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

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 Houston, TX, Medicare pays $24.29 for 36405 in the office and $13.01 when it’s performed in a hospital or facility.

$24.29Office (non-facility)
$13.01Hospital or facility
+1.0%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $24.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

36405 in Houston, TX vs other payment areas
  1. Houston, TX · this page$24.29
  2. Austin, TX · Texas$24.77+$0.48
  3. Beaumont, TX · Texas$22.80−$1.49
  4. Brazoria, TX · Texas$23.86−$0.43
  5. Dallas, TX · Texas$23.99−$0.30
  6. Fort Worth, TX · Texas$23.87−$0.42
  7. Galveston, TX · Texas$23.92−$0.37

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

Every other payment area

36405 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$23.30$12.53
Los Angeles, CACalifornia$26.68$13.25
Washington, DC areaDistrict of Columbia$27.04$13.67
Miami, FLFlorida$25.62$13.80
Chicago, ILIllinois$25.05$13.64
Manhattan, NYNew York$27.25$14.05
AlaskaAlaska$29.63$17.53
AlabamaAlabama$22.09$12.15

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 36405 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work0.30× 1.0080.3024
Practice expense0.40× 0.9930.3972
Malpractice0.02× 1.3760.0275
Total RVUs0.7271
Conversion factor× 33.4009

Office rate, Houston, TX$24.29

Office: (0.3 × 1.008 + 0.4 × 0.993 + 0.02 × 1.376) × $33.4009 = $24.29

Facility: (0.3 × 1.008 + 0.06 × 0.993 + 0.02 × 1.376) × $33.4009 = $13.01

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 Houston, TX

36405 · Office / nonfacility

$24.29

Effective 2026-10-01

The base rate is $0.88 higher than on 2025-10-01, moving from $23.41 to $24.29 (3.8%).

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

    $23.41changed to$24.29

    • 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 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $24.42changed to$23.41

    • 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

    $24.02changed to$24.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $24.27changed to$24.02

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.37 changed to 0.39
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $24.87changed to$24.27

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $24.36changed to$24.87

    • 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

    $24.29changed to$24.36

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.33 changed to 0.35
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $24.11changed to$24.29

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $24.08changed to$24.11

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $26.47changed to$24.08

    • 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 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $27.10changed to$26.47

    • 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 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $27.22changed to$27.10

    • 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

    $27.08changed to$27.22

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $27.33changed to$27.08

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $26.87changed to$27.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.43 changed to 0.40
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $26.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$24.29$13.01RVU26D
2026-07-01$24.29$13.01RVU26C
2026-04-01$24.29$13.01RVU26B
2026-01-01$24.29$13.01RVU26A
2025-10-01$23.41$14.65RVU25D
2025-07-01$23.41$14.65RVU25C
2025-04-01$23.41$14.65RVU25B
2025-01-01$23.41$14.65RVU25A
2024-10-01$24.42$15.07RVU24D
2024-07-01$24.42$15.07RVU24C
2024-04-01$24.42$15.07RVU24B
2024-03-09$24.42$15.07RVU24AR
2024-01-01$24.02$14.83RVU24A
2023-10-01$24.27$15.32RVU23D
2023-07-01$24.27$15.32RVU23C
2023-04-01$24.27$15.32RVU23B
2023-01-01$24.27$15.32RVU23A
2022-10-01$24.87$15.61RVU22D
2022-07-01$24.87$15.61RVU22C
2022-04-01$24.87$15.61RVU22B
2022-01-01$24.87$15.61RVU22A
2021-10-01$24.36$15.74RVU21D
2021-07-01$24.36$15.74RVU21C
2021-04-01$24.36$15.74RVU21B
2021-01-01$24.36$15.74RVU21A
2020-10-01$24.29$16.19RVU20D
2020-07-01$24.29$16.19RVU20C
2020-04-01$24.29$16.19RVU20B
2020-01-01$24.29$16.19RVU20A
2019-10-01$24.11$16.08RVU19D
2019-07-01$24.11$16.08RVU19C
2019-04-01$24.11$16.08RVU19B
2019-01-01$24.11$16.08RVU19A
2018-10-01$24.08$16.06RVU18D
2018-07-01$24.08$16.06RVU18C
2018-04-01$24.08$16.06RVU18B
2018-01-01$24.08$16.06RVU18AR1
2017-10-01$26.47$17.05RVU17D
2017-07-01$26.47$17.05RVU17C
2017-04-01$26.47$17.05RVU17B
2017-01-01$26.47$17.05RVU17A
2016-10-01$27.10$17.02RVU16D
2016-07-01$27.10$17.02RVU16C
2016-04-01$27.10$17.02RVU16B
2016-01-01$27.10$17.02RVU16A
2015-10-01$27.22$16.74RVU15D
2015-07-01$27.22$16.74RVU15C
2015-04-01$27.08$16.65RVU15B
2015-01-01$27.08$16.65RVU15A
2014-10-01$27.33$17.62RVU14D
2014-07-01$27.33$17.62RVU14C
2014-04-01$27.33$17.62RVU14B
2014-01-01$27.33$17.62RVU14A
2013-10-01$26.87$16.64RVU13D
2013-07-01$26.87$16.64RVU13C
2013-04-01$26.87$16.64RVU13B
2013-01-01$26.87$16.64RVU13AR

Price 36405 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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