CPT code 36474: Vein ablation, additional vein2026 Medicare rate & RVUs
Reports mechanochemical catheter ablation of an additional incompetent vein in the same extremity, following treatment of the first vein.
Medicare pays $240.49 for 36474 nationally in the office and $78.16 in a hospital or facility. Local office rates run $210.27–$316.32.
Medicare rate · 36474
Vein ablation, additional vein
- Work RVUs
- 1.71
- Total RVUs
- 7.20
- Global days
- ZZZ
National rate · 2026
$240.49
Office setting, before claim adjustments.
See every locality for 36474 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 36474 covers
This add-on represents catheter-based mechanochemical ablation of an additional incompetent vein, using mechanical action together with a sclerosant to close the treated vein. It is used for venous reflux treatment, including treatment of superficial truncal veins, and is typically performed by a vascular surgeon, interventional radiologist, or vein specialist in an office or outpatient procedural setting. The additional vein is treated through a separate access site in the same extremity as the first vein.
Report 36474 only with the primary mechanochemical ablation code 36473; it is not a stand-alone service. Documentation should identify the treated veins, extremity, separate access sites, and the mechanochemical technique. CMS treats this add-on as paid within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays at 150%.
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 36474 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$210.27 to $316.32
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $213.64 | $71.61 |
| Alaska | $274.44 | $101.56 |
| Arizona | $233.37 | $76.07 |
| Arkansas | $210.27 | $70.82 |
| Atlanta, GA | $245.94 | $81.01 |
| Austin, TX | $249.05 | $77.31 |
| Bakersfield, CA | $252.99 | $75.08 |
| Baltimore area, MD | $256.87 | $82.69 |
| Beaumont, TX | $224.22 | $76.51 |
| Brazoria, TX | $236.61 | $75.75 |
| Chicago, IL | $258.18 | $95.04 |
| Chico, CA | $251.95 | $74.04 |
| Colorado | $249.32 | $76.60 |
| Connecticut | $257.44 | $82.61 |
| Dallas, TX | $238.52 | $76.84 |
| Delaware | $237.44 | $77.06 |
| Detroit, MI | $243.22 | $86.57 |
| East St. Louis, IL | $239.70 | $90.36 |
| El Centro, CA | $252.02 | $74.10 |
| Fort Lauderdale, FL | $252.96 | $88.52 |
| Fort Worth, TX | $236.97 | $76.92 |
| Fresno, CA | $251.95 | $74.04 |
| Galveston, TX | $237.57 | $76.37 |
| Hanford, CA | $251.95 | $74.04 |
| Hawaii, Guam, HI | $258.53 | $73.96 |
| Houston, TX | $244.52 | $83.33 |
| Idaho | $220.14 | $70.80 |
| Indiana | $221.50 | $71.02 |
| Iowa | $218.33 | $69.79 |
| Kansas | $217.81 | $71.06 |
| Kentucky | $220.46 | $76.15 |
| King County, WA | $279.76 | $80.59 |
| Los Angeles, CA | $269.80 | $77.76 |
| Madera, CA | $251.95 | $74.04 |
| Manhattan, NY | $279.23 | $90.60 |
| Marin County, CA | $309.02 | $80.14 |
| Merced, CA | $251.95 | $74.04 |
| Metropolitan Boston, MA | $274.54 | $80.72 |
| Metropolitan Kansas City, MO | $229.78 | $77.36 |
| Metropolitan Philadelphia, PA | $250.96 | $81.98 |
| Metropolitan St. Louis, MO | $232.32 | $77.78 |
| Miami, FL | $266.89 | $97.91 |
| Minnesota | $236.50 | $69.46 |
| Mississippi | $213.45 | $73.68 |
| Modesto, CA | $251.95 | $74.04 |
| Montana | $240.46 | $78.13 |
| Napa, CA | $292.12 | $78.17 |
| Nebraska | $219.45 | $69.62 |
| Nevada | $238.54 | $76.05 |
| New Hampshire | $245.90 | $76.91 |
| New Mexico | $228.87 | $80.02 |
| New Orleans, LA | $232.14 | $79.39 |
| North Carolina | $224.47 | $73.02 |
| North Dakota | $232.95 | $70.62 |
| Northern New Jersey | $272.26 | $83.96 |
| NYC suburbs and Long Island, NY | $287.28 | $94.27 |
| Ohio | $225.74 | $77.53 |
| Oklahoma | $219.39 | $74.43 |
| Oxnard, CA | $268.36 | $76.49 |
| Portland, OR | $257.10 | $76.75 |
| Poughkeepsie and northern NYC suburbs, NY | $261.94 | $84.19 |
| Puerto Rico | $242.17 | $78.06 |
| Queens, NY | $280.82 | $88.94 |
| Redding, CA | $251.95 | $74.04 |
| Rest of California | $251.95 | $74.04 |
| Rest of Florida | $239.36 | $84.17 |
| Rest of Georgia | $224.49 | $79.69 |
| Rest of Illinois | $232.78 | $84.58 |
| Rest of Louisiana | $220.33 | $76.66 |
| Rest of Maine | $222.03 | $72.69 |
| Rest of Maryland | $242.07 | $77.79 |
| Rest of Massachusetts | $247.87 | $76.94 |
| Rest of Michigan | $227.27 | $79.07 |
| Rest of Missouri | $216.60 | $76.68 |
| Rest of New Jersey | $259.70 | $82.44 |
| Rest of New York | $228.18 | $73.97 |
| Rest of Oregon | $236.03 | $74.36 |
| Rest of Pennsylvania | $225.79 | $76.78 |
| Rest of Texas | $230.55 | $76.50 |
| Rest of Washington | $247.24 | $76.31 |
| Rhode Island | $245.83 | $78.15 |
| Riverside, CA | $256.03 | $78.12 |
| Sacramento, CA | $264.47 | $75.69 |
| Salinas, CA | $263.51 | $75.37 |
| San Benito County, CA | $316.32 | $82.24 |
| San Diego, CA | $269.84 | $75.70 |
| San Francisco, CA | $308.59 | $79.71 |
| San Luis Obispo