HCPCS 36415

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

Procedures Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

86,467
100th percentile among 6,405 codes billed · 2023
$329M
99th percentile among 6,405 codes billed · 2023
40.2M
100th percentile among 6,405 codes billed · 2023
91
85th percentile among 6,405 codes billed · 2023
817
84th percentile among 6,405 codes billed · 2023
+173.8%
Medicare payment on the code vs 2022; billers -0.2% · 2023

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
California4,544$33,595,5724,064,60375973
Florida6,018$29,979,3313,700,700841,332
Texas6,267$27,995,5413,417,86695861
New Jersey2,201$24,406,9192,967,130107947
North Carolina3,487$22,460,3722,698,61088750
New York8,106$18,449,4632,253,808103829
Arizona1,442$11,847,1991,452,02786785
Illinois4,175$11,124,3251,358,31289693
Tennessee3,306$10,598,4181,281,731118943
Ohio1,913$10,315,4151,245,28088485
Massachusetts2,131$9,859,6481,183,102111740
Georgia3,014$9,635,6671,158,302100826
Virginia2,616$7,817,071979,583124965
Pennsylvania2,338$7,565,369919,14375627
Alabama1,545$7,465,115935,18796825

Not listed: 10 billers with an armed-forces or unknown state code (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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ8,192$38,641,5614,702,395105
Burlington, NC78$15,048,9661,792,97586
Los Angeles-Long Beach-Anaheim, CA2,824$13,098,2161,593,92184
Tampa-St. Petersburg-Clearwater, FL789$12,836,4201,561,38867
Dallas-Fort Worth-Arlington, TX2,094$10,791,9101,306,350112
Phoenix-Mesa-Chandler, AZ977$10,628,7271,295,81381
Chicago-Naperville-Elgin, IL-IN3,037$9,783,2251,184,91384
Boston-Cambridge-Newton, MA-NH1,689$8,499,7651,021,407109
San Diego-Chula Vista-Carlsbad, CA429$7,149,623855,85745
Houston-Pasadena-The Woodlands, TX728$6,572,368799,78063
Sacramento-Roseville-Folsom, CA81$6,260,595746,41952
Atlanta-Sandy Springs-Roswell, GA1,314$5,873,379702,98394
Miami-Fort Lauderdale-West Palm Beach, FL1,818$5,501,992704,84471
Columbus, OH634$5,462,278653,137119
Birmingham, AL375$5,369,677656,34094

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 36415 nationally

Clinical Laboratory accounts for 53% of payment for 36415 nationally in 2023, across 58 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory1,2311.4%$174,464,74353%21,101,24117,142
Family Practice22,38326%$39,322,04912%4,887,950218
Internal Medicine15,84118%$37,652,03311%4,673,918295
Hematology-Oncology2,5703.0%$18,318,4155.6%2,227,899867
Nurse Practitioner17,65620%$14,037,6164.3%1,742,77899
Pathology1270.15%$8,289,5712.5%1,000,3027,876
Urology2,8063.2%$5,799,5171.8%722,515257
Physician Assistant7,4458.6%$5,505,0331.7%683,43492
Medical Oncology7750.90%$4,840,0251.5%583,408753
Rheumatology1,3721.6%$3,869,7401.2%488,330356
Endocrinology1,3961.6%$3,738,9341.1%466,071334
Cardiology2,4212.8%$3,113,9620.95%385,540159
Nephrology1,1381.3%$2,280,1040.69%283,411249
General Practice7590.88%$1,105,1350.34%141,939187
Gastroenterology1,0731.2%$827,0040.25%101,09594

Not listed: 16 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 2023.

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