CPT code 36410: Skilled venipuncture, age three or older2026 Medicare rate & RVUs in Madera, CA

Report skilled venipuncture for a patient age three or older when diagnostic or therapeutic access requires physician or qualified health care professional skill.

CMS RVU26DEffective Oct 1, 2026One payment locality108.4K Medicare services in 2024

In Madera, CA, Medicare pays $20.02 for 36410 in the office and $7.94 when it’s performed in a hospital or facility.

$20.02Office (non-facility)
$7.94Hospital or facility
+5.1%vs the national office rate ($19.04)

Check a contract rate as a % of Medicare · 36410 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 36410 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Madera, CA
  2. What 36410 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 36410 covers

CPT 36410 represents a skilled needle puncture of a vein for diagnostic or therapeutic purposes in a patient age three or older. A physician or qualified health care professional performs it when the access requires that level of skill, such as a difficult venous draw for laboratory testing or access needed for treatment. It is not the routine venous blood collection performed through ordinary venipuncture.

Select the code based on the patient’s age, purpose, and documented need for skilled venous access. The record should identify the diagnostic or therapeutic reason and support why the puncture required physician or qualified professional skill rather than routine collection. When multiple procedures subject to the standard reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Madera, CA compares for 36410

Across 109 of 109 payment localities, the office rate for 36410 runs from $16.97 in Arkansas to $24.85 in San Benito County, CA. Madera, CA pays $20.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

36410 in Madera, CA vs other payment areas
  1. Madera, CA · this page$20.02
  2. Bakersfield, CA · California$20.08+$0.06
  3. Chico, CA · California$20.02
  4. El Centro, CA · California$20.02
  5. Fresno, CA · California$20.02
  6. Hanford, CA · California$20.02
  7. Los Angeles, CA · California$21.32+$1.30

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

36410 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$20.02$7.94
Modesto, CACalifornia$20.02$7.94
Napa, CACalifornia$23.02$8.49
Oxnard, CACalifornia$21.20$8.18
Redding, CACalifornia$20.02$7.94
Rest of CaliforniaCalifornia$20.02$7.94
Riverside, CACalifornia$20.23$8.15
Sacramento, CACalifornia$20.96$8.14

36410 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$16.97

$22.55

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
36410 office rate range by state
State / territoryOffice rate rangeLocalities
AK$22.551
AL$17.201
AR$16.971
AZ$18.561
CA$20.02–$24.8529
CO$19.761
CT$20.251
DC$21.641
DE$18.851
FL$18.83–$20.573
GA$17.83–$19.392
GU$20.451
HI$20.451
IA$17.591
ID$17.701
IL$18.34–$20.014
IN$17.791
KS$17.521
KY$17.611
LA$17.59–$18.402
MA$19.65–$21.612
MD$19.19–$21.643
ME$17.80–$18.682
MI$18.05–$19.062
MN$18.931
MO$17.32–$18.453
MS$17.151
MT$19.041
NC$17.971
ND$18.641
NE$17.671
NH$19.461
NJ$20.48–$21.442
NM$18.151
NV$18.941
NY$18.22–$22.335
OH$17.971
OK$17.571
OR$18.79–$20.342
PA$17.99–$19.782
PR$19.161
RI$19.491
SC$18.001
SD$18.591
TN$17.601
TX$17.88–$19.698
UT$18.231
VA$18.63–$21.642
VI$19.161
VT$18.581
WA$19.61–$22.022
WI$18.061
WV$17.711
WY$18.861

See 36410 in every payment locality

How the 36410 rate is calculated

Each of 36410’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 36410

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.37

0.37 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.5700

Conversion factor

$33.4009

Medicare rate

$19.04

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Madera, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,470

Code
36410
Physician work
0.18
Practice expense
0.37
Malpractice
0.02

GPCI2026.csv

14

Locality
Madera, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 36410 in Madera, CA
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0170.1831
Practice expense0.37× 1.0960.4055
Malpractice0.02× 0.5360.0107
Total RVUs0.5993
Conversion factor× 33.4009

Office rate, Madera, CA$20.02

Office: (0.18 × 1.017 + 0.37 × 1.096 + 0.02 × 0.536) × $33.4009 = $20.02

Facility: (0.18 × 1.017 + 0.04 × 1.096 + 0.02 × 0.536) × $33.4009 = $7.94

Open 36410 in the RVU calculator

Payment rules and modifiers for 36410

The CMS indicators that decide how 36410 is paid alongside other services.

