CPT code 36468: Sclerotherapy, spider veins2026 Medicare rate & RVUs in Michigan
Reports sclerosant injection directed at spider veins on a limb or trunk, rather than injection treatment of incompetent veins.
Medicare pays $0.00 for 36468 in the office in Michigan (Detroit, MI). Which amount applies depends on the service address.
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 36468 covers
Code 36468 covers injection of sclerosant for superficial spider veins (telangiectasias) on a limb or trunk. The target is the visible small-vessel network, not an incompetent truncal or other vein. Dermatologists, vascular specialists, and other clinicians who provide vein treatment may perform it, most often in an office or outpatient clinic.
Medicare lists restricted coverage, so payment is limited to specific circumstances; the record should identify the treated spider veins and support applicable coverage criteria. CMS lists zero work, office and facility practice-expense, and malpractice RVUs. Its 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and each other procedure is subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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.
Where 36468 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $0.00 | $0.00 |
| Rest of Michigan | $0.00 | $0.00 |
How the 36468 rate is calculated
Each of 36468’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 · 36468
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36468
The CMS indicators that decide how 36468 is paid alongside other services.
CMS payment indicators · 36468
Sclerotherapy, spider veins
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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) | 0 | Not paid without supporting documentation. |
| 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
36468 without 51 · national office
$0.00
Sclerotherapy, spider veins
36468-51 · Second procedure: 50%
$0.00
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%).
36468 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36470Vein sclerotherapyOne incompetent vein
- Choose 36470 for sclerosant injection directed at a single incompetent vein. Code 36468 targets spider veins, not an incompetent vein.
- 36471SclerotherapyMultiple incompetent veins
- Choose 36471 when sclerosant injection treats multiple incompetent veins. Spider-vein treatment is reported with 36468 instead.
- 36465Foam sclerotherapyOne incompetent truncal vein
- Code 36465 describes non-compounded foam sclerosant treatment of one incompetent vein. Code 36468 is for injection treatment of spider veins.
- 36466Foam sclerotherapyMultiple incompetent veins
- Code 36466 describes non-compounded foam treatment of multiple incompetent veins. It is not the spider-vein injection code.
36468 billing questions
How is 36468 different from 36470 or 36471?
Use 36468 for spider veins. Codes 36470 and 36471 describe sclerosant injection directed at incompetent veins, for a single vein or multiple veins, respectively.
Can modifier 50 be used for spider veins on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
Does Medicare cover every service reported with 36468?
No. CMS classifies the code as restricted coverage, paid only in specific circumstances. The clinical record should identify the spider-vein treatment and support the applicable coverage criteria.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, the standard multiple procedure reduction applies.
What documentation supports reporting 36468?
Document that sclerosant was injected to treat spider veins on a limb or trunk. The record should make clear that the target was spider veins rather than an incompetent 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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