Billing code 36514: Plasma exchangeMedicare rate & RVUs in Oregon
Report therapeutic plasma exchange when a patient’s plasma is removed during an apheresis session to treat a condition such as thrombotic thrombocytopenic purpura.
Medicare pays $710.26–$786.20 for 36514 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 9 sections
What 36514 covers
This service processes a patient’s blood through an apheresis system to separate and remove plasma while returning blood cells to the patient; replacement fluid is used as clinically indicated. It is commonly performed in a hospital or other facility by an apheresis team under physician direction. Typical clinical situations include plasma exchange for thrombotic thrombocytopenic purpura, myasthenia gravis, or Guillain-Barré syndrome when removal of plasma is part of the treatment plan.
Select this code when the treatment removes plasma, rather than targeting red cells, white cells, or platelets. Document the clinical indication, the plasma-directed treatment performed, and the service date. The code has 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is unavailable, and co-surgeon and team-surgery reporting 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 36514 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $786.20 | $79.29 |
| Rest Of Oregon | $710.26 | $76.51 |
How the 36514 rate is calculated
Each of 36514’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 · 36514
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.76Practice expense 19.47Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36514
The CMS indicators that decide how 36514 is paid alongside other services.
CMS payment indicators · 36514
Plasma exchange
| 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
36514 without 51 · national office
$714.45
Plasma exchange
36514-51 · Second procedure: 50%
$357.23
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%).
36514 compared with similar codes
Compare codes
36514 vs 36511 vs 36512 vs 36513 vs 36516: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36511Leukocyte apheresis
- Use 36511 when the apheresis treatment targets white blood cells. Use 36514 when plasma is removed.
- 36512Red cell apheresis
- Use 36512 for therapeutic apheresis targeting red blood cells; this code is for plasma removal.
- 36513Platelet apheresis
- Use 36513 when platelets are the treatment target. This code describes plasma-directed exchange.
- 36516Therapeutic apheresis
- Use 36516 for selective adsorption of targeted substances from plasma. Use this code for therapeutic plasma removal.
36514 billing questions
When should this code be chosen over 36516?
Use this code for therapeutic removal of plasma. Code 36516 describes selective adsorption treatment, which targets selected substances rather than removing plasma broadly.
How does this differ from the other therapeutic apheresis codes?
Choose the code according to the blood component being treated: this service targets plasma, while 36511, 36512, and 36513 target white cells, red cells, and platelets, respectively.
Can modifier 50 be reported?
No. Plasma exchange is not reported as a bilateral service, so modifier 50 is inappropriate.
What documentation supports reporting this service?
Record the indication for treatment and document that the apheresis session removed plasma. The record should make clear that plasma, rather than another blood component, was targeted.
How is this code affected when other procedures occur in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in this code’s 0-day global period.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is unavailable for this service. Co-surgeon and team-surgery reporting are not permitted.
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
Fee sheets
Put 36514 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →