Billing code 36410: Skilled venipunctureMedicare rate & RVUs
Report skilled venipuncture for a patient age three or older when diagnostic or therapeutic access requires physician or qualified health care professional skill.
Medicare pays $19.04 for 36410 nationally in the office and $8.02 in a hospital or facility. Local office rates run $16.97–$24.85.
Medicare rate · 36410
Skilled venipuncture
Swap in your local Medicare rate.
- Work RVUs
- 0.18
- Total RVUs
- 0.57
- Global days
- XXX
National rate · 2026
$19.04
Office setting, before claim adjustments.
See every locality for 36410 → · Billed by an NP, PA or therapist? →
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 10 sections
What 36410 covers
billing code 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.
Where 36410 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$16.97 to $24.85
109 of 109 payment localities
36410 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
Swap in your local Medicare rate.
Work 0.18Practice expense 0.37Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36410
The CMS indicators that decide how 36410 is paid alongside other services.
CMS payment indicators · 36410
Skilled venipuncture
| 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
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%).
36410 compared with similar codes
Compare codes
36410 vs 36415 vs 36400 vs 36405 vs 36420: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36415Coll venous bld venipuncture
- 36415 describes routine venous blood collection. Choose 36410 when the diagnostic or therapeutic puncture requires physician or qualified health care professional skill.
- 36400Venipuncture
- 36400 is for a patient under three and specifies femoral or jugular venipuncture; 36410 is for age three or older.
- 36405Scalp venipuncture
- 36405 covers scalp-vein venipuncture in a patient under three. Age and vein site distinguish it from 36410.
- 36420Venous cutdown
- 36420 involves venous access by cutdown in a patient under one. 36410 describes skilled needle venipuncture in a patient age three or older.
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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