CPT code 36406: Pediatric venipuncture, other vein, under age three2026 Medicare rate & RVUs in Utah
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.
In Utah, Medicare pays $17.61 for 36406 in the office and $7.57 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Utah 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. Utah pays $17.61. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$17.61
- Los Angeles, CA · California$20.71+$3.10
- Washington, DC area · District of Columbia$20.87+$3.26
- Miami, FL · Florida$19.37+$1.76
- Chicago, IL · Illinois$18.91+$1.30
- Manhattan, NY · New York$20.90+$3.29
- Alaska · Alaska$22.01+$4.40
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| 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 |
| Merced, CACalifornia | $19.47 | $7.76 |
| Modesto, CACalifornia | $19.47 | $7.76 |
| Napa, CACalifornia | $22.41 | $8.32 |
| Oxnard, CACalifornia | $20.60 | $7.97 |
| Redding, CACalifornia | $19.47 | $7.76 |
| Rest of CaliforniaCalifornia | $19.47 | $7.76 |
| Riverside, CACalifornia | $19.58 | $7.87 |
| Sacramento, CACalifornia | $20.39 | $7.96 |
| Salinas, CACalifornia | $20.31 | $7.93 |
| San Diego, CACalifornia | $20.75 | $7.97 |
| Marin County, CACalifornia | $23.69 | $8.62 |
| San Francisco, CACalifornia | $23.68 | $8.61 |
| San Benito County, CACalifornia | $24.19 | $8.78 |
| Santa Clara County, CACalifornia | $24.15 | $8.73 |
| San Luis Obispo, CACalifornia | $19.99 | $7.82 |
| Santa Cruz, CACalifornia | $20.93 | $7.94 |
| Santa Maria, CACalifornia | $20.38 | $7.92 |
| Santa Rosa, CACalifornia | $21.14 | $8.01 |
| Stockton, CACalifornia | $19.47 | $7.76 |
| Vallejo, CACalifornia | $22.39 | $8.31 |
| Visalia, CACalifornia | $19.47 | $7.76 |
| Yuba City, CACalifornia | $19.47 | $7.76 |
| ColoradoColorado | $19.14 | $7.77 |
| ConnecticutConnecticut | $19.49 | $7.98 |
| DelawareDelaware | $18.22 | $7.66 |
| Fort Lauderdale, FLFlorida | $18.80 | $7.97 |
| Rest of FloridaFlorida | $18.01 | $7.79 |
| Atlanta, GAGeorgia | $18.65 | $7.79 |
| Rest of GeorgiaGeorgia | $17.14 | $7.60 |
| Hawaii, Guam, HIHawaii | $19.88 | $7.72 |
| IowaIowa | $17.15 | $7.37 |
| IdahoIdaho | $17.23 | $7.40 |
| East St. Louis, ILIllinois | $17.75 | $7.91 |
| Rest of IllinoisIllinois | $17.51 | $7.75 |
| Suburban Chicago, ILIllinois | $19.00 | $8.02 |
| IndianaIndiana | $17.32 | $7.41 |
| KansasKansas | $17.05 | $7.39 |
| KentuckyKentucky | $17.01 | $7.51 |
| New Orleans, LALouisiana | $17.71 | $7.65 |
| Rest of LouisianaLouisiana | $16.97 | $7.51 |
| Metropolitan Boston, MAMassachusetts | $20.91 | $8.15 |
| Rest of MassachusettsMassachusetts | $19.04 | $7.78 |
| Baltimore area, MDMaryland | $19.42 | $7.96 |
| Rest of MarylandMaryland | $18.55 | $7.73 |
| Rest of MaineMaine | $17.28 | $7.45 |
| Southern Maine, MEMaine | $18.14 | $7.55 |
| Detroit, MIMichigan | $18.18 | $7.86 |
| Rest of MichiganMichigan | $17.37 | $7.61 |
| MinnesotaMinnesota | $18.48 | $7.49 |
| Metropolitan Kansas City, MOMissouri | $17.63 | $7.59 |
| Metropolitan St. Louis, MOMissouri | $17.79 | $7.62 |
| Rest of MissouriMissouri | $16.70 | $7.49 |
| MississippiMississippi | $16.61 | $7.41 |
| MontanaMontana | $18.37 | $7.68 |
| North CarolinaNorth Carolina | $17.44 | $7.47 |
| North DakotaNorth Dakota | $18.17 | $7.48 |
| NebraskaNebraska | $17.24 | $7.37 |
| New HampshireNew Hampshire | $18.82 | $7.70 |
| Northern New JerseyNew Jersey | $20.70 | $8.30 |
| Rest of New JerseyNew Jersey | $19.75 | $8.08 |
| New MexicoNew Mexico | $17.44 | $7.64 |
| NevadaNevada | $18.33 | $7.63 |
| NYC suburbs and Long Island, NYNew York | $21.31 | $8.61 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $19.85 | $8.15 |
| Queens, NYNew York | $21.09 | $8.46 |
| Rest of New YorkNew York | $17.67 | $7.52 |
| OhioOhio | $17.33 | $7.57 |
| OklahomaOklahoma | $17.01 | $7.46 |
| Portland, OROregon | $19.72 | $7.84 |
| Rest of OregonOregon | $18.22 | $7.58 |
| Metropolitan Philadelphia, PAPennsylvania | $19.04 | $7.91 |
| Rest of PennsylvaniaPennsylvania | $17.37 | $7.55 |
| Puerto RicoPuerto Rico | $18.50 | $7.69 |
| Rhode IslandRhode Island | $18.85 | $7.80 |
| South CarolinaSouth Carolina | $17.41 | $7.53 |
| South DakotaSouth Dakota | $18.15 | $7.46 |
| TennesseeTennessee | $17.12 | $7.41 |
| Austin, TXTexas | $19.04 | $7.73 |
| Beaumont, TXTexas | $17.26 | $7.54 |
| Brazoria, TXTexas | $18.24 | $7.64 |
| Dallas, TXTexas | $18.33 | $7.68 |
| Fort Worth, TXTexas | $18.21 | $7.67 |
| Galveston, TXTexas | $18.28 | $7.66 |
| Houston, TXTexas | $18.46 | $7.85 |
| Rest of TexasTexas | $17.72 | $7.58 |
| VirginiaVirginia | $18.07 | $7.56 |
| Virgin Islands, VIUnited States Virgin Islands | $18.50 | $7.69 |
| VermontVermont | $18.09 | $7.50 |
| Rest of WashingtonWashington | $19.01 | $7.75 |
| King County, WAWashington | $21.34 | $8.22 |
| WisconsinWisconsin | $17.63 | $7.39 |
| West VirginiaWest Virginia | $16.94 | $7.65 |
| WyomingWyoming | $18.28 | $7.60 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $22.01 | 1 |
| AL | $16.72 | 1 |
| AR | $16.51 | 1 |
| AZ | $17.95 | 1 |
| CA | $19.47–$24.19 | 29 |
| CO | $19.14 | 1 |
| CT | $19.49 | 1 |
| DC | $20.87 | 1 |
| DE | $18.22 | 1 |
| FL | $18.01–$19.37 | 3 |
| GA | $17.14–$18.65 | 2 |
| GU | $19.88 | 1 |
| HI | $19.88 | 1 |
| IA | $17.15 | 1 |
| ID | $17.23 | 1 |
| IL | $17.51–$19.00 | 4 |
| IN | $17.32 | 1 |
| KS | $17.05 | 1 |
| KY | $17.01 | 1 |
| LA | $16.97–$17.71 | 2 |
| MA | $19.04–$20.91 | 2 |
| MD | $18.55–$20.87 | 3 |
| ME | $17.28–$18.14 | 2 |
| MI | $17.37–$18.18 | 2 |
| MN | $18.48 | 1 |
| MO | $16.70–$17.79 | 3 |
| MS | $16.61 | 1 |
| MT | $18.37 | 1 |
| NC | $17.44 | 1 |
| ND | $18.17 | 1 |
| NE | $17.24 | 1 |
| NH | $18.82 | 1 |
| NJ | $19.75–$20.70 | 2 |
| NM | $17.44 | 1 |
| NV | $18.33 | 1 |
| NY | $17.67–$21.31 | 5 |
| OH | $17.33 | 1 |
| OK | $17.01 | 1 |
| OR | $18.22–$19.72 | 2 |
| PA | $17.37–$19.04 | 2 |
| PR | $18.50 | 1 |
| RI | $18.85 | 1 |
| SC | $17.41 | 1 |
| SD | $18.15 | 1 |
| TN | $17.12 | 1 |
| TX | $17.26–$19.04 | 8 |
| UT | $17.61 | 1 |
| VA | $18.07–$20.87 | 2 |
| VI | $18.50 | 1 |
| VT | $18.09 | 1 |
| WA | $19.01–$21.34 | 2 |
| WI | $17.63 | 1 |
| WV | $16.94 | 1 |
| WY | $18.28 | 1 |
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
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 Utah 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
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.36 | × 0.940 | 0.3384 |
| Malpractice | 0.01 | × 0.898 | 0.0090 |
| Total RVUs | 0.5274 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$17.61
Office: (0.18 × 1 + 0.36 × 0.94 + 0.01 × 0.898) × $33.4009 = $17.61
Facility: (0.18 × 1 + 0.04 × 0.94 + 0.01 × 0.898) × $33.4009 = $7.57
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
| 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
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%).
How 36406 has changed in Utah
36406 · Office / nonfacility
$17.61
Effective 2026-10-01
The base rate is $1.23 higher than on 2025-10-01, moving from $16.38 to $17.61 (7.5%).