CMS payment indicators · 36410

Skilled venipuncture, age three or older

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36410 without 51 · national office

$19.04

Skilled venipuncture, age three or older

36410-51 · Second procedure: 50%

$9.52

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 36410 has changed in Madera, CA

36410 · Office / nonfacility

$20.02

Effective 2026-10-01

The base rate is $1.73 higher than on 2025-10-01, moving from $18.29 to $20.02 (9.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $18.29changed to$20.02

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.37
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $18.45changed to$18.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.33 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $18.15changed to$18.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $18.32changed to$18.15

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.32 changed to 0.33
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $18.60changed to$18.32

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $18.39changed to$18.60

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.31 changed to 0.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $18.27changed to$18.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.29 changed to 0.31
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $18.25changed to$18.27

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $17.84changed to$18.25

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.28 changed to 0.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $17.90changed to$17.84

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$17.90

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$20.02$7.94RVU26D
2026-07-01$20.02$7.94RVU26C
2026-04-01$20.02$7.94RVU26B
2026-01-01$20.02$7.94RVU26A
2025-10-01$18.29$8.74RVU25D
2025-07-01$18.29$8.74RVU25C
2025-04-01$18.29$8.74RVU25B
2025-01-01$18.29$8.74RVU25A
2024-10-01$18.45$9.00RVU24D
2024-07-01$18.45$9.00RVU24C
2024-04-01$18.45$9.00RVU24B
2024-03-09$18.45$9.00RVU24AR
2024-01-01$18.15$8.85RVU24A
2023-10-01$18.32$9.18RVU23D
2023-07-01$18.32$9.18RVU23C
2023-04-01$18.32$9.18RVU23B
2023-01-01$18.32$9.18RVU23A
2022-10-01$18.60$9.39RVU22D
2022-07-01$18.60$9.39RVU22C
2022-04-01$18.60$9.39RVU22B
2022-01-01$18.60$9.39RVU22A
2021-10-01$18.39$9.47RVU21D
2021-07-01$18.39$9.47RVU21C
2021-04-01$18.39$9.47RVU21B
2021-01-01$18.39$9.47RVU21A
2020-10-01$18.27$9.77RVU20D
2020-07-01$18.27$9.77RVU20C
2020-04-01$18.27$9.77RVU20B
2020-01-01$18.27$9.77RVU20A
2019-10-01$18.25$9.73RVU19D
2019-07-01$18.25$9.73RVU19C
2019-04-01$18.25$9.73RVU19B
2019-01-01$18.25$9.73RVU19A
2018-10-01$17.84$9.72RVU18D
2018-07-01$17.84$9.72RVU18C
2018-04-01$17.84$9.72RVU18B
2018-01-01$17.84$9.72RVU18AR1
2017-10-01$17.90$9.76RVU17D
2017-07-01$17.90$9.76RVU17C
2017-04-01$17.90$9.76RVU17B
2017-01-01$17.90$9.76RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36410 for an earlier date of service

Where the Madera, CA rate applies

Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Madera
  • Ahwahnee
  • Bass Lake
  • Bonadelle Ranchos
  • Chowchilla
  • Coarsegold
  • Fairmead
  • La Vina

Browse all communities in California

36410 billing questions

When should 36410 be reported instead of 36415?

Use 36410 when venipuncture for a diagnostic or therapeutic purpose requires physician or qualified health care professional skill. Use 36415 for routine venous blood collection.

Can 36410 be reported for a patient younger than three?

No. This code is for patients age three or older; the pediatric venipuncture codes distinguish younger patients by age and vein site.

Can 36410 and 36415 be reported for the same puncture?

Do not count one venipuncture twice as both skilled and routine collection. Report the code that reflects the service actually performed and the skill it required.

How does the multiple procedure reduction affect 36410?

When multiple procedures subject to the standard reduction occur in the same session, CMS pays the highest-valued procedure in full and the others at 50%.

What documentation supports 36410?

Document the diagnostic or therapeutic purpose, the patient’s age, and the reason the venipuncture required physician or qualified health care professional skill rather than routine collection.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 36410PPRRVU2026_Oct_nonQPP.csv, line 4,470 (RVU26D)
Geographic factors for Madera, CAGPCI2026.csv, line 14 (RVU26D)

Open CMS sourceHow we calculate rates

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