CPT code 36410: Skilled venipuncture, age three or older2026 Medicare rate & RVUs in North Carolina
Report skilled venipuncture for a patient age three or older when diagnostic or therapeutic access requires physician or qualified health care professional skill.
In North Carolina, Medicare pays $17.97 for 36410 in the office and $7.69 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Carolina 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. North Carolina pays $17.97. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$17.97
- Los Angeles, CA · California$21.32+$3.35
- Washington, DC area · District of Columbia$21.64+$3.67
- Miami, FL · Florida$20.57+$2.60
- Chicago, IL · Illinois$20.01+$2.04
- Manhattan, NY · New York$21.82+$3.85
- Alaska · Alaska$22.55+$4.58
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $17.20 | $7.56 |
| ArkansasArkansas | $16.97 | $7.50 |
| ArizonaArizona | $18.56 | $7.88 |
| Bakersfield, CACalifornia | $20.08 | $8.00 |
| Chico, CACalifornia | $20.02 | $7.94 |
| El Centro, CACalifornia | $20.02 | $7.94 |
| Fresno, CACalifornia | $20.02 | $7.94 |
| Hanford, CACalifornia | $20.02 | $7.94 |
| Madera, CACalifornia | $20.02 | $7.94 |
| 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 |
| Salinas, CACalifornia | $20.88 | $8.11 |
| San Diego, CACalifornia | $21.34 | $8.15 |
| Marin County, CACalifornia | $24.32 | $8.77 |
| San Francisco, CACalifornia | $24.29 | $8.75 |
| San Benito County, CACalifornia | $24.85 | $8.96 |
| Santa Clara County, CACalifornia | $24.76 | $8.87 |
| San Luis Obispo, CACalifornia | $20.55 | $7.99 |
| Santa Cruz, CACalifornia | $21.51 | $8.12 |
| Santa Maria, CACalifornia | $20.95 | $8.10 |
| Santa Rosa, CACalifornia | $21.73 | $8.19 |
| Stockton, CACalifornia | $20.02 | $7.94 |
| Vallejo, CACalifornia | $22.99 | $8.46 |
| Visalia, CACalifornia | $20.02 | $7.94 |
| Yuba City, CACalifornia | $20.02 | $7.94 |
| ColoradoColorado | $19.76 | $8.03 |
| ConnecticutConnecticut | $20.25 | $8.38 |
| DelawareDelaware | $18.85 | $7.96 |
| Fort Lauderdale, FLFlorida | $19.74 | $8.57 |
| Rest of FloridaFlorida | $18.83 | $8.29 |
| Atlanta, GAGeorgia | $19.39 | $8.19 |
| Rest of GeorgiaGeorgia | $17.83 | $8.00 |
| Hawaii, Guam, HIHawaii | $20.45 | $7.92 |
| IowaIowa | $17.59 | $7.50 |
| IdahoIdaho | $17.70 | $7.56 |
| East St. Louis, ILIllinois | $18.73 | $8.59 |
| Rest of IllinoisIllinois | $18.34 | $8.28 |
| Suburban Chicago, ILIllinois | $19.93 | $8.61 |
| IndianaIndiana | $17.79 | $7.58 |
| KansasKansas | $17.52 | $7.56 |
| KentuckyKentucky | $17.61 | $7.81 |
| New Orleans, LALouisiana | $18.40 | $8.03 |
| Rest of LouisianaLouisiana | $17.59 | $7.83 |
| Metropolitan Boston, MAMassachusetts | $21.61 | $8.45 |
| Rest of MassachusettsMassachusetts | $19.65 | $8.05 |
| Baltimore area, MDMaryland | $20.20 | $8.37 |
| Rest of MarylandMaryland | $19.19 | $8.04 |
| Rest of MaineMaine | $17.80 | $7.66 |
| Southern Maine, MEMaine | $18.68 | $7.76 |
| Detroit, MIMichigan | $19.06 | $8.43 |
| Rest of MichiganMichigan | $18.05 | $7.99 |
| MinnesotaMinnesota | $18.93 | $7.58 |
| Metropolitan Kansas City, MOMissouri | $18.27 | $7.92 |
| Metropolitan St. Louis, MOMissouri | $18.45 | $7.95 |
| Rest of MissouriMissouri | $17.32 | $7.81 |
| MississippiMississippi | $17.15 | $7.66 |
| MontanaMontana | $19.04 | $8.01 |
| North DakotaNorth Dakota | $18.64 | $7.62 |
| NebraskaNebraska | $17.67 | $7.50 |
| New HampshireNew Hampshire | $19.46 | $7.99 |
| Northern New JerseyNew Jersey | $21.44 | $8.65 |
| Rest of New JerseyNew Jersey | $20.48 | $8.44 |
| New MexicoNew Mexico | $18.15 | $8.04 |
| NevadaNevada | $18.94 | $7.91 |
| NYC suburbs and Long Island, NYNew York | $22.33 | $9.23 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $20.62 | $8.55 |
