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CPT code 36405: Scalp venipuncture, younger than 3 years2026 Medicare rate & RVUs in Washington, DC area

Reports physician- or qualified health professional-performed scalp-vein venipuncture in a child younger than 3 years for specimen collection or therapeutic purposes.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $27.04 for 36405 in the office and $13.67 when it’s performed in a hospital or facility.

$27.04Office (non-facility)
$13.67Hospital or facility
+12.4%vs the national office rate ($24.05)

Check a contract rate as a % of Medicare · 36405 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 36405 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 36405 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 36405 covers

This code represents venipuncture using a scalp vein in a child younger than 3 years when the procedure requires a physician’s or qualified health professional’s skill. It may be performed to obtain a blood specimen or for a therapeutic purpose, such as gaining venous access to administer treatment. The age and access site distinguish this service from other pediatric venipuncture codes.

Report the service when the documented procedure uses a scalp vein and the child is younger than 3 years; the record should support the site, age, and purpose. This code describes the venipuncture, not laboratory analysis of the specimen. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and the others at 50%.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 36405

Across 109 of 109 payment localities, the office rate for 36405 runs from $21.84 in Arkansas to $30.75 in San Benito County, CA. Washington, DC area pays $27.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

36405 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$27.04
  2. Los Angeles, CA · California$26.68−$0.36
  3. Miami, FL · Florida$25.62−$1.42
  4. Chicago, IL · Illinois$25.05−$1.99
  5. Manhattan, NY · New York$27.25+$0.21
  6. Alaska · Alaska$29.63+$2.59
  7. Alabama · Alabama$22.09−$4.95

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

36405 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$21.84$12.09
ArizonaArizona$23.54$12.53
Bakersfield, CACalifornia$25.26$12.81
Chico, CACalifornia$25.19$12.75
El Centro, CACalifornia$25.19$12.75
Fresno, CACalifornia$25.19$12.75
Hanford, CACalifornia$25.19$12.75
Madera, CACalifornia$25.19$12.75

36405 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$21.84

$29.63

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
36405 office rate range by state
State / territoryOffice rate rangeLocalities
AK$29.631
AL$22.091
AR$21.841
AZ$23.541
CA$25.19–$30.7529
CO$24.881
CT$25.421
DC$27.041
DE$23.871
FL$23.80–$25.623
GA$22.73–$24.432
GU$25.601
HI$25.601
IA$22.511
ID$22.631
IL$23.26–$25.054
IN$22.731
KS$22.431
KY$22.511
LA$22.48–$23.352
MA$24.78–$26.982
MD$24.25–$27.043
ME$22.73–$23.682
MI$22.97–$24.042
MN$23.971
MO$22.19–$23.413
MS$22.021
MT$24.051
NC$22.911
ND$23.651
NE$22.601
NH$24.511
NJ$25.74–$26.862
NM$23.071
NV$23.951
NY$23.18–$27.795
OH$22.891
OK$22.471
OR$23.80–$25.522
PA$22.92–$24.912
PR$24.191
RI$24.611
SC$22.931
SD$23.611
TN$22.521
TX$22.80–$24.778
UT$23.181
VA$23.63–$27.042
VI$24.191
VT$23.591
WA$24.73–$27.462
WI$23.031
WV$22.591
WY$23.871

See 36405 in every payment locality

How the 36405 rate is calculated

Each of 36405’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 36405

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.30

0.30 RVUs× 1.000 GPCI

Practice expense0.40

0.40 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.7200

Conversion factor

$33.4009

Medicare rate

$24.05

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,468

Code
36405
Physician work
0.30
Practice expense
0.40
Malpractice
0.02

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 36405 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.30× 1.0540.3162
Practice expense0.40× 1.1780.4712
Malpractice0.02× 1.1130.0223
Total RVUs0.8097
Conversion factor× 33.4009

Office rate, Washington, DC area$27.04

Office: (0.3 × 1.054 + 0.4 × 1.178 + 0.02 × 1.113) × $33.4009 = $27.04

Facility: (0.3 × 1.054 + 0.06 × 1.178 + 0.02 × 1.113) × $33.4009 = $13.67

Open 36405 in the RVU calculator

Payment rules and modifiers for 36405

The CMS indicators that decide how 36405 is paid alongside other services.

CMS payment indicators · 36405

Scalp venipuncture, younger than 3 years

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36405 without 51 · national office

$24.05

Scalp venipuncture, younger than 3 years

36405-51 · Second procedure: 50%

$12.03

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 36405

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 36405
CodeHow it relatesOffice range, Washington, DC area
Same family
36400Venipuncture, under age three, femoral or jugularPediatric venipuncture for a different specified venous site.$30.69
36406Pediatric venipuncture, other vein, under age threePediatric venipuncture for a vein other than the scalp or specified sites.$20.87
Used instead
36410Skilled venipuncture, age three or olderPhysician- or qualified health professional-performed venipuncture for patients age 3 years or older.$21.64
36415Venipuncture, routine venous sampleRoutine venous blood collection rather than the specified skilled pediatric access.$9.34
36420Venous cutdown, under 1 yearVenous access by cutdown in a child younger than 1 year.No office rate

