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See a sample rate comparisonCPT 36416 Fee Schedule
CPT 36416 is classified under Surgery, in the Surgical Procedures on the Cardiovascular System subgroup.
Collect Of Capillary Blood Specimen (Eg Finger Heel Ear Stick), Collection Of Capillary Blood Specimen (Eg Finger Heel Ear Stick)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 59 - Distinct Procedural Service EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 36416 |
| Medicaid Fee Schedule | $3.335 median of the 8 states in the free preview · View Medicaid rates for 36416 |
National average reimbursement for CPT 36416 by major payers:
$3.96
BCBS / Anthem
$2.93
UnitedHealthcare
$4.77
Aetna
$3.65
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 36416.
CPT 36416
5 of 25 sample ratesHigher to lower in this preview
Nora Gashi
White Plains Hospital Medical Center
$9.96Published rateAddi Suleiman
The Heart Center Of The Oranges
$4.00Published rateClinton Ogolo
$3.68Published rateAdvanced Care Center
$2.05Published rateElizabeth Salcedo
Consensus Medical Group LLC
$1.52Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 36416 vs. Other Surgical Procedures on the Cardiovascular System Codes
The table lists codes related to 36416. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 36405-CPT | Low | Vnpnxr<3yrs Phy/Qhp Scalp Vn, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture; Scalp Vein |
| 36415-CPT | Low | Routine Venipuncture Or Finge, Routine Venipuncture Or Fingerheelear Stick Forcollection Of Specimen(S) Routine Venipuncture Or Fingerheelear Stick For |
| 36416-CPT | Low | Collect Of Capillary Blood Specimen (Eg Finger Heel Ear Stick), Collection Of Capillary Blood Specimen (Eg Finger Heel Ear Stick) |
| 36430-CPT | Low | Blood Transfusion, A Blood Transfusion Delivers Additional Or Needed Blood Or Blood Products. It May Be Manually Injected (Push Transfusion) Or As An Exchange Simultaneously While Blood Is Removed From The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36416. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36416 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find the cost of a medical procedure beforehand, you'll need to know the specific Current Procedural Terminology (CPT) code for the service and your geographic location. Many factors influence healthcare costs, including the provider, facility, and your insurance plan. For accurate, localized pricing information, you can use Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get an estimate of costs.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to report medical, surgical, and diagnostic services to entities like insurance companies. It's crucial for understanding healthcare costs because it standardizes the description of services. When you know the CPT code for a procedure, you can use it to search for pricing information, such as through Payerprice's fee schedule lookup tool, which allows you to find costs based on specific CPT codes and locations.
Finding transparent pricing for specific medical services based on your location can be challenging, but specialized tools are available. For accurate and specific pricing information, you should use Payerprice. Their fee schedule lookup tool allows you to input the CPT code for the service you need and your specific location to find relevant cost data, helping you understand the potential expense before receiving care.
To compare prices for different healthcare providers in your area, you'll need to know the CPT code for the specific service you're interested in. With this information, you can then utilize tools designed for price transparency. Payerprice provides a fee schedule lookup tool that enables you to search for costs using a CPT code and your specific location, allowing you to compare potential prices from various providers that might perform that service. This helps you make informed decisions about where to seek care.
To understand your out-of-pocket costs for a specific medical service, it's best to start by obtaining the CPT code for the service from your doctor or the facility. Once you have the CPT code, you can use a resource like Payerprice. Payerprice's fee schedule lookup tool allows you to search for estimated costs by entering the CPT code and your specific location. While this gives you a good estimate of the service cost, you should also contact your insurance provider to understand how your specific plan benefits, deductibles, co-pays, and co-insurance will apply to that cost, as Payerprice provides the base fee schedule, not your personalized insurance benefit application.