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

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 Queens, NY, Medicare pays $21.09 for 36406 in the office and $8.46 when it’s performed in a hospital or facility.

$21.09Office (non-facility)
$8.46Hospital or facility
+14.8%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $21.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

36406 in Queens, NY vs other payment areas
  1. Queens, NY · this page$21.09
  2. Manhattan, NY · New York$20.90−$0.19
  3. NYC suburbs and Long Island, NY · New York$21.31+$0.22
  4. Poughkeepsie and northern NYC suburbs, NY · New York$19.85−$1.24
  5. Rest of New York · New York$17.67−$3.42
  6. Los Angeles, CA · California$20.71−$0.38
  7. Washington, DC area · District of Columbia$20.87−$0.22

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

Every other payment area

36406 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$19.37$8.25
Chicago, ILIllinois$18.91$8.16
AlaskaAlaska$22.01$10.63
AlabamaAlabama$16.72$7.37
ArkansasArkansas$16.51$7.33
ArizonaArizona$17.95$7.59
Bakersfield, CACalifornia$19.51$7.79
Chico, CACalifornia$19.47$7.76

36406 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 36406 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0640.1915
Practice expense0.36× 1.1820.4255
Malpractice0.01× 1.4420.0144
Total RVUs0.6315
Conversion factor× 33.4009

Office rate, Queens, NY$21.09

Office: (0.18 × 1.064 + 0.36 × 1.182 + 0.01 × 1.442) × $33.4009 = $21.09

Facility: (0.18 × 1.064 + 0.04 × 1.182 + 0.01 × 1.442) × $33.4009 = $8.46

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

Codes related to 36406

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

Codes related to 36406
CodeHow it relatesOffice range, Queens, NY
Same family
36400Venipuncture, under age three, femoral or jugularSame age and skill context, but for femoral or jugular venipuncture.$31.09
36405Scalp venipuncture, younger than 3 yearsSame age and skill context, but for scalp-vein venipuncture.$27.42
Used instead
36410Skilled venipuncture, age three or olderRelated skilled venipuncture code for patients age three or older.$21.97
36415Venipuncture, routine venous sampleRoutine venous blood collection, rather than this code’s skilled pediatric venipuncture.$9.34
36416Capillary collection, skin punctureCapillary specimen collection when a venous puncture is not the collection method.No office rate

How 36406 has changed in Queens, NY

36406 · Office / nonfacility

$21.09

Effective 2026-10-01

The base rate is $1.27 higher than on 2025-10-01, moving from $19.82 to $21.09 (6.4%).

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

    $19.82changed to$21.09

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.36
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $20.39changed to$19.82

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $20.06changed to$20.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $20.72changed to$20.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.33 changed to 0.34
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $21.10changed to$20.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.32 changed to 0.33
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $20.84changed to$21.10

    • 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

    $19.98changed to$20.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.28 changed to 0.31
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $19.70changed to$19.98

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $19.68changed to$19.70

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $22.55changed to$19.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.33 changed to 0.28
    • Malpractice RVU 0.02 changed to 0.01
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $19.93changed to$22.55

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.27 changed to 0.33
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $25.10changed to$19.93

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.37 changed to 0.27
    • Malpractice RVU 0.03 changed to 0.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $24.97changed to$25.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $22.94changed to$24.97

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.33 changed to 0.37
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $23.48changed to$22.94

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.38 changed to 0.33
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $23.48

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$21.09$8.46RVU26D
2026-07-01$21.09$8.46RVU26C
2026-04-01$21.09$8.46RVU26B
2026-01-01$21.09$8.46RVU26A
2025-10-01$19.82$9.38RVU25D
2025-07-01$19.82$9.38RVU25C
2025-04-01$19.82$9.38RVU25B
2025-01-01$19.82$9.38RVU25A
2024-10-01$20.39$9.65RVU24D
2024-07-01$20.39$9.65RVU24C
2024-04-01$20.39$9.65RVU24B
2024-03-09$20.39$9.65RVU24AR
2024-01-01$20.06$9.49RVU24A
2023-10-01$20.72$10.05RVU23D
2023-07-01$20.72$10.05RVU23C
2023-04-01$20.72$10.05RVU23B
2023-01-01$20.72$10.05RVU23A
2022-10-01$21.10$10.47RVU22D
2022-07-01$21.10$10.47RVU22C
2022-04-01$21.10$10.47RVU22B
2022-01-01$21.10$10.47RVU22A
2021-10-01$20.84$10.13RVU21D
2021-07-01$20.84$10.13RVU21C
2021-04-01$20.84$10.13RVU21B
2021-01-01$20.84$10.13RVU21A
2020-10-01$19.98$10.34RVU20D
2020-07-01$19.98$10.34RVU20C
2020-04-01$19.98$10.34RVU20B
2020-01-01$19.98$10.34RVU20A
2019-10-01$19.70$10.18RVU19D
2019-07-01$19.70$10.18RVU19C
2019-04-01$19.70$10.18RVU19B
2019-01-01$19.70$10.18RVU19A
2018-10-01$19.68$10.17RVU18D
2018-07-01$19.68$10.17RVU18C
2018-04-01$19.68$10.17RVU18B
2018-01-01$19.68$10.17RVU18AR1
2017-10-01$22.55$10.92RVU17D
2017-07-01$22.55$10.92RVU17C
2017-04-01$22.55$10.92RVU17B
2017-01-01$22.55$10.92RVU17A
2016-10-01$19.93$10.06RVU16D
2016-07-01$19.93$10.06RVU16C
2016-04-01$19.93$10.06RVU16B
2016-01-01$19.93$10.06RVU16A
2015-10-01$25.10$12.60RVU15D
2015-07-01$25.10$12.60RVU15C
2015-04-01$24.97$12.54RVU15B
2015-01-01$24.97$12.54RVU15A
2014-10-01$22.94$11.36RVU14D
2014-07-01$22.94$11.36RVU14C
2014-04-01$22.94$11.36RVU14B
2014-01-01$22.94$11.36RVU14A
2013-10-01$23.48$11.28RVU13D
2013-07-01$23.48$11.28RVU13C
2013-04-01$23.48$11.28RVU13B
2013-01-01$23.48$11.28RVU13AR

Price 36406 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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