CPT code 36425: Venous cutdown, age 1 year or older2026 Medicare rate & RVUs in California
Reports venous access obtained by surgically exposing a vein through a cutdown in a patient who is at least one year old.
CMS doesn’t publish an office rate for 36425 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 36425 covers
This service involves making an incision to expose a vein and obtain venous access in a patient age one year or older. It may be used when access is needed but a vein cannot be reached by ordinary percutaneous venipuncture. Physicians or other qualified clinicians perform it in settings equipped for procedural vascular access, including hospitals and offices.
Report 36425 when the documented method is a cutdown, not simply a difficult needle puncture. The record should support the patient’s age and describe the incision, vein exposure, and access performed. A routine blood draw or specimen collection alone does not describe this service. Under the CMS multiple-procedure rule, when this and other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% 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 36425 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $32.87 |
| Chico, CA | Unavailable | $32.61 |
| El Centro, CA | Unavailable | $32.62 |
| Fresno, CA | Unavailable | $32.61 |
| Hanford, CA | Unavailable | $32.61 |
| Los Angeles, CA | Unavailable | $34.05 |
| Madera, CA | Unavailable | $32.61 |
| Marin County, CA | Unavailable | $35.98 |
| Merced, CA | Unavailable | $32.61 |
| Modesto, CA | Unavailable | $32.61 |
| Napa, CA | Unavailable | $34.84 |
| Oxnard, CA | Unavailable | $33.60 |
| Redding, CA | Unavailable | $32.61 |
| Rest of California | Unavailable | $32.61 |
| Riverside, CA | Unavailable | $33.58 |
| Sacramento, CA | Unavailable | $33.43 |
| Salinas, CA | Unavailable | $33.29 |
| San Benito County, CA | Unavailable | $36.75 |
| San Diego, CA | Unavailable | $33.48 |
| San Francisco, CA | Unavailable | $35.88 |
| San Luis Obispo, CA | Unavailable | $32.84 |
| Santa Clara County, CA | Unavailable | $36.34 |
| Santa Cruz, CA | Unavailable | $33.34 |
| Santa Maria, CA | Unavailable | $33.25 |
| Santa Rosa, CA | Unavailable | $33.63 |
| Stockton, CA | Unavailable | $32.61 |
| Vallejo, CA | Unavailable | $34.70 |
| Visalia, CA | Unavailable | $32.61 |
| Yuba City, CA | Unavailable | $32.61 |
How the 36425 rate is calculated
Each of 36425’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 · 36425
RVUs × geographic indexes × conversion factor
Work0.74
0.74 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
0.9900
Conversion factor
$33.4009
Medicare rate
$33.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36425
The CMS indicators that decide how 36425 is paid alongside other services.
CMS payment indicators · 36425
Venous cutdown, age 1 year or older
| 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
36425 without 51 · national facility
$33.07
Venous cutdown, age 1 year or older
36425-51 · Second procedure: 50%
$16.54
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%).
36425 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36420Venous cutdownUnder 1 year
- Both codes describe cutdown access; 36420 is for patients younger than one year, while 36425 is for patients age one year or older.
- 36410Skilled venipunctureAge three or older
- Use 36410 for difficult venipuncture in a patient age three or older when access is obtained without a cutdown. Use 36425 when the vein is surgically exposed.
- 36415VenipunctureRoutine venous sample
- Use 36415 for routine venous blood collection. It does not describe the incision and vein exposure involved in a cutdown.
36425 billing questions
How does 36425 differ from difficult venipuncture code 36410?
36425 describes access obtained by surgically exposing a vein through a cutdown. Code 36410 is for difficult venipuncture in patients age three or older without a cutdown.
Can a routine blood collection code also be reported?
A routine collection alone is not a cutdown. Do not report a separate routine collection code for the same access merely because blood was drawn through it.
What documentation supports 36425?
Document the patient's age and that an incision was used to expose a vein and obtain access. A note describing only a difficult or unsuccessful needle attempt does not establish a cutdown.
How does CMS apply the multiple-procedure reduction?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and reduces the others by 50%.
Is 36425 selected by the vein used?
The defining distinction is the cutdown method in a patient age one year or older. Do not select it solely because access was obtained from a particular vein.
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
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