| Queens, NYNew York | $21.97 | $8.94 |
| Rest of New YorkNew York | $18.22 | $7.75 |
| OhioOhio | $17.97 | $7.91 |
| OklahomaOklahoma | $17.57 | $7.72 |
| Portland, OROregon | $20.34 | $8.09 |
| Rest of OregonOregon | $18.79 | $7.81 |
| Metropolitan Philadelphia, PAPennsylvania | $19.78 | $8.31 |
| Rest of PennsylvaniaPennsylvania | $17.99 | $7.87 |
| Puerto RicoPuerto Rico | $19.16 | $8.02 |
| Rhode IslandRhode Island | $19.49 | $8.10 |
| South CarolinaSouth Carolina | $18.00 | $7.81 |
| South DakotaSouth Dakota | $18.59 | $7.57 |
| TennesseeTennessee | $17.60 | $7.59 |
| Austin, TXTexas | $19.69 | $8.03 |
| Beaumont, TXTexas | $17.88 | $7.85 |
| Brazoria, TXTexas | $18.83 | $7.91 |
| Dallas, TXTexas | $18.95 | $7.97 |
| Fort Worth, TXTexas | $18.83 | $7.97 |
| Galveston, TXTexas | $18.89 | $7.94 |
| Houston, TXTexas | $19.25 | $8.31 |
| Rest of TexasTexas | $18.34 | $7.88 |
| UtahUtah | $18.23 | $7.87 |
| VirginiaVirginia | $18.63 | $7.80 |
| Virgin Islands, VIUnited States Virgin Islands | $19.16 | $8.02 |
| VermontVermont | $18.58 | $7.67 |
| Rest of WashingtonWashington | $19.61 | $8.01 |
| King County, WAWashington | $22.02 | $8.50 |
| WisconsinWisconsin | $18.06 | $7.50 |
| West VirginiaWest Virginia | $17.71 | $8.13 |
| WyomingWyoming | $18.86 | $7.84 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $22.55 | 1 |
| AL | $17.20 | 1 |
| AR | $16.97 | 1 |
| AZ | $18.56 | 1 |
| CA | $20.02–$24.85 | 29 |
| CO | $19.76 | 1 |
| CT | $20.25 | 1 |
| DC | $21.64 | 1 |
| DE | $18.85 | 1 |
| FL | $18.83–$20.57 | 3 |
| GA | $17.83–$19.39 | 2 |
| GU | $20.45 | 1 |
| HI | $20.45 | 1 |
| IA | $17.59 | 1 |
| ID | $17.70 | 1 |
| IL | $18.34–$20.01 | 4 |
| IN | $17.79 | 1 |
| KS | $17.52 | 1 |
| KY | $17.61 | 1 |
| LA | $17.59–$18.40 | 2 |
| MA | $19.65–$21.61 | 2 |
| MD | $19.19–$21.64 | 3 |
| ME | $17.80–$18.68 | 2 |
| MI | $18.05–$19.06 | 2 |
| MN | $18.93 | 1 |
| MO | $17.32–$18.45 | 3 |
| MS | $17.15 | 1 |
| MT | $19.04 | 1 |
| NC | $17.97 | 1 |
| ND | $18.64 | 1 |
| NE | $17.67 | 1 |
| NH | $19.46 | 1 |
| NJ | $20.48–$21.44 | 2 |
| NM | $18.15 | 1 |
| NV | $18.94 | 1 |
| NY | $18.22–$22.33 | 5 |
| OH | $17.97 | 1 |
| OK | $17.57 | 1 |
| OR | $18.79–$20.34 | 2 |
| PA | $17.99–$19.78 | 2 |
| PR | $19.16 | 1 |
| RI | $19.49 | 1 |
| SC | $18.00 | 1 |
| SD | $18.59 | 1 |
| TN | $17.60 | 1 |
| TX | $17.88–$19.69 | 8 |
| UT | $18.23 | 1 |
| VA | $18.63–$21.64 | 2 |
| VI | $19.16 | 1 |
| VT | $18.58 | 1 |
| WA | $19.61–$22.02 | 2 |
| WI | $18.06 | 1 |
| WV | $17.71 | 1 |
| WY | $18.86 | 1 |
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
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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.37 | × 0.933 | 0.3452 |
| Malpractice | 0.02 | × 0.639 | 0.0128 |
| Total RVUs | 0.5380 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$17.97
Office: (0.18 × 1 + 0.37 × 0.933 + 0.02 × 0.639) × $33.4009 = $17.97
Facility: (0.18 × 1 + 0.04 × 0.933 + 0.02 × 0.639) × $33.4009 = $7.69
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
How 36410 has changed in North Carolina
36410 · Office / nonfacility
$17.97
Effective 2026-10-01
The base rate is $1.53 higher than on 2025-10-01, moving from $16.44 to $17.97 (9.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$16.44changed to$17.97
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.34 changed to 0.37
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$16.61changed to$16.44
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.33 changed to 0.34
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$16.34changed to$16.61
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$16.65changed to$16.34
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.32 changed to 0.33
