Phlebotomy

What is CPT Code 99195?

Phlebotomy for the purpose of therapeutic blood removal — drawing blood as treatment (e.g., for hemochromatosis or polycythemia vera), not simply for diagnostic testing. Distinct from a routine blood draw (36415).

The Medicare reimbursement rate shown above is the amount the federal government has determined is a reasonable payment for this service. Hospitals and providers that participate in Medicare have agreed to accept these rates from Medicare patients.

Who typically bills this:Hematologist, internist, or infusion center

Common Billing Errors for CPT 99195

• !Billed for routine diagnostic blood draws instead of the correct 36415 code
• !Multiple units billed for a single therapeutic session without documentation of volume removed
• !Facility and physician both billing for the therapeutic phlebotomy without coordination

Red Flags on Your Bill

Negotiation Tips for CPT 99195

1. 1The Medicare rate for 99195 is roughly $25–$35; a charge of $300+ warrants a detailed itemization request
2. 2If the phlebotomy was diagnostic (a standard blood draw for labs), 99195 is incorrect — it should be 36415
3. 3Therapeutic phlebotomy frequency should match the treatment protocol for your specific condition

Codes That Often Appear With This One

These CPT codes commonly appear on the same bill. Review each one to spot potential bundling errors or duplicate charges.

Found CPT 99195 on Your Bill?

If you see CPT code 99195 on a hospital or medical bill, compare the charged amount to the Medicare rate above. If your bill shows a significantly higher charge, you may have grounds to negotiate.

1. Note the amount charged for CPT 99195 on your itemized bill
2. Compare it to the Medicare rate above — calculate the markup
3. Call the billing department and use the Medicare rate as your anchor:“I see CPT code 99195 billed at [amount]. The Medicare rate for this procedure is $94.94. I'd like to discuss a fair adjustment.”