36415
No office rateColl venous bld venipuncture
Use 36415 for routine venous blood collection to obtain a laboratory specimen. Use 99195 when blood removal itself is the treatment.
On this page
CMS RVU26D · Effective 2026-10-01
99195 Therapeutic phlebotomy Medicare reimbursement rates in Nevada
Report therapeutic phlebotomy when blood is removed as treatment, such as for hemochromatosis or polycythemia, rather than collected only for testing. Compare 99195 office and facility rates across CMS payment localities in Nevada.
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 99195 in Nevada?
Nevada 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
$98.02
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
No supported rate
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.
Phlebotomy
About 99195: Therapeutic blood removal by phlebotomy
Report therapeutic phlebotomy when blood is removed as treatment, such as for hemochromatosis or polycythemia, rather than collected only for testing.
CPT 99195 represents blood removal for a therapeutic purpose, such as reducing iron stores in a patient with hemochromatosis or lowering red cell mass in a patient with polycythemia. It is distinct from drawing a sample for laboratory analysis. A physician or office staff member may perform the procedure in an outpatient setting; when staff perform it, Medicare treats the service as incident-to and requires physician supervision for billing.
Document the treatment indication and that therapeutic blood removal was performed; recording the amount removed helps show the service provided. Report 99195 for the therapeutic procedure, not for each specimen tube or laboratory test. A CBC or hematocrit may be reported separately when performed as a distinct test. Medicare payment requires physician supervision when the service is performed incident-to.
CMS billing rules for 99195
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU2.89 · 98%
- Malpractice RVU0.05 · 2%
68.7K
Medicare services in 2024 · #680 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.
99195 compared with similar codes
Office rates for Nevada, from the same CMS release.
85025
No office rateComplete cbc w/auto diff wbc
Code 85025 reports a blood count with an automated differential, not the therapeutic removal of blood. It may be reported separately when that test is performed.
Compare 99195 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
Nevada** →
Office / nonfacility
$98.02
Facility
Unavailable
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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 99195 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
13,007
- Code
- 99195
- Physician work
- 0.00
- Practice expense
- 2.89
- Malpractice
- 0.05
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 2.89 | × 1.001 | 2.8929 |
| Malpractice | 0.05 | × 0.833 | 0.0416 |
| Total RVUs | 2.9345 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$98.02
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 2.89 | 1.001 |
| Malpractice | 0.05 | 0.833 |
(0 × 1 + 2.89 × 1.001 + 0.05 × 0.833) × $33.4009 = $98.02
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.
99195 billing questions
How is 99195 different from 36415?
99195 represents blood removal as treatment, such as for hemochromatosis or polycythemia. Code 36415 represents routine venous blood collection for testing.
Can a CBC or hematocrit be reported with 99195?
A CBC or hematocrit may be separately reported when the test is performed as a distinct service, such as monitoring blood counts. The test result alone does not establish that therapeutic phlebotomy was performed.
What documentation supports reporting 99195?
Document the therapeutic indication and that blood was removed as treatment. Including the amount removed helps describe the procedure performed.
Who may perform the procedure for Medicare billing?
The service is billed as incident-to and, when performed by staff, requires physician supervision under the CMS rule supplied for this code.
Is 99195 reported for each tube collected?
No. The code represents therapeutic blood removal, not the number of diagnostic specimen tubes.
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.
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13,00599191,,Special pump services,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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13,00999202,,Office o/p new sf 15 min,A,,0.93,1.25,,0.23,,0.07,2.25,1.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,01099203,,Office o/p new low 30 min,A,,1.60,1.76,,0.38,,0.16,3.52,2.14,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097