20232024: 86K providers202486K050K100K2020: 91K providers20202021: 88K providers20212022: 87K providers20222023: 86K providers20232024: 86K providers202486K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
202485,982$339,504,704+3%39,989,147877940.00
202386,467$328,696,833+174%40,177,505918170.00
202286,670$120,038,594-5%40,602,868958360.00
202188,328$125,979,925+3%42,095,636998720.00
202090,924$122,247,740first year in data41,117,428948510.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida5,922$11,650,1853,914,9951001,556
California4,490$11,573,0293,889,62075958
Texas6,284$10,246,2403,441,809105953
North Carolina3,947$8,277,2522,779,107100836
New York8,456$6,940,2452,332,19995732
New Jersey2,503$6,937,7812,328,78097765
Arizona1,449$4,152,8651,396,16787801
Illinois3,666$4,135,2021,389,195100786
Tennessee3,389$3,878,8991,310,543112952
Pennsylvania2,795$3,844,1191,290,77667643
Ohio2,254$3,800,5361,278,00594552
Georgia3,151$3,536,7841,192,235117904
Massachusetts2,398$3,385,8491,136,42094736
Virginia2,644$2,922,842983,2481421,005
Alabama1,761$2,865,967963,17197906

Not listed: 13 billers with an armed-forces or unknown state code (AA, AE, AP, XX, ZZ); they are in the national totals.

Not listed: 1 state with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,593$12,078,6904,055,81098
Burlington, NC72$4,954,0931,662,550113
Los Angeles-Long Beach-Anaheim, CA2,818$4,640,3561,561,10177
Tampa-St. Petersburg-Clearwater, FL846$4,607,3121,546,90575
Phoenix-Mesa-Chandler, AZ901$3,822,2231,285,11483
Dallas-Fort Worth-Arlington, TX2,036$3,710,7711,246,014110
Chicago-Naperville-Elgin, IL-IN2,687$3,405,4321,144,13293
Boston-Cambridge-Newton, MA-NH1,770$2,752,286923,52491
Sacramento-Roseville-Folsom, CA78$2,358,178791,32549
Houston-Pasadena-The Woodlands, TX696$2,308,143774,26193
Miami-Fort Lauderdale-West Palm Beach, FL1,736$2,242,011752,94779
San Diego-Chula Vista-Carlsbad, CA397$2,241,168752,71761
Columbus, OH600$2,006,175673,471128
Atlanta-Sandy Springs-Roswell, GA1,371$1,972,592662,922105
Birmingham, AL424$1,842,834618,82180

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 36415 nationally

Clinical Laboratory accounts for 50% of payment for 36415 nationally in 2020, across 61 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,3961.5%$61,307,16250%20,577,94014,741
Family Practice24,77327%$16,205,70013%5,463,399221
Internal Medicine17,86020%$15,960,17213%5,373,546301
Hematology-Oncology2,7243.0%$7,237,8765.9%2,437,640895
Nurse Practitioner15,70317%$4,464,1653.7%1,506,23496
Pathology1110.12%$2,849,4712.3%964,1168,686
Urology3,0823.4%$2,259,6291.8%762,265247
Medical Oncology8160.90%$1,927,8261.6%649,321796
Physician Assistant7,2768.0%$1,761,1621.4%593,65182
Rheumatology1,4541.6%$1,566,2891.3%529,067364
Endocrinology1,3841.5%$1,427,2791.2%481,248348
Cardiology2,5652.8%$1,323,4351.1%445,473174
Nephrology1,2721.4%$919,8550.75%310,446244
General Practice8660.95%$492,3930.40%165,685191
Emergency Medicine1,0851.2%$296,4440.24%99,64992

Not listed: 12 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2020.

Top billers of 36415 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations