CPT code 36405: Scalp venipuncture, younger than 3 years2026 Medicare rate & RVUs in Utah
Reports physician- or qualified health professional-performed scalp-vein venipuncture in a child younger than 3 years for specimen collection or therapeutic purposes.
In Utah, Medicare pays $23.18 for 36405 in the office and $12.50 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Utah 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. Utah pays $23.18. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$23.18
- Los Angeles, CA · California$26.68+$3.50
- Washington, DC area · District of Columbia$27.04+$3.86
- Miami, FL · Florida$25.62+$2.44
- Chicago, IL · Illinois$25.05+$1.87
- Manhattan, NY · New York$27.25+$4.07
- Alaska · Alaska$29.63+$6.45
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $25.19 | $12.75 |
| Merced, CACalifornia | $25.19 | $12.75 |
| Modesto, CACalifornia | $25.19 | $12.75 |
| Napa, CACalifornia | $28.60 | $13.63 |
| Oxnard, CACalifornia | $26.51 | $13.09 |
| Redding, CACalifornia | $25.19 | $12.75 |
| Rest of CaliforniaCalifornia | $25.19 | $12.75 |
| Riverside, CACalifornia | $25.41 | $12.97 |
| Sacramento, CACalifornia | $26.28 | $13.07 |
| Salinas, CACalifornia | $26.17 | $13.01 |
| San Diego, CACalifornia | $26.66 | $13.08 |
| Marin County, CACalifornia | $30.12 | $14.10 |
| San Francisco, CACalifornia | $30.09 | $14.08 |
| San Benito County, CACalifornia | $30.75 | $14.37 |
| Santa Clara County, CACalifornia | $30.65 | $14.28 |
| San Luis Obispo, CACalifornia | $25.77 | $12.83 |
| Santa Cruz, CACalifornia | $26.82 | $13.02 |
| Santa Maria, CACalifornia | $26.24 | $13.00 |
| Santa Rosa, CACalifornia | $27.09 | $13.14 |
| Stockton, CACalifornia | $25.19 | $12.75 |
| Vallejo, CACalifornia | $28.57 | $13.60 |
| Visalia, CACalifornia | $25.19 | $12.75 |
| Yuba City, CACalifornia | $25.19 | $12.75 |
| ColoradoColorado | $24.88 | $12.79 |
| ConnecticutConnecticut | $25.42 | $13.19 |
| DelawareDelaware | $23.87 | $12.65 |
| Fort Lauderdale, FLFlorida | $24.76 | $13.26 |
| Rest of FloridaFlorida | $23.80 | $12.94 |
| Atlanta, GAGeorgia | $24.43 | $12.89 |
| Rest of GeorgiaGeorgia | $22.73 | $12.60 |
| Hawaii, Guam, HIHawaii | $25.60 | $12.69 |
| IowaIowa | $22.51 | $12.12 |
| IdahoIdaho | $22.63 | $12.18 |
| East St. Louis, ILIllinois | $23.66 | $13.21 |
| Rest of IllinoisIllinois | $23.26 | $12.89 |
| Suburban Chicago, ILIllinois | $25.00 | $13.33 |
| IndianaIndiana | $22.73 | $12.20 |
| KansasKansas | $22.43 | $12.17 |
| KentuckyKentucky | $22.51 | $12.41 |
| New Orleans, LALouisiana | $23.35 | $12.66 |
| Rest of LouisianaLouisiana | $22.48 | $12.43 |
| Metropolitan Boston, MAMassachusetts | $26.98 | $13.42 |
| Rest of MassachusettsMassachusetts | $24.78 | $12.82 |
| Baltimore area, MDMaryland | $25.34 | $13.16 |
| Rest of MarylandMaryland | $24.25 | $12.76 |
| Rest of MaineMaine | $22.73 | $12.28 |
| Southern Maine, MEMaine | $23.68 | $12.43 |
| Detroit, MIMichigan | $24.04 | $13.08 |
| Rest of MichiganMichigan | $22.97 | $12.60 |
| MinnesotaMinnesota | $23.97 | $12.28 |
| Metropolitan Kansas City, MOMissouri | $23.22 | $12.55 |
