HCPCS 36415

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

Procedures Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

88,328
100th percentile among 6,253 codes billed · 2021
$126M
98th percentile among 6,253 codes billed · 2021
42.1M
100th percentile among 6,253 codes billed · 2021
99
86th percentile among 6,253 codes billed · 2021
872
87th percentile among 6,253 codes billed · 2021
+3.1%
Medicare payment on the code vs 2020; billers -2.9% · 2021

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
California4,129$12,047,5054,018,672821,072
Florida5,956$11,684,7503,898,728971,513
Texas6,266$10,685,4323,568,038109962
North Carolina3,584$8,434,4572,810,58397879
New Jersey2,367$7,921,4162,643,420114874
New York8,250$7,248,1762,421,965108824
Arizona1,310$4,337,2631,447,79397883
Illinois3,694$4,293,1981,433,835102818
Tennessee3,360$4,016,3501,348,607115999
Ohio2,083$3,950,1161,319,916103558
Georgia3,083$3,644,0811,220,174122905
Massachusetts2,381$3,639,4951,213,910109809
Pennsylvania2,624$3,417,1331,140,37378590
Virginia2,552$2,928,765978,6081431,019
Alabama1,662$2,881,749962,268108887

Not listed: 12 billers with an armed-forces or unknown state code (AA, AE, XX, ZZ); they are in the national totals.

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,462$13,450,3674,490,386109
Burlington, NC81$5,372,7581,788,61397
Los Angeles-Long Beach-Anaheim, CA2,587$4,919,1231,640,94188
Tampa-St. Petersburg-Clearwater, FL831$4,702,7191,568,29278
Dallas-Fort Worth-Arlington, TX1,978$3,933,8231,313,139129
Phoenix-Mesa-Chandler, AZ849$3,915,6201,306,95885
Chicago-Naperville-Elgin, IL-IN2,721$3,571,5801,193,06091
Boston-Cambridge-Newton, MA-NH1,761$2,981,130994,220105
Sacramento-Roseville-Folsom, CA72$2,436,864812,53656
Houston-Pasadena-The Woodlands, TX707$2,396,561799,24382
San Diego-Chula Vista-Carlsbad, CA364$2,387,898796,27548
Miami-Fort Lauderdale-West Palm Beach, FL1,771$2,267,672756,46581
Columbus, OH621$2,171,318724,238123
Atlanta-Sandy Springs-Roswell, GA1,372$2,102,133701,925111
Birmingham, AL415$1,900,929634,14491

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 2021.

Specialties billing 36415 nationally

Clinical Laboratory accounts for 51% of payment for 36415 nationally in 2021, across 60 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,3541.5%$63,972,45251%21,332,99315,756
Internal Medicine16,90519%$16,232,62513%5,430,518321
Family Practice23,68527%$16,215,02713%5,430,868229
Hematology-Oncology2,6313.0%$7,129,8325.7%2,385,111907
Nurse Practitioner16,16718%$4,949,6453.9%1,658,934103
Pathology1050.12%$2,942,8952.3%987,3619,403
Urology2,9813.4%$2,333,1751.9%782,058262
Medical Oncology8050.91%$1,908,1671.5%638,901794
Physician Assistant7,0027.9%$1,852,0771.5%620,61589
Rheumatology1,4641.7%$1,620,1271.3%543,506371
Endocrinology1,3861.6%$1,506,6871.2%504,539364
Cardiology2,5492.9%$1,366,8041.1%457,233179
Nephrology1,2141.4%$943,6060.75%316,121260
General Practice7900.89%$471,5190.37%157,565199
Gastroenterology1,2331.4%$303,9710.24%102,28483

Not listed: 13 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 2021.

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