CPT 83036: hemoglobin A1c test (average blood sugar). What Medicare pays and what to ask
The A1C test is one of the most common blood tests for people with or at risk of diabetes. Here is what 83036 covers and what Medicare's laboratory rate is.
What this code means
CPT 83036 is a hemoglobin A1c test, a blood test that shows average blood sugar over roughly the past two to three months.
It is used to diagnose diabetes and prediabetes and to check how well diabetes is controlled. It is often ordered with a lipid panel (80061) or a metabolic panel (80053).
Why the bill can be much higher than the Medicare rate
The blood draw is usually billed on its own line, with 36415.
Lab charges on hospital bills can be many times the Medicare lab rate. The rate is a public reference point, not a legal limit.
| If a line is billed at | It would be |
|---|---|
| 5x the Medicare rate | $48.55 |
| 10x the Medicare rate | $97.10 |
| 20x the Medicare rate | $194.20 |
The Medicare rate is a published benchmark, not a legal ceiling on what a provider may charge. Our free scan flags a line as worth a closer look when it is billed at more than 10 times the Medicare rate.
Questions worth asking before you pay
- Was the A1C test run once on this date?
- Is the blood draw (36415) listed only once?
- Was it billed as a screening or as a diagnostic test, and does that match why it was ordered?
Check every line against the official Medicare rates in about a minute. The scan is free.
Related codes
Source: Medicare Clinical Laboratory Fee Schedule (CMS, 2026), national payment limit. Last updated October 2026. This page is general information, not legal or medical advice. Rates change each year and a hospital bill can include charges that the benchmark does not cover.