CPT 2026 · Surgery (Respiratory/Cardiovascular)

CPT 36415

Global XXX

Coll venous bld venipuncture

Effective 2026-04-01 Conv. factor $33.4009
No national RVU
Payment Methodology
X
Status Indicator
10
NCCI Partners
XXX
Global Period
No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 36415 Billing & Documentation Guide

CPT code 36415 (Coll venous bld venipuncture) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of XXX. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 36415, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 36415 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Coding Tips for 36415

Real-world specialist guidance from the PayerReady Medical Coding Team, not generic boilerplate.

Venipuncture, routine (36415). Paid about $3 Medicare non-facility. Cannot be billed with modifier 51 (multiple procedures) since it is a low-RVU code already paid at full rate.

Billable once per patient encounter regardless of how many tubes are drawn. Billing multiple units on the same day will trigger MUE rejection.

Not billable with venipuncture that is inherently part of another procedure (IV access for infusion 96374, central line placement). Standalone draw for lab work only.

Payment Status & Global Period

CMS Status Indicator
X

Statutory exclusion

Global Period
XXX

No global period (E/M and other non-procedural services)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service
2
Rationale: CMS Policy
Adjudication: Date of Service (Clinical)
Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 2 units of 36415 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 36415

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36415 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code Relationship Modifier Allowed Rationale
36591 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
36592 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
96523 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
99211 Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
99211 Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0232T Column 2 (secondary), bundled into primary Yes CPT Manual or CMS manual coding instruction
0481T Column 2 (secondary), bundled into primary Yes CPT Manual or CMS manual coding instruction
99291 Column 2 (secondary), bundled into primary Yes CPT Manual or CMS manual coding instruction
99291 Column 2 (secondary), bundled into primary Yes CPT Manual or CMS manual coding instruction
99293 Column 2 (secondary), bundled into primary Yes CPT Manual or CMS manual coding instruction

Frequently Asked Questions, CPT 36415

What does CPT code 36415 mean? +

CPT code 36415 represents: Coll venous bld venipuncture. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of XXX.

What is the Medicare reimbursement for CPT 36415? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 36415? +

Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.

What bundling edits apply to CPT 36415? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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