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

Physician- or qualified-practitioner venipuncture from a non-scalp, non-femoral or jugular vein in a child younger than three when skilled access is required.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Alabama, Medicare pays $16.72 for 36406 in the office and $7.37 when it’s performed in a hospital or facility.

$16.72Office (non-facility)
$7.37Hospital or facility
−9.0%vs the national office rate ($18.37)

Check a contract rate as a % of Medicare · 36406 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 36406 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 36406 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 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.

How Alabama compares for 36406

Across 109 of 109 payment localities, the office rate for 36406 runs from $16.51 in Arkansas to $24.19 in San Benito County, CA. Alabama pays $16.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

36406 in Alabama vs other payment areas
  1. Alabama · this page$16.72
  2. Los Angeles, CA · California$20.71+$3.99
  3. Washington, DC area · District of Columbia$20.87+$4.15
  4. Miami, FL · Florida$19.37+$2.65
  5. Chicago, IL · Illinois$18.91+$2.19
  6. Manhattan, NY · New York$20.90+$4.18
  7. Alaska · Alaska$22.01+$5.29

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

Every other payment area

36406 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$16.51$7.33
ArizonaArizona$17.95$7.59
Bakersfield, CACalifornia$19.51$7.79
Chico, CACalifornia$19.47$7.76
El Centro, CACalifornia$19.47$7.76
Fresno, CACalifornia$19.47$7.76
Hanford, CACalifornia$19.47$7.76
Madera, CACalifornia$19.47$7.76

36406 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.

$16.51

$22.01

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

View every state and territory as a table
36406 office rate range by state
State / territoryOffice rate rangeLocalities
AK$22.011
AL$16.721
AR$16.511
AZ$17.951
CA$19.47–$24.1929
CO$19.141
CT$19.491
DC$20.871
DE$18.221
FL$18.01–$19.373
GA$17.14–$18.652
GU$19.881
HI$19.881
IA$17.151
ID$17.231
IL$17.51–$19.004
IN$17.321
KS$17.051
KY$17.011
LA$16.97–$17.712
MA$19.04–$20.912
MD$18.55–$20.873
ME$17.28–$18.142
MI$17.37–$18.182
MN$18.481
MO$16.70–$17.793
MS$16.611
MT$18.371
NC$17.441
ND$18.171
NE$17.241
NH$18.821
NJ$19.75–$20.702
NM$17.441
NV$18.331
NY$17.67–$21.315
OH$17.331
OK$17.011
OR$18.22–$19.722
PA$17.37–$19.042
PR$18.501
RI$18.851
SC$17.411
SD$18.151
TN$17.121
TX$17.26–$19.048
UT$17.611
VA$18.07–$20.872
VI$18.501
VT$18.091
WA$19.01–$21.342
WI$17.631
WV$16.941
WY$18.281

See 36406 in every payment locality

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.

How the rate is built · 36406

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.36

0.36 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.5500

Conversion factor

$33.4009

Medicare rate

$18.37

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,469

Code
36406
Physician work
0.18
Practice expense
0.36
Malpractice
0.01

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 36406 in Alabama
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0000.1800
Practice expense0.36× 0.8750.3150
Malpractice0.01× 0.5660.0057
Total RVUs0.5007
Conversion factor× 33.4009

Office rate, Alabama$16.72

Office: (0.18 × 1 + 0.36 × 0.875 + 0.01 × 0.566) × $33.4009 = $16.72

Facility: (0.18 × 1 + 0.04 × 0.875 + 0.01 × 0.566) × $33.4009 = $7.37

Open 36406 in the RVU calculator

Payment rules and modifiers for 36406

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

CMS payment indicators · 36406

Pediatric venipuncture, other vein, under age three

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

36406 without 51 · national office

$18.37

Pediatric venipuncture, other vein, under age three

36406-51 · Second procedure: 50%

$9.19

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 36406 has changed in Alabama

36406 · Office / nonfacility

$16.72

Effective 2026-10-01

The base rate is $1.15 higher than on 2025-10-01, moving from $15.57 to $16.72 (7.4%).

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

    $15.57changed to$16.72

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.36
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $16.02changed to$15.57

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $15.76changed to$16.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $16.17changed to$15.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.33 changed to 0.34
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $16.38changed to$16.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.32 changed to 0.33
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $16.21changed to$16.38

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.31 changed to 0.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $15.73changed to$16.21

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.28 changed to 0.31
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $15.65changed to$15.73

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $15.63changed to$15.65

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$15.63

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$16.72$7.37RVU26D
2026-07-01$16.72$7.37RVU26C
2026-04-01$16.72$7.37RVU26B
2026-01-01$16.72$7.37RVU26A
2025-10-01$15.57$7.98RVU25D
2025-07-01$15.57$7.98RVU25C
2025-04-01$15.57$7.98RVU25B
2025-01-01$15.57$7.98RVU25A
2024-10-01$16.02$8.21RVU24D
2024-07-01$16.02$8.21RVU24C
2024-04-01$16.02$8.21RVU24B
2024-03-09$16.02$8.21RVU24AR
2024-01-01$15.76$8.07RVU24A
2023-10-01$16.17$8.44RVU23D
2023-07-01$16.17$8.44RVU23C
2023-04-01$16.17$8.44RVU23B
2023-01-01$16.17$8.44RVU23A
2022-10-01$16.38$8.70RVU22D
2022-07-01$16.38$8.70RVU22C
2022-04-01$16.38$8.70RVU22B
2022-01-01$16.38$8.70RVU22A
2021-10-01$16.21$8.46RVU21D
2021-07-01$16.21$8.46RVU21C
2021-04-01$16.21$8.46RVU21B
2021-01-01$16.21$8.46RVU21A
2020-10-01$15.73$8.68RVU20D
2020-07-01$15.73$8.68RVU20C
2020-04-01$15.73$8.68RVU20B
2020-01-01$15.73$8.68RVU20A
2019-10-01$15.65$8.59RVU19D
2019-07-01$15.65$8.59RVU19C
2019-04-01$15.65$8.59RVU19B
2019-01-01$15.65$8.59RVU19A
2018-10-01$15.63$8.58RVU18D
2018-07-01$15.63$8.58RVU18C
2018-04-01$15.63$8.58RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36406 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

36406 billing questions

How does this code differ from 36405 and 36400?

This code is for a vein other than the scalp, femoral, or jugular vein. Code 36405 is for scalp access, while 36400 is for femoral or jugular access in a child younger than three.

When is 36410 used instead?

Code 36410 is the related venipuncture code for a patient age three or older when physician or qualified-practitioner skill is required.

Does this code include laboratory testing?

No. It represents the skilled venipuncture; the laboratory analysis is a separate service.

Can routine staff-performed blood collection be reported with this code?

The code describes venipuncture requiring physician or qualified-practitioner skill. A routine collection without that skilled service does not fit this code.

How does the multiple-procedure reduction affect payment?

For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are paid at 50% under the standard multiple-procedure reduction.

What should the record show?

Document the child’s age, the access site, the clinical purpose, and why the puncture required physician or qualified-practitioner skill.

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 36406PPRRVU2026_Oct_nonQPP.csv, line 4,469 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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