$766.82
Use 36516 for selective adsorption or filtration of a targeted plasma constituent. Use 36514 for therapeutic plasma exchange.
On this page
CMS RVU26D · Effective 2026-10-01
36516 Therapeutic apheresis Medicare reimbursement rates in Connecticut
Report 36516 for therapeutic apheresis that selectively adsorbs or filters a targeted plasma constituent, rather than removing a blood-cell type or exchanging plasma. Compare 36516 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 36516 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$2398.04
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$78.88
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Apheresis
About 36516: Selective adsorption apheresis treatment
Report 36516 for therapeutic apheresis that selectively adsorbs or filters a targeted plasma constituent, rather than removing a blood-cell type or exchanging plasma.
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.
CMS billing rules for 36516
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.52 · 2%
- Practice expense (office) RVU64.83 · 97%
- Malpractice RVU0.35 · 1%
1.1K
Medicare services in 2024 · #2879 by national volume
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.
36516 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
36511 is directed at white blood cells. It does not describe selective removal of a plasma constituent by adsorption or filtration.
$1,464.65
36522 describes photopheresis, not selective adsorption or filtration of a targeted plasma constituent.
Compare 36516 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$2398.04
Facility
$78.88
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 36516 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
4,502
- Code
- 36516
- Physician work
- 1.52
- Practice expense
- 64.83
- Malpractice
- 0.35
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.52 | × 1.020 | 1.5504 |
| Practice expense | 64.83 | × 1.077 | 69.8219 |
| Malpractice | 0.35 | × 1.210 | 0.4235 |
| Total RVUs | 71.7958 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$2398.04
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.52 | 1.02 |
| Practice expense | 64.83 | 1.077 |
| Malpractice | 0.35 | 1.21 |
(1.52 × 1.02 + 64.83 × 1.077 + 0.35 × 1.21) × $33.4009 = $2398.04
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.52 | 1.02 |
| Practice expense | 0.36 | 1.077 |
| Malpractice | 0.35 | 1.21 |
(1.52 × 1.02 + 0.36 × 1.077 + 0.35 × 1.21) × $33.4009 = $78.88
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,49936512,,Apheresis rbc,A,,1.95,0.50,NA,0.50,,0.12,2.57,2.57,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50036513,,Apheresis platelets,A,,1.95,0.53,NA,0.53,,0.16,2.64,2.64,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50136514,,Apheresis plasma,A,,1.76,19.47,,0.42,,0.16,21.39,2.34,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50236516,,Apheresis immunoads slctv,A,,1.52,64.83,,0.36,,0.35,66.70,2.23,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50336522,,Photopheresis,A,,1.71,38.95,,0.50,,0.13,40.79,2.34,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50436555,,Insert non-tunnel cv cath,A,,1.88,4.35,,0.33,,0.16,6.39,2.37,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,50536556,,Insert non-tunnel cv cath,A,,1.71,5.18,,0.38,,0.23,7.12,2.32,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808