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

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 Kansas, Medicare pays $22.43 for 36405 in the office and $12.17 when it’s performed in a hospital or facility.

$22.43Office (non-facility)
$12.17Hospital or facility
−6.7%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 Kansas
  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 Kansas 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. Kansas pays $22.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

36405 in Kansas vs other payment areas
  1. Kansas · this page$22.43
  2. Los Angeles, CA · California$26.68+$4.25
  3. Washington, DC area · District of Columbia$27.04+$4.61
  4. Miami, FL · Florida$25.62+$3.19
  5. Chicago, IL · Illinois$25.05+$2.62
  6. Manhattan, NY · New York$27.25+$4.82
  7. Alaska · Alaska$29.63+$7.20

Other areas in Kansas first, then benchmark localities. Bars start at $0.

Every other payment area

36405 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$22.09$12.15
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

36405 rates by state

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

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 Kansas 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

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Office calculation for 36405 in Kansas
ComponentRVULocality factorAdjusted
Physician work0.30× 1.0000.3000
Practice expense0.40× 0.9040.3616
Malpractice0.02× 0.5040.0101
Total RVUs0.6717
Conversion factor× 33.4009

Office rate, Kansas$22.43

Office: (0.3 × 1 + 0.4 × 0.904 + 0.02 × 0.504) × $33.4009 = $22.43

Facility: (0.3 × 1 + 0.06 × 0.904 + 0.02 × 0.504) × $33.4009 = $12.17

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

How 36405 has changed in Kansas

36405 · Office / nonfacility

$22.43

Effective 2026-10-01

The base rate is $0.92 higher than on 2025-10-01, moving from $21.51 to $22.43 (4.3%).

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

    $21.51changed to$22.43

    • 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
    • Practice expense GPCI 0.906 changed to 0.904
    • Malpractice GPCI 0.540 changed to 0.504

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $22.44changed to$21.51

    • 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

    $22.07changed to$22.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $22.22changed to$22.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.37 changed to 0.39
    • Practice expense GPCI 0.907 changed to 0.906
    • Malpractice GPCI 0.499 changed to 0.540
  5. January 1, 2023

    RVU23A

    $22.67changed to$22.22

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.908 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.499

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $22.23changed to$22.67

    • 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

    $22.41changed to$22.23

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.33 changed to 0.35
    • Practice expense GPCI 0.910 changed to 0.908
    • Malpractice GPCI 0.536 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $22.45changed to$22.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.911 changed to 0.910
    • Malpractice GPCI 0.615 changed to 0.536

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $22.43changed to$22.45

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $24.41changed to$22.43

    • 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
    • Practice expense GPCI 0.907 changed to 0.911
    • Malpractice GPCI 0.639 changed to 0.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $25.07changed to$24.41

    • 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
    • Practice expense GPCI 0.903 changed to 0.907
    • Malpractice GPCI 0.662 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $25.24changed to$25.07

    • 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

    $25.12changed to$25.24

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $25.44changed to$25.12

    • 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
    • Practice expense GPCI 0.899 changed to 0.903
    • Malpractice GPCI 0.810 changed to 0.662

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $25.25changed to$25.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.43 changed to 0.40
    • Practice expense GPCI 0.894 changed to 0.899
    • Malpractice GPCI 0.957 changed to 0.810

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $25.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$22.43$12.17RVU26D
2026-07-01$22.43$12.17RVU26C
2026-04-01$22.43$12.17RVU26B
2026-01-01$22.43$12.17RVU26A
2025-10-01$21.51$13.60RVU25D
2025-07-01$21.51$13.60RVU25C
2025-04-01$21.51$13.60RVU25B
2025-01-01$21.51$13.60RVU25A
2024-10-01$22.44$14.00RVU24D
2024-07-01$22.44$14.00RVU24C
2024-04-01$22.44$14.00RVU24B
2024-03-09$22.44$14.00RVU24AR
2024-01-01$22.07$13.77RVU24A
2023-10-01$22.22$14.22RVU23D
2023-07-01$22.22$14.22RVU23C
2023-04-01$22.22$14.22RVU23B
2023-01-01$22.22$14.22RVU23A
2022-10-01$22.67$14.50RVU22D
2022-07-01$22.67$14.50RVU22C
2022-04-01$22.67$14.50RVU22B
2022-01-01$22.67$14.50RVU22A
2021-10-01$22.23$14.62RVU21D
2021-07-01$22.23$14.62RVU21C
2021-04-01$22.23$14.62RVU21B
2021-01-01$22.23$14.62RVU21A
2020-10-01$22.41$15.19RVU20D
2020-07-01$22.41$15.19RVU20C
2020-04-01$22.41$15.19RVU20B
2020-01-01$22.41$15.19RVU20A
2019-10-01$22.45$15.23RVU19D
2019-07-01$22.45$15.23RVU19C
2019-04-01$22.45$15.23RVU19B
2019-01-01$22.45$15.23RVU19A
2018-10-01$22.43$15.21RVU18D
2018-07-01$22.43$15.21RVU18C
2018-04-01$22.43$15.21RVU18B
2018-01-01$22.43$15.21RVU18AR1
2017-10-01$24.41$15.95RVU17D
2017-07-01$24.41$15.95RVU17C
2017-04-01$24.41$15.95RVU17B
2017-01-01$24.41$15.95RVU17A
2016-10-01$25.07$16.01RVU16D
2016-07-01$25.07$16.01RVU16C
2016-04-01$25.07$16.01RVU16B
2016-01-01$25.07$16.01RVU16A
2015-10-01$25.24$15.83RVU15D
2015-07-01$25.24$15.83RVU15C
2015-04-01$25.12$15.75RVU15B
2015-01-01$25.12$15.75RVU15A
2014-10-01$25.44$16.74RVU14D
2014-07-01$25.44$16.74RVU14C
2014-04-01$25.44$16.74RVU14B
2014-01-01$25.44$16.74RVU14A
2013-10-01$25.25$16.13RVU13D
2013-07-01$25.25$16.13RVU13C
2013-04-01$25.25$16.13RVU13B
2013-01-01$25.25$16.13RVU13AR

Price 36405 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

  • Abbyville
  • Abilene
  • Ada
  • Admire
  • Agenda
  • Agra
  • Albert
  • Alden

Browse all communities in Kansas

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 KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

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