CPT code 36516: Therapeutic apheresis2026 Medicare rate & RVUs
Report 36516 for therapeutic apheresis that selectively adsorbs or filters a targeted plasma constituent, rather than removing a blood-cell type or exchanging plasma.
Medicare pays $2,227.84 for 36516 nationally in the office and $74.48 in a hospital or facility. Local office rates run $1,916.85–$3,185.10.
Medicare rate · 36516
Therapeutic apheresis
- Work RVUs
- 1.52
- Total RVUs
- 66.70
- Global days
- 000
National rate · 2026
$2,227.84
Office setting, before claim adjustments.
See every locality for 36516 →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.
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On this page 10 sections
What 36516 covers
Code 36516 describes therapeutic apheresis in which a selective adsorption or filtration method removes a targeted substance from the patient’s blood, with the processed blood returned. The method may be used to remove specific antibodies or lipoproteins. Transfusion medicine, hematology, and other clinicians managing apheresis treatments may perform or oversee the service in a hospital or specialized treatment setting. The selective technique—not simply the diagnosis or the fact that apheresis occurred—distinguishes this service from other apheresis procedures.
Choose the code based on the documented procedure and processing method. The record should identify the selective adsorption or filtration performed and the targeted plasma constituent. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
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 36516 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
$1916.85 to $3185.10
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,952.09 | $67.91 |
| Alaska | $2,388.73 | $95.40 |
| Arizona | $2,159.03 | $72.43 |
| Arkansas | $1,916.85 | $67.12 |
| Atlanta, GA | $2,264.99 | $77.18 |
| Austin, TX | $2,352.20 | $73.95 |
| Bakersfield, CA | $2,432.11 | $72.03 |
| Baltimore area, MD | $2,389.50 | $78.94 |
| Beaumont, TX | $2,032.13 | $72.57 |
| Brazoria, TX | $2,206.19 | $72.21 |
| Chicago, IL | $2,254.16 | $90.04 |
| Chico, CA | $2,431.16 | $71.08 |
| Colorado | $2,364.47 | $73.30 |
| Connecticut | $2,398.04 | $78.88 |
| Dallas, TX | $2,217.98 | $73.23 |
| Delaware | $2,200.93 | $73.41 |
| Detroit, MI | $2,160.07 | $82.08 |
| East St. Louis, IL | $2,066.46 | $85.38 |
| El Centro, CA | $2,431.21 | $71.14 |
| Fort Lauderdale, FL | $2,265.44 | $84.09 |
| Fort Worth, TX | $2,196.47 | $73.26 |
| Fresno, CA | $2,431.16 | $71.08 |
| Galveston, TX | $2,211.08 | $72.80 |
| Hanford, CA | $2,431.16 | $71.08 |
| Hawaii, Guam, HI | $2,519.58 | $71.21 |
| Houston, TX | $2,217.48 | $79.20 |
| Idaho | $2,048.45 | $67.36 |
| Indiana | $2,063.76 | $67.60 |
| Iowa | $2,036.73 | $66.41 |
| Kansas | $2,014.17 | $67.53 |
| Kentucky | $1,986.49 | $72.16 |
| King County, WA | $2,719.78 | $77.61 |
| Los Angeles, CA | $2,622.26 | $74.84 |
| Madera, CA | $2,431.16 | $71.08 |
| Manhattan, NY | $2,588.73 | $86.53 |
| Marin County, CA | $3,114.14 | $77.91 |