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
$16.38changed to$17.61
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.34 changed to 0.36
- 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
$16.86changed to$16.38
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$16.59changed to$16.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$16.75changed to$16.59
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.33 changed to 0.34
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
$16.68changed to$16.75
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.32 changed to 0.33
- 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
$16.50changed to$16.68
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.31 changed to 0.32
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$16.18changed to$16.50
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.28 changed to 0.31
- 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
$16.26changed to$16.18
- 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
$16.24changed to$16.26
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$18.25changed to$16.24
- 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
- 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
$16.20changed to$18.25
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.27 changed to 0.33
- 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
$19.99changed to$16.20
- 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.
July 1, 2015
RVU15C
$19.89changed to$19.99
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$18.53changed to$19.89
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.33 changed to 0.37
- Practice expense GPCI 0.919 changed to 0.922
- Malpractice GPCI 1.136 changed to 1.169
Held through RVU15B.
January 1, 2014
RVU14A
$19.09changed to$18.53
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.38 changed to 0.33
- 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: $19.09
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $17.61 | $7.57 | RVU26D |
| 2026-07-01 | $17.61 | $7.57 | RVU26C |
| 2026-04-01 | $17.61 | $7.57 | RVU26B |
| 2026-01-01 | $17.61 | $7.57 | RVU26A |
| 2025-10-01 | $16.38 | $8.24 | RVU25D |
| 2025-07-01 | $16.38 | $8.24 | RVU25C |
| 2025-04-01 | $16.38 | $8.24 | RVU25B |
| 2025-01-01 | $16.38 | $8.24 | RVU25A |
| 2024-10-01 | $16.86 | $8.48 | RVU24D |
| 2024-07-01 | $16.86 | $8.48 | RVU24C |
| 2024-04-01 | $16.86 | $8.48 | RVU24B |
| 2024-03-09 | $16.86 | $8.48 | RVU24AR |
| 2024-01-01 | $16.59 | $8.34 | RVU24A |
| 2023-10-01 | $16.75 | $8.59 | RVU23D |
| 2023-07-01 | $16.75 | $8.59 | RVU23C |
| 2023-04-01 | $16.75 | $8.59 | RVU23B |
| 2023-01-01 | $16.75 | $8.59 | RVU23A |
| 2022-10-01 | $16.68 | $8.73 | RVU22D |
| 2022-07-01 | $16.68 | $8.73 | RVU22C |
| 2022-04-01 | $16.68 | $8.73 | RVU22B |
| 2022-01-01 | $16.68 | $8.73 | RVU22A |
| 2021-10-01 | $16.50 | $8.48 | RVU21D |
| 2021-07-01 | $16.50 | $8.48 | RVU21C |
| 2021-04-01 | $16.50 | $8.48 | RVU21B |
| 2021-01-01 | $16.50 | $8.48 | RVU21A |
| 2020-10-01 | $16.18 | $8.85 | RVU20D |
| 2020-07-01 | $16.18 | $8.85 | RVU20C |
| 2020-04-01 | $16.18 | $8.85 | RVU20B |
| 2020-01-01 | $16.18 | $8.85 | RVU20A |
| 2019-10-01 | $16.26 | $8.91 | RVU19D |
| 2019-07-01 | $16.26 | $8.91 | RVU19C |
| 2019-04-01 | $16.26 | $8.91 | RVU19B |
| 2019-01-01 | $16.26 | $8.91 | RVU19A |
| 2018-10-01 | $16.24 | $8.90 | RVU18D |
| 2018-07-01 | $16.24 | $8.90 | RVU18C |
| 2018-04-01 | $16.24 | $8.90 | RVU18B |
| 2018-01-01 | $16.24 | $8.90 | RVU18AR1 |
| 2017-10-01 | $18.25 | $9.29 | RVU17D |
| 2017-07-01 | $18.25 | $9.29 | RVU17C |
| 2017-04-01 | $18.25 | $9.29 | RVU17B |
| 2017-01-01 | $18.25 | $9.29 | RVU17A |
| 2016-10-01 | $16.20 | $8.60 | RVU16D |
| 2016-07-01 | $16.20 | $8.60 | RVU16C |
| 2016-04-01 | $16.20 | $8.60 | RVU16B |
| 2016-01-01 | $16.20 | $8.60 | RVU16A |
| 2015-10-01 | $19.99 | $10.38 | RVU15D |
| 2015-07-01 | $19.99 | $10.38 | RVU15C |
| 2015-04-01 | $19.89 | $10.33 | RVU15B |
| 2015-01-01 | $19.89 | $10.33 | RVU15A |
| 2014-10-01 | $18.53 | $9.64 | RVU14D |
| 2014-07-01 | $18.53 | $9.64 | RVU14C |
| 2014-04-01 | $18.53 | $9.64 | RVU14B |
| 2014-01-01 | $18.53 | $9.64 | RVU14A |
| 2013-10-01 | $19.09 | $9.74 | RVU13D |
| 2013-07-01 | $19.09 | $9.74 | RVU13C |
| 2013-04-01 | $19.09 | $9.74 | RVU13B |
| 2013-01-01 | $19.09 | $9.74 | 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
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
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