CPT code 36465: Foam sclerotherapy, one incompetent truncal vein2026 Medicare rate & RVUs in Alabama

Reports ultrasound-guided treatment of one incompetent truncal vein using noncompounded foam sclerosant for symptomatic venous reflux.

CMS RVU26DEffective Oct 1, 2026One payment locality101.8K Medicare services in 2024

In Alabama, Medicare pays $1,130.38 for 36465 in the office and $96.96 when it’s performed in a hospital or facility.

$1,130.38Office (non-facility)
$96.96Hospital or facility
−12.1%vs the national office rate ($1,286.60)

Check a contract rate as a % of Medicare · 36465 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 36465 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 36465 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 36465 covers

This service treats venous reflux in one incompetent truncal vein, such as the great saphenous or an accessory saphenous vein. The clinician injects noncompounded foam sclerosant percutaneously and uses ultrasound and compression maneuvers to guide its spread and monitor treatment. Vascular specialists commonly perform it in an office or outpatient setting for patients with symptomatic varicose veins related to truncal reflux.

Report one unit for treatment of one qualifying truncal vein. Documentation should identify the treated vein and extremity, the reflux problem, and the foam treatment performed. Ultrasound guidance and monitoring for this treatment are included. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 results in payment at 150% for bilateral treatment. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

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 36465

Across 109 of 109 payment localities, the office rate for 36465 runs from $1,110.46 in Arkansas to $1,815.36 in San Benito County, CA. Alabama pays $1,130.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

36465 in Alabama vs other payment areas
  1. Alabama · this page$1,130.38
  2. Los Angeles, CA · California$1,502.87+$372.49
  3. Washington, DC area · District of Columbia$1,505.09+$374.71
  4. Miami, FL · Florida$1,360.07+$229.69
  5. Chicago, IL · Illinois$1,313.87+$183.49
  6. Manhattan, NY · New York$1,494.33+$363.95
  7. Alaska · Alaska$1,395.26+$264.88

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

Every other payment area

36465 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$1,110.46$95.93
ArizonaArizona$1,247.28$102.83
Bakersfield, CACalifornia$1,396.42$101.98
Chico, CACalifornia$1,395.10$100.66
El Centro, CACalifornia$1,395.18$100.74
Fresno, CACalifornia$1,395.10$100.66
Hanford, CACalifornia$1,395.10$100.66
Madera, CACalifornia$1,395.10$100.66

36465 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.

$1,110.46

$1,605.23

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

View every state and territory as a table
36465 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,395.261
AL$1,130.381
AR$1,110.461
AZ$1,247.281
CA$1,395.10–$1,815.3629
CO$1,360.431
CT$1,383.441
DC$1,505.091
DE$1,271.041
FL$1,242.13–$1,360.073
GA$1,160.72–$1,309.162
GU$1,443.441
HI$1,443.441
IA$1,175.441
ID$1,182.631
IL$1,191.74–$1,331.764
IN$1,191.191
KS$1,164.021
KY$1,152.701
LA$1,148.61–$1,218.332
MA$1,347.86–$1,519.632
MD$1,300.38–$1,505.093
ME$1,185.02–$1,269.942
MI$1,184.79–$1,255.812
MN$1,309.941
MO$1,121.40–$1,229.323
MS$1,116.441
MT$1,286.571
NC$1,200.811
ND$1,277.081
NE$1,184.691
NH$1,333.561
NJ$1,401.07–$1,483.562
NM$1,190.721
NV$1,285.121
NY$1,222.14–$1,530.925
OH$1,182.851
OK$1,155.261
OR$1,277.06–$1,416.272
PA$1,187.81–$1,340.032
PR$1,299.501
RI$1,325.731
SC$1,193.451
SD$1,275.961
TN$1,170.521
TX$1,178.00–$1,354.188
UT$1,213.321
VA$1,261.59–$1,505.092
VI$1,299.501
VT$1,266.741
WA$1,347.05–$1,558.552
WI$1,225.361
WV$1,137.091
WY$1,282.431

See 36465 in every payment locality

How the 36465 rate is calculated

Each of 36465’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 · 36465

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.29

2.29 RVUs× 1.000 GPCI

Practice expense35.75

35.75 RVUs× 1.000 GPCI

Malpractice0.48

0.48 RVUs× 1.000 GPCI

Adjusted RVUs

38.5200

Conversion factor

$33.4009

Medicare rate

$1,286.60

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

4,481

Code
36465
Physician work
2.29
Practice expense
35.75
Malpractice
0.48

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 36465 in Alabama
ComponentRVULocality factorAdjusted
Physician work2.29× 1.0002.2900
Practice expense35.75× 0.87531.2813
Malpractice0.48× 0.5660.2717
Total RVUs33.8429
Conversion factor× 33.4009

Office rate, Alabama$1130.38

Office: (2.29 × 1 + 35.75 × 0.875 + 0.48 × 0.566) × $33.4009 = $1130.38

Facility: (2.29 × 1 + 0.39 × 0.875 + 0.48 × 0.566) × $33.4009 = $96.96

Open 36465 in the RVU calculator

Payment rules and modifiers for 36465

The CMS indicators that decide how 36465 is paid alongside other services.

CMS payment indicators · 36465

Foam sclerotherapy, one incompetent truncal vein

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

36465 without 50 · national office

$1,286.60

Foam sclerotherapy, one incompetent truncal vein

36465-50 · Bilateral: 150%

$1,929.90

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 36465 has changed in Alabama

36465 · Office / nonfacility

$1130.38

Effective 2026-10-01

The base rate is $96.85 higher than on 2025-10-01, moving from $1033.53 to $1130.38 (9.4%).

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

    $1033.53changed to$1130.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.35 changed to 2.29
    • Practice expense RVU 33.74 changed to 35.75
    • Malpractice RVU 0.49 changed to 0.48
    • 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

    $1111.33changed to$1033.53

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 35.41 changed to 33.74
    • Malpractice RVU 0.46 changed to 0.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1093.19changed to$1111.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1182.72changed to$1093.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 36.70 changed to 35.41
    • Malpractice RVU 0.44 changed to 0.46
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $1260.32changed to$1182.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 37.92 changed to 36.70
    • Malpractice RVU 0.43 changed to 0.44
    • 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

    $1382.03changed to$1260.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 41.49 changed to 37.92
    • Malpractice RVU 0.45 changed to 0.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1384.39changed to$1382.03

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 40.14 changed to 41.49
    • Malpractice RVU 0.46 changed to 0.45
    • 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

    $1402.32changed to$1384.39

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 40.82 changed to 40.14
    • Malpractice RVU 0.47 changed to 0.46
    • 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

    $1448.06changed to$1402.32

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 42.29 changed to 40.82
    • Malpractice RVU 0.48 changed to 0.47

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$1448.06

    Held through RVU18C, RVU18D.

  11. January 1, 2018

    RVU18AR1

    No ratechanged toNo rate

  12. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,130.38$96.96RVU26D
2026-07-01$1,130.38$96.96RVU26C
2026-04-01$1,130.38$96.96RVU26B
2026-01-01$1,130.38$96.96RVU26A
2025-10-01$1,033.53$104.80RVU25D
2025-07-01$1,033.53$104.80RVU25C
2025-04-01$1,033.53$104.80RVU25B
2025-01-01$1,033.53$104.80RVU25A
2024-10-01$1,111.33$106.70RVU24D
2024-07-01$1,111.33$106.70RVU24C
2024-04-01$1,111.33$106.70RVU24B
2024-03-09$1,111.33$106.70RVU24AR
2024-01-01$1,093.19$104.96RVU24A
2023-10-01$1,182.72$111.32RVU23D
2023-07-01$1,182.72$111.32RVU23C
2023-04-01$1,182.72$111.32RVU23B
2023-01-01$1,182.72$111.32RVU23A
2022-10-01$1,260.32$115.93RVU22D
2022-07-01$1,260.32$115.93RVU22C
2022-04-01$1,260.32$115.93RVU22B
2022-01-01$1,260.32$115.93RVU22A
2021-10-01$1,382.03$117.22RVU21D
2021-07-01$1,382.03$117.22RVU21C
2021-04-01$1,382.03$117.22RVU21B
2021-01-01$1,382.03$117.22RVU21A
2020-10-01$1,384.39$118.04RVU20D
2020-07-01$1,384.39$118.04RVU20C
2020-04-01$1,384.39$118.04RVU20B
2020-01-01$1,384.39$118.04RVU20A
2019-10-01$1,402.32$113.23RVU19D
2019-07-01$1,402.32$113.23RVU19C
2019-04-01$1,402.32$113.23RVU19B
2019-01-01$1,402.32$113.23RVU19A
2018-10-01$1,448.06$113.29RVU18D
2018-07-01$1,448.06$113.29RVU18C
2018-04-01$1,448.06$113.29RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 36465 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

36465 billing questions

When should 36465 be used instead of 36466?

Use 36465 when one incompetent truncal vein is treated with noncompounded foam. Use 36466 when multiple incompetent truncal veins are treated.

Is ultrasound guidance separately reported with 36465?

No. Ultrasound guidance and monitoring used to direct and observe the foam treatment are included in 36465.

How many units are reported for one treated vein?

Report one unit for treatment of one qualifying truncal vein. The documentation should identify the treated vein and extremity.

How does 36465 differ from 36470 or 36471?

36465 is for noncompounded foam treatment of an incompetent truncal vein. Codes 36470 and 36471 describe sclerosant treatment of one or multiple other incompetent veins, rather than truncal-vein foam treatment.

How is bilateral treatment handled?

When bilateral treatment is reported with modifier 50, CMS payment is 150% of the single-procedure rate. Multiple procedures in the same session are subject to the standard reduction, with the highest-valued procedure paid in full and others at 50%.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

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 36465PPRRVU2026_Oct_nonQPP.csv, line 4,481 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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