How 36405 has changed in Washington, DC area

36405 · Office / nonfacility

$27.04

Effective 2026-10-01

The base rate is $1.03 higher than on 2025-10-01, moving from $26.01 to $27.04 (4.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $26.01changed to$27.04

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.31 changed to 0.30
    • Practice expense RVU 0.38 changed to 0.40
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $27.16changed to$26.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.39 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $26.72changed to$27.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $27.15changed to$26.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.37 changed to 0.39
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $28.03changed to$27.15

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $27.40changed to$28.03

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.35 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $27.20changed to$27.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.33 changed to 0.35
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $26.91changed to$27.20

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $26.89changed to$26.91

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $29.92changed to$26.89

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.38 changed to 0.33
    • Malpractice RVU 0.04 changed to 0.02
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $30.73changed to$29.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.41 changed to 0.38
    • Malpractice RVU 0.03 changed to 0.04
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $30.81changed to$30.73

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.42 changed to 0.41
    • Malpractice RVU 0.02 changed to 0.03

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $30.66changed to$30.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $31.04changed to$30.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.40 changed to 0.42
    • Malpractice RVU 0.05 changed to 0.02
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $30.51changed to$31.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.43 changed to 0.40
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $30.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$27.04$13.67RVU26D
2026-07-01$27.04$13.67RVU26C
2026-04-01$27.04$13.67RVU26B
2026-01-01$27.04$13.67RVU26A
2025-10-01$26.01$15.60RVU25D
2025-07-01$26.01$15.60RVU25C
2025-04-01$26.01$15.60RVU25B
2025-01-01$26.01$15.60RVU25A
2024-10-01$27.16$16.05RVU24D
2024-07-01$27.16$16.05RVU24C
2024-04-01$27.16$16.05RVU24B
2024-03-09$27.16$16.05RVU24AR
2024-01-01$26.72$15.79RVU24A
2023-10-01$27.15$16.45RVU23D
2023-07-01$27.15$16.45RVU23C
2023-04-01$27.15$16.45RVU23B
2023-01-01$27.15$16.45RVU23A
2022-10-01$28.03$16.91RVU22D
2022-07-01$28.03$16.91RVU22C
2022-04-01$28.03$16.91RVU22B
2022-01-01$28.03$16.91RVU22A
2021-10-01$27.40$17.05RVU21D
2021-07-01$27.40$17.05RVU21C
2021-04-01$27.40$17.05RVU21B
2021-01-01$27.40$17.05RVU21A
2020-10-01$27.20$17.50RVU20D
2020-07-01$27.20$17.50RVU20C
2020-04-01$27.20$17.50RVU20B
2020-01-01$27.20$17.50RVU20A
2019-10-01$26.91$17.36RVU19D
2019-07-01$26.91$17.36RVU19C
2019-04-01$26.91$17.36RVU19B
2019-01-01$26.91$17.36RVU19A
2018-10-01$26.89$17.34RVU18D
2018-07-01$26.89$17.34RVU18C
2018-04-01$26.89$17.34RVU18B
2018-01-01$26.89$17.34RVU18AR1
2017-10-01$29.92$18.67RVU17D
2017-07-01$29.92$18.67RVU17C
2017-04-01$29.92$18.67RVU17B
2017-01-01$29.92$18.67RVU17A
2016-10-01$30.73$18.65RVU16D
2016-07-01$30.73$18.65RVU16C
2016-04-01$30.73$18.65RVU16B
2016-01-01$30.73$18.65RVU16A
2015-10-01$30.81$18.26RVU15D
2015-07-01$30.81$18.26RVU15C
2015-04-01$30.66$18.17RVU15B
2015-01-01$30.66$18.17RVU15A
2014-10-01$31.04$19.42RVU14D
2014-07-01$31.04$19.42RVU14C
2014-04-01$31.04$19.42RVU14B
2014-01-01$31.04$19.42RVU14A
2013-10-01$30.51$18.28RVU13D
2013-07-01$30.51$18.28RVU13C
2013-04-01$30.51$18.28RVU13B
2013-01-01$30.51$18.28RVU13AR

Price 36405 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

36405 billing questions

When should 36405 be chosen over 36400 or 36406?

Choose 36405 for a scalp vein in a child younger than 3 years. Codes 36400 and 36406 distinguish other venous sites in this age group.

Can 36405 be reported for routine blood collection?

Use it when the documented scalp-vein access in a child younger than 3 requires physician or qualified health professional skill. Routine venous collection is represented by 36415.

Does 36405 include testing the blood specimen?

No. It represents the venipuncture; laboratory analysis is a separate service when performed and reportable.

How does Medicare handle 36405 with other procedures in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.

What documentation supports reporting 36405?

Document the child's age, scalp-vein access, and whether the venipuncture was for specimen collection or a therapeutic purpose.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 36405PPRRVU2026_Oct_nonQPP.csv, line 4,468 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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