| Metropolitan St. Louis, MOMissouri | $23.41 | $12.60 |
| Rest of MissouriMissouri | $22.19 | $12.40 |
| MississippiMississippi | $22.02 | $12.24 |
| MontanaMontana | $24.05 | $12.69 |
| North CarolinaNorth Carolina | $22.91 | $12.32 |
| North DakotaNorth Dakota | $23.65 | $12.30 |
| NebraskaNebraska | $22.60 | $12.12 |
| New HampshireNew Hampshire | $24.51 | $12.69 |
| Northern New JerseyNew Jersey | $26.86 | $13.69 |
| Rest of New JerseyNew Jersey | $25.74 | $13.34 |
| New MexicoNew Mexico | $23.07 | $12.66 |
| NevadaNevada | $23.95 | $12.58 |
| NYC suburbs and Long Island, NYNew York | $27.79 | $14.28 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $25.91 | $13.47 |
| Queens, NYNew York | $27.42 | $13.99 |
| Rest of New YorkNew York | $23.18 | $12.39 |
| OhioOhio | $22.89 | $12.52 |
| OklahomaOklahoma | $22.47 | $12.33 |
| Portland, OROregon | $25.52 | $12.90 |
| Rest of OregonOregon | $23.80 | $12.49 |
| Metropolitan Philadelphia, PAPennsylvania | $24.91 | $13.08 |
| Rest of PennsylvaniaPennsylvania | $22.92 | $12.49 |
| Puerto RicoPuerto Rico | $24.19 | $12.70 |
| Rhode IslandRhode Island | $24.61 | $12.88 |
| South CarolinaSouth Carolina | $22.93 | $12.44 |
| South DakotaSouth Dakota | $23.61 | $12.25 |
| TennesseeTennessee | $22.52 | $12.20 |
| Austin, TXTexas | $24.77 | $12.75 |
| Beaumont, TXTexas | $22.80 | $12.46 |
| Brazoria, TXTexas | $23.86 | $12.61 |
| Dallas, TXTexas | $23.99 | $12.68 |
| Fort Worth, TXTexas | $23.87 | $12.67 |
| Galveston, TXTexas | $23.92 | $12.64 |
| Houston, TXTexas | $24.29 | $13.01 |
| Rest of TexasTexas | $23.30 | $12.53 |
| VirginiaVirginia | $23.63 | $12.46 |
| Virgin Islands, VIUnited States Virgin Islands | $24.19 | $12.70 |
| VermontVermont | $23.59 | $12.34 |
| Rest of WashingtonWashington | $24.73 | $12.77 |
| King County, WAWashington | $27.46 | $13.53 |
| WisconsinWisconsin | $23.03 | $12.15 |
| West VirginiaWest Virginia | $22.59 | $12.72 |
| WyomingWyoming | $23.87 | $12.52 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $29.63 | 1 |
| AL | $22.09 | 1 |
| AR | $21.84 | 1 |
| AZ | $23.54 | 1 |
| CA | $25.19–$30.75 | 29 |
| CO | $24.88 | 1 |
| CT | $25.42 | 1 |
| DC | $27.04 | 1 |
| DE | $23.87 | 1 |
| FL | $23.80–$25.62 | 3 |
| GA | $22.73–$24.43 | 2 |
| GU | $25.60 | 1 |
| HI | $25.60 | 1 |
| IA | $22.51 | 1 |
| ID | $22.63 | 1 |
| IL | $23.26–$25.05 | 4 |
| IN | $22.73 | 1 |
| KS | $22.43 | 1 |
| KY | $22.51 | 1 |
| LA | $22.48–$23.35 | 2 |
| MA | $24.78–$26.98 | 2 |
| MD | $24.25–$27.04 | 3 |
| ME | $22.73–$23.68 | 2 |
| MI | $22.97–$24.04 | 2 |
| MN | $23.97 | 1 |
| MO | $22.19–$23.41 | 3 |
| MS | $22.02 | 1 |
| MT | $24.05 | 1 |
| NC | $22.91 | 1 |
| ND | $23.65 | 1 |
| NE | $22.60 | 1 |
| NH | $24.51 | 1 |
| NJ | $25.74–$26.86 | 2 |
| NM | $23.07 | 1 |
| NV | $23.95 | 1 |
| NY | $23.18–$27.79 | 5 |
| OH | $22.89 | 1 |
| OK | $22.47 | 1 |
| OR | $23.80–$25.52 | 2 |
| PA | $22.92–$24.91 | 2 |
| PR | $24.19 | 1 |
| RI | $24.61 | 1 |
| SC | $22.93 | 1 |
| SD | $23.61 | 1 |
| TN | $22.52 | 1 |
| TX | $22.80–$24.77 | 8 |
| UT | $23.18 | 1 |
| VA | $23.63–$27.04 | 2 |
| VI | $24.19 | 1 |
| VT | $23.59 | 1 |
| WA | $24.73–$27.46 | 2 |
| WI | $23.03 | 1 |
| WV | $22.59 | 1 |
| WY | $23.87 | 1 |
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
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 Utah 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
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.30 | × 1.000 | 0.3000 |
| Practice expense | 0.40 | × 0.940 | 0.3760 |
| Malpractice | 0.02 | × 0.898 | 0.0180 |
| Total RVUs | 0.6940 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$23.18
Office: (0.3 × 1 + 0.4 × 0.94 + 0.02 × 0.898) × $33.4009 = $23.18
Facility: (0.3 × 1 + 0.06 × 0.94 + 0.02 × 0.898) × $33.4009 = $12.50
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
How 36405 has changed in Utah
36405 · Office / nonfacility
$23.18
Effective 2026-10-01
The base rate is $1.08 higher than on 2025-10-01, moving from $22.10 to $23.18 (4.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$22.10changed to$23.18
- 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 0.933 changed to 0.940
- Malpractice GPCI 0.930 changed to 0.898
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.05changed to$22.10
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.39 changed to 0.38
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$22.67changed to$23.05
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$22.70changed to$22.67
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.37 changed to 0.39
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
$23.05changed to$22.70
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.919 changed to 0.926
- Malpractice GPCI 0.799 changed to 0.865
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$22.60changed to$23.05
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.35 changed to 0.37
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$22.89changed to$22.60
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.33 changed to 0.35
- Practice expense GPCI 0.923 changed to 0.919
- Malpractice GPCI 0.982 changed to 0.799
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$23.04changed to$22.89
- Conversion factor 36.0391 changed to 36.0896
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.165 changed to 0.982
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$23.01changed to$23.04
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$25.42changed to$23.01
- 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 0.925 changed to 0.927
- Malpractice GPCI 1.167 changed to 1.165
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$25.89changed to$25.42
- 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 0.922 changed to 0.925
- Malpractice GPCI 1.169 changed to 1.167
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$25.89changed to$25.89
- 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.
July 1, 2015
RVU15C
$25.77changed to$25.89
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$26.31changed to$25.77
- 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 0.919 changed to 0.922
- Malpractice GPCI 1.136 changed to 1.169
Held through RVU15B.
January 1, 2014
RVU14A
$25.82changed to$26.31
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.43 changed to 0.40
- Practice expense GPCI 0.916 changed to 0.919
- Malpractice GPCI 1.102 changed to 1.136
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $25.82
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $23.18 | $12.50 | RVU26D |
| 2026-07-01 | $23.18 | $12.50 | RVU26C |
| 2026-04-01 | $23.18 | $12.50 | RVU26B |
| 2026-01-01 | $23.18 | $12.50 | RVU26A |
| 2025-10-01 | $22.10 | $13.95 | RVU25D |
| 2025-07-01 | $22.10 | $13.95 | RVU25C |
| 2025-04-01 | $22.10 | $13.95 | RVU25B |
| 2025-01-01 | $22.10 | $13.95 | RVU25A |
| 2024-10-01 | $23.05 | $14.35 | RVU24D |
| 2024-07-01 | $23.05 | $14.35 | RVU24C |
| 2024-04-01 | $23.05 | $14.35 | RVU24B |
| 2024-03-09 | $23.05 | $14.35 | RVU24AR |
| 2024-01-01 | $22.67 | $14.12 | RVU24A |
| 2023-10-01 | $22.70 | $14.54 | RVU23D |
| 2023-07-01 | $22.70 | $14.54 | RVU23C |
| 2023-04-01 | $22.70 | $14.54 | RVU23B |
| 2023-01-01 | $22.70 | $14.54 | RVU23A |
| 2022-10-01 | $23.05 | $14.78 | RVU22D |
| 2022-07-01 | $23.05 | $14.78 | RVU22C |
| 2022-04-01 | $23.05 | $14.78 | RVU22B |
| 2022-01-01 | $23.05 | $14.78 | RVU22A |
| 2021-10-01 | $22.60 | $14.90 | RVU21D |
| 2021-07-01 | $22.60 | $14.90 | RVU21C |
| 2021-04-01 | $22.60 | $14.90 | RVU21B |
| 2021-01-01 | $22.60 | $14.90 | RVU21A |
| 2020-10-01 | $22.89 | $15.56 | RVU20D |
| 2020-07-01 | $22.89 | $15.56 | RVU20C |
| 2020-04-01 | $22.89 | $15.56 | RVU20B |
| 2020-01-01 | $22.89 | $15.56 | RVU20A |
| 2019-10-01 | $23.04 | $15.69 | RVU19D |
| 2019-07-01 | $23.04 | $15.69 | RVU19C |
| 2019-04-01 | $23.04 | $15.69 | RVU19B |
| 2019-01-01 | $23.04 | $15.69 | RVU19A |
| 2018-10-01 | $23.01 | $15.67 | RVU18D |
| 2018-07-01 | $23.01 | $15.67 | RVU18C |
| 2018-04-01 | $23.01 | $15.67 | RVU18B |
| 2018-01-01 | $23.01 | $15.67 | RVU18AR1 |
| 2017-10-01 | $25.42 | $16.78 | RVU17D |
| 2017-07-01 | $25.42 | $16.78 | RVU17C |
| 2017-04-01 | $25.42 | $16.78 | RVU17B |
| 2017-01-01 | $25.42 | $16.78 | RVU17A |
| 2016-10-01 | $25.89 | $16.65 | RVU16D |
| 2016-07-01 | $25.89 | $16.65 | RVU16C |
| 2016-04-01 | $25.89 | $16.65 | RVU16B |
| 2016-01-01 | $25.89 | $16.65 | RVU16A |
| 2015-10-01 | $25.89 | $16.29 | RVU15D |
| 2015-07-01 | $25.89 | $16.29 | RVU15C |
| 2015-04-01 | $25.77 | $16.21 | RVU15B |
| 2015-01-01 | $25.77 | $16.21 | RVU15A |
| 2014-10-01 | $26.31 | $17.42 | RVU14D |
| 2014-07-01 | $26.31 | $17.42 | RVU14C |
| 2014-04-01 | $26.31 | $17.42 | RVU14B |
| 2014-01-01 | $26.31 | $17.42 | RVU14A |
| 2013-10-01 | $25.82 | $16.47 | RVU13D |
| 2013-07-01 | $25.82 | $16.47 | RVU13C |
| 2013-04-01 | $25.82 | $16.47 | RVU13B |
| 2013-01-01 | $25.82 | $16.47 | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
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
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