CPT code 36406: Pediatric venipuncture, other vein, under age three2026 Medicare rate & RVUs

Medicare pays $18.37 for 36406 nationally in the office and $7.68 in a hospital or facility. Local office rates run $16.51–$24.19.

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

What 36406 covers

This service is a venous puncture in a child younger than three that requires a physician’s or qualified health care professional’s skill. It covers access through a vein other than the scalp, femoral, or jugular sites represented by neighboring codes. Examples of other sites include peripheral veins in the hand, foot, or arm. It may be performed in a hospital, clinic, or other setting where the child needs a venous specimen or venous access for a clinical purpose.

Report the code for the skilled puncture, not for the laboratory test performed on the specimen. Documentation should identify the child’s age, the vein accessed, the clinical purpose, and the circumstances supporting the need for physician or qualified-practitioner skill. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction.

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.

Where 36406 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

36406 rates by state

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

How the 36406 rate is calculated

Each of 36406’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.

Payment rules and modifiers for 36406

The CMS indicators that decide how 36406 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

36406 compared with similar codes

How to choose

36400VenipunctureUnder age three, femoral or jugular

Use 36400 for femoral or jugular access in a child younger than three. This code is for another vein.

36405Scalp venipunctureYounger than 3 years

Use 36405 for scalp-vein access in a child younger than three. This code covers other venous sites.

36410Skilled venipunctureAge three or older

Use 36410 for skilled venipuncture in a patient age three or older; this code is for children younger than three.

36415VenipunctureRoutine venous sample

Code 36415 represents routine venous blood collection. This code represents a pediatric puncture requiring physician or qualified-practitioner skill.

Codes related to 36406

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

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

Open CMS sourceHow we calculate rates