HCPCS 36415

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

Procedures Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

86,670
100th percentile among 6,326 codes billed · 2022
$120M
98th percentile among 6,326 codes billed · 2022
40.6M
100th percentile among 6,326 codes billed · 2022
95
86th percentile among 6,326 codes billed · 2022
836
86th percentile among 6,326 codes billed · 2022
-4.7%
Medicare payment on the code vs 2021; billers -1.9% · 2022

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
California4,323$11,791,6363,982,00678971
Florida5,984$11,040,6313,727,253901,389
Texas6,223$10,412,0703,518,968103903
New Jersey2,267$8,327,0362,813,680114900
North Carolina3,561$8,152,4292,753,63190793
New York8,075$6,947,3362,350,600109820
Arizona1,402$4,350,6091,469,99195847
Illinois3,923$4,098,4681,386,55589735
Tennessee3,293$3,834,1371,302,199121942
Ohio1,917$3,765,0311,273,20793492
Massachusetts2,384$3,482,1051,176,182106754
Georgia3,007$3,367,4721,141,053108842
Virginia2,578$2,938,743994,346135972
Alabama1,582$2,740,246926,741104862
Pennsylvania2,366$2,711,343916,29975597

Not listed: 12 billers with an armed-forces or unknown state code (AA, AE, AP, 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,209$13,670,1234,620,918112
Burlington, NC84$5,270,7311,779,85189
Los Angeles-Long Beach-Anaheim, CA2,790$4,892,2101,651,61682
Tampa-St. Petersburg-Clearwater, FL779$4,575,3581,544,37877
Dallas-Fort Worth-Arlington, TX2,000$3,878,7001,310,488120
Phoenix-Mesa-Chandler, AZ942$3,823,6041,291,52687
Chicago-Naperville-Elgin, IL-IN2,790$3,527,6811,193,89883
Boston-Cambridge-Newton, MA-NH1,752$2,888,376975,639103
San Diego-Chula Vista-Carlsbad, CA381$2,461,695831,42356
Houston-Pasadena-The Woodlands, TX688$2,347,656792,75174
Sacramento-Roseville-Folsom, CA76$2,257,522762,20851
Miami-Fort Lauderdale-West Palm Beach, FL1,777$2,134,221720,35773
Atlanta-Sandy Springs-Roswell, GA1,325$2,024,456684,41299
Columbus, OH614$2,008,436678,524128
Kansas City, MO-KS503$1,870,282631,893151

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 2022.

Specialties billing 36415 nationally

Clinical Laboratory accounts for 52% of payment for 36415 nationally in 2022, across 57 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,2681.5%$62,007,94752%20,940,87516,515
Family Practice22,80226%$14,983,64712%5,078,718223
Internal Medicine16,28619%$14,700,56712%4,977,180306
Hematology-Oncology2,5933.0%$6,661,6425.5%2,255,221870
Nurse Practitioner16,72819%$4,987,9204.2%1,691,043101
Pathology1080.12%$2,909,8032.4%986,3649,133
Urology2,8923.3%$2,222,1111.9%753,655261
Physician Assistant7,1538.3%$1,928,8891.6%654,04291
Medical Oncology7860.91%$1,749,8201.5%592,394754
Rheumatology1,4241.6%$1,499,4861.2%508,945357
Endocrinology1,4181.6%$1,434,4161.2%486,186343
Cardiology2,4162.8%$1,187,5670.99%401,978166
Nephrology1,1941.4%$868,6030.72%294,467247
General Practice7630.88%$456,9170.38%154,641203
Gastroenterology1,1611.3%$348,4750.29%118,700102

Not listed: 19 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 2022.

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