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36415 Coll venous bld venipuncture

What 36415 is

CMS fee schedule short descriptor: Coll venous bld venipuncture.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 36415 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 36415 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 36415? These codes are bundled into it

36415 is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
99211Off/op est may x req phy/qhp1 - modifier may bypassCheck pair

36415 is bundled into these codes

36415 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 36415 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0232TNjx platelet plasma1Check pair
0481TNjx autol wbc concentrate1Check pair
99291Critical care first hour1Check pair
99466Ped crit care transport1Check pair
99467Ped crit care transport addl1Check pair
99468Neonate crit care initial1Check pair
99469Neonate crit care subsq1Check pair
99471Ped critical care initial1Check pair
99472Ped critical care subsq1Check pair
99475Ped crit care age 2-5 init1Check pair
99476Ped crit care age 2-5 subsq1Check pair
99477Init day hosp neonate care1Check pair
99478Sbsq ic vlbw inf<1,500 gm1Check pair
99479Sbsq ic lbw inf 1,500-2,5001Check pair
99480Sbsq ic inf pbw 2,501-5,0001Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.