| Merced, CA | $2,431.16 | $71.08 |
| Metropolitan Boston, MA | $2,648.72 | $77.61 |
| Metropolitan Kansas City, MO | $2,095.48 | $73.48 |
| Metropolitan Philadelphia, PA | $2,319.79 | $78.15 |
| Metropolitan St. Louis, MO | $2,123.93 | $73.93 |
| Miami, FL | $2,334.50 | $92.85 |
| Minnesota | $2,282.41 | $66.60 |
| Mississippi | $1,923.80 | $69.76 |
| Modesto, CA | $2,431.16 | $71.08 |
| Montana | $2,227.82 | $74.46 |
| Napa, CA | $2,913.88 | $75.75 |
| Nebraska | $2,053.83 | $66.29 |
| Nevada | $2,228.05 | $72.54 |
| New Hampshire | $2,315.16 | $73.52 |
| New Mexico | $2,050.46 | $75.84 |
| New Orleans, LA | $2,101.67 | $75.36 |
| North Carolina | $2,078.54 | $69.46 |
| North Dakota | $2,220.90 | $67.54 |
| Northern New Jersey | $2,578.29 | $80.40 |
| NYC suburbs and Long Island, NY | $2,650.36 | $90.02 |
| Ohio | $2,039.55 | $73.53 |
| Oklahoma | $1,993.54 | $70.59 |
| Oxnard, CA | $2,618.95 | $73.69 |
| Portland, OR | $2,466.02 | $73.64 |
| Poughkeepsie and northern NYC suburbs, NY | $2,438.29 | $80.37 |
| Puerto Rico | $2,251.48 | $74.44 |
| Queens, NY | $2,630.36 | $85.09 |
| Redding, CA | $2,431.16 | $71.08 |
| Rest of California | $2,431.16 | $71.08 |
| Rest of Florida | $2,138.44 | $79.84 |
| Rest of Georgia | $1,996.22 | $75.43 |
| Rest of Illinois | $2,046.03 | $80.02 |
| Rest of Louisiana | $1,978.33 | $72.61 |
| Rest of Maine | $2,050.19 | $69.10 |
| Rest of Maryland | $2,253.37 | $74.18 |
| Rest of Massachusetts | $2,341.04 | $73.56 |
| Rest of Michigan | $2,040.96 | $74.95 |
| Rest of Missouri | $1,928.71 | $72.52 |
| Rest of New Jersey | $2,430.22 | $78.75 |
| Rest of New York | $2,116.10 | $70.41 |
| Rest of Oregon | $2,215.71 | $70.96 |
| Rest of Pennsylvania | $2,049.64 | $72.86 |
| Rest of Texas | $2,116.27 | $72.74 |
| Rest of Washington | $2,340.47 | $72.99 |
| Rhode Island | $2,299.00 | $74.58 |
| Riverside, CA | $2,434.91 | $74.83 |
| Sacramento, CA | $2,577.20 | $72.85 |
| Salinas, CA | $2,568.29 | $72.55 |
| San Benito County, CA | $3,185.10 | $79.96 |
| San Diego, CA | $2,648.42 | $73.01 |
| San Francisco, CA | $3,113.75 | $77.52 |
| San Luis Obispo, CA | $2,524.27 | $71.59 |
| Santa Clara County, CA | $3,183.47 | $78.33 |
| Santa Cruz, CA | $2,689.04 | $72.71 |
| Santa Maria, CA | $2,583.29 | $72.48 |
| Santa Rosa, CA | $2,717.65 | $73.32 |
| South Carolina | $2,061.52 | $71.82 |
| South Dakota | $2,220.08 | $66.72 |
| Southern Maine, ME | $2,204.04 | $70.06 |
| Stockton, CA | $2,431.16 | $71.08 |
| Suburban Chicago, IL | $2,295.69 | $84.19 |
| Tennessee | $2,025.38 | $67.98 |
| Utah | $2,096.72 | $72.57 |
| Vallejo, CA | $2,913.30 | $75.18 |
| Vermont | $2,200.41 | $68.59 |
| Virgin Islands, VI | $2,251.48 | $74.44 |
| Virginia | $2,187.59 | $70.84 |
| Visalia, CA | $2,431.16 | $71.08 |
| Washington, DC area | $2,617.34 | $80.69 |
| West Virginia | $1,949.21 | $77.95 |
| Wisconsin | $2,128.80 | $65.89 |
| Wyoming | $2,224.80 | $71.44 |
| Yuba City, CA | $2,431.16 | $71.08 |
36516 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.
$1,916.85
$2,808.13
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 | $2,388.73 | 1 |
| AL | $1,952.09 | 1 |
| AR | $1,916.85 | 1 |
| AZ | $2,159.03 | 1 |
| CA | $2,431.16–$3,185.10 | 29 |
| CO | $2,364.47 | 1 |
| CT | $2,398.04 | 1 |
| DC | $2,617.34 | 1 |
| DE | $2,200.93 | 1 |
| FL | $2,138.44–$2,334.50 | 3 |
| GA | $1,996.22–$2,264.99 | 2 |
| GU | $2,519.58 | 1 |
| HI | $2,519.58 | 1 |
| IA | $2,036.73 | 1 |
| ID | $2,048.45 | 1 |
| IL | $2,046.03–$2,295.69 | 4 |
| IN | $2,063.76 | 1 |
| KS | $2,014.17 | 1 |
| KY | $1,986.49 | 1 |
| LA | $1,978.33–$2,101.67 | 2 |
| MA | $2,341.04–$2,648.72 | 2 |
| MD | $2,253.37–$2,617.34 | 3 |
| ME | $2,050.19–$2,204.04 | 2 |
| MI | $2,040.96–$2,160.07 | 2 |
| MN | $2,282.41 | 1 |
| MO | $1,928.71–$2,123.93 | 3 |
| MS | $1,923.80 | 1 |
| MT | $2,227.82 | 1 |
| NC | $2,078.54 | 1 |
| ND | $2,220.90 | 1 |
| NE | $2,053.83 | 1 |
| NH | $2,315.16 | 1 |
| NJ | $2,430.22–$2,578.29 | 2 |
| NM | $2,050.46 | 1 |
| NV | $2,228.05 | 1 |
| NY | $2,116.10–$2,650.36 | 5 |
| OH | $2,039.55 | 1 |
| OK | $1,993.54 | 1 |
| OR | $2,215.71–$2,466.02 | 2 |
| PA | $2,049.64–$2,319.79 | 2 |
| PR | $2,251.48 | 1 |
| RI | $2,299.00 | 1 |
| SC | $2,061.52 | 1 |
| SD | $2,220.08 | 1 |
| TN | $2,025.38 | 1 |
| TX | $2,032.13–$2,352.20 | 8 |
| UT | $2,096.72 | 1 |
| VA | $2,187.59–$2,617.34 | 2 |
| VI | $2,251.48 | 1 |
| VT | $2,200.41 | 1 |
| WA | $2,340.47–$2,719.78 | 2 |
| WI | $2,128.80 | 1 |
| WV | $1,949.21 | 1 |
| WY | $2,224.80 | 1 |
How the 36516 rate is calculated
Each of 36516’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 · 36516
RVUs × geographic indexes × conversion factor
Work1.52
1.52 RVUs× 1.000 GPCI
Practice expense64.83
64.83 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
66.7000
Conversion factor
$33.4009
Medicare rate
$2,227.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36516
The CMS indicators that decide how 36516 is paid alongside other services.
CMS payment indicators · 36516
Therapeutic apheresis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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
36516 without 51 · national office
$2,227.84
Therapeutic apheresis
36516-51 · Second procedure: 50%
$1,113.92
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%).
36516 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36514Plasma exchange
- Use 36516 for selective adsorption or filtration of a targeted plasma constituent. Use 36514 for therapeutic plasma exchange.
- 36511Leukocyte apheresis
- 36511 is directed at white blood cells. It does not describe selective removal of a plasma constituent by adsorption or filtration.
- 36522Photopheresis
- 36522 describes photopheresis, not selective adsorption or filtration of a targeted plasma constituent.
36516 billing questions
How is 36516 different from plasma exchange?
36516 involves selective adsorption or filtration of a targeted plasma constituent. Code 36514 describes therapeutic plasma exchange, a different apheresis method.
Does removing antibodies qualify for 36516?
It may, when the documented treatment selectively adsorbs or filters the targeted antibodies. The procedure method, not the diagnosis alone, supports code selection.
Can 36516 be reported with another procedure in the same session?
When distinct procedures are performed in the same session, Medicare applies its multiple-procedure reduction: the highest-valued procedure is paid in full and others at 50%.
Should modifier 50 be used?
No. Bilateral adjustment does not apply to 36516, and modifier 50 is inappropriate.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or surgical team be reported?
Assistant-at-surgery payment is statutorily restricted. Co-surgeons and team surgery are not permitted for this service.
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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