Posted by: notdeaddinosaur | January 6, 2015

Relative Value

How much would you pay a valet to park your car?

Certainly a job consisting of getting into a car not your own, safely navigating it from point A and parking it at point B, then reversing the procedure at your request is a service that deserves compensation. The question is how much?

Does it depend on the car? Or the skill of valet?

I would say, talking to various people, that the appropriate amount lies somewhere between five and twenty dollars, depending on the specific locale.

Now consider how much you would pay someone to draw your blood, a job that consists of the following steps:

  1. Wrapping a tourniquet around your arm
  2. Palpating to locate an appropriate vein
  3. Cleansing your skin to prevent infection
  4. Passing a needle through your skin and into the vein (but not all the way through it)
  5. Attaching one or more vacuum tubes to the needle (without pushing the needle through the vein)
  6. Removing said tubes and needle, dressing the puncture wound, labeling the tubes, completing the paperwork, and processing the specimens.

Here’s a question: who deserves to be paid more? Or in other words, what is the relative value of each task?

Medicare pays $3.00 (less 1% for the sequestration) for the procedure, coded 36415. Other insurers pay from $2.25 to $5.75, if they pay at all.

Because I draw blood in my office, I can legitimately add to the list above:

  1. Reviewing current medications
  2. Inquiring about the need for any refills, and
  3. Refilling meds as needed
  4. Reviewing results when available
  5. Forwarding results to ordering physicians, when someone other than me is the one who wants the tests
  6. Communicating results to the patient by their preferred means (phone call, email, snail mail)

By adding (“bundling”) the things on the second list, I legitimately bill these encounters as Level 1 office visits. Still makes you wonder about the pricing: I guess people care more about their cars than about their arms.




  1. Unfortunately, we, the people involved, have no say in what medicare or any insurer pays for any procedure. If we did, you would definitely be better compensated and there would be no high priced executives stealing our money.

    And what are you doing up at 4:19 am? Lu


  2. Margaret said it very well.

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