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$17.07changed to$16.65
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$16.89changed to$17.07
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.31 changed to 0.32
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$16.78changed to$16.89
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.29 changed to 0.31
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$16.72changed to$16.78
- Conversion factor 36.0391 changed to 36.0896
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$16.36changed to$16.72
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.28 changed to 0.29
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$16.34changed to$16.36
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$16.32changed to$16.34
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$16.38changed to$16.32
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$16.30changed to$16.38
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$16.22changed to$16.30
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.27 changed to 0.28
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$16.30changed to$16.22
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.30 changed to 0.27
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $16.30
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $17.97 | $7.69 | RVU26D |
| 2026-07-01 | $17.97 | $7.69 | RVU26C |
| 2026-04-01 | $17.97 | $7.69 | RVU26B |
| 2026-01-01 | $17.97 | $7.69 | RVU26A |
| 2025-10-01 | $16.44 | $8.35 | RVU25D |
| 2025-07-01 | $16.44 | $8.35 | RVU25C |
| 2025-04-01 | $16.44 | $8.35 | RVU25B |
| 2025-01-01 | $16.44 | $8.35 | RVU25A |
| 2024-10-01 | $16.61 | $8.59 | RVU24D |
| 2024-07-01 | $16.61 | $8.59 | RVU24C |
| 2024-04-01 | $16.61 | $8.59 | RVU24B |
| 2024-03-09 | $16.61 | $8.59 | RVU24AR |
| 2024-01-01 | $16.34 | $8.45 | RVU24A |
| 2023-10-01 | $16.65 | $8.80 | RVU23D |
| 2023-07-01 | $16.65 | $8.80 | RVU23C |
| 2023-04-01 | $16.65 | $8.80 | RVU23B |
| 2023-01-01 | $16.65 | $8.80 | RVU23A |
| 2022-10-01 | $17.07 | $9.04 | RVU22D |
| 2022-07-01 | $17.07 | $9.04 | RVU22C |
| 2022-04-01 | $17.07 | $9.04 | RVU22B |
| 2022-01-01 | $17.07 | $9.04 | RVU22A |
| 2021-10-01 | $16.89 | $9.12 | RVU21D |
| 2021-07-01 | $16.89 | $9.12 | RVU21C |
| 2021-04-01 | $16.89 | $9.12 | RVU21B |
| 2021-01-01 | $16.89 | $9.12 | RVU21A |
| 2020-10-01 | $16.78 | $9.39 | RVU20D |
| 2020-07-01 | $16.78 | $9.39 | RVU20C |
| 2020-04-01 | $16.78 | $9.39 | RVU20B |
| 2020-01-01 | $16.78 | $9.39 | RVU20A |
| 2019-10-01 | $16.72 | $9.34 | RVU19D |
| 2019-07-01 | $16.72 | $9.34 | RVU19C |
| 2019-04-01 | $16.72 | $9.34 | RVU19B |
| 2019-01-01 | $16.72 | $9.34 | RVU19A |
| 2018-10-01 | $16.36 | $9.33 | RVU18D |
| 2018-07-01 | $16.36 | $9.33 | RVU18C |
| 2018-04-01 | $16.36 | $9.33 | RVU18B |
| 2018-01-01 | $16.36 | $9.33 | RVU18AR1 |
| 2017-10-01 | $16.34 | $9.32 | RVU17D |
| 2017-07-01 | $16.34 | $9.32 | RVU17C |
| 2017-04-01 | $16.34 | $9.32 | RVU17B |
| 2017-01-01 | $16.34 | $9.32 | RVU17A |
| 2016-10-01 | $16.32 | $9.33 | RVU16D |
| 2016-07-01 | $16.32 | $9.33 | RVU16C |
| 2016-04-01 | $16.32 | $9.33 | RVU16B |
| 2016-01-01 | $16.32 | $9.33 | RVU16A |
| 2015-10-01 | $16.38 | $9.36 | RVU15D |
| 2015-07-01 | $16.38 | $9.36 | RVU15C |
| 2015-04-01 | $16.30 | $9.31 | RVU15B |
| 2015-01-01 | $16.30 | $9.31 | RVU15A |
| 2014-10-01 | $16.22 | $9.56 | RVU14D |
| 2014-07-01 | $16.22 | $9.56 | RVU14C |
| 2014-04-01 | $16.22 | $9.56 | RVU14B |
| 2014-01-01 | $16.22 | $9.56 | RVU14A |
| 2013-10-01 | $16.30 | $9.04 | RVU13D |
| 2013-07-01 | $16.30 | $9.04 | RVU13C |
| 2013-04-01 | $16.30 | $9.04 | RVU13B |
| 2013-01-01 | $16.30 | $9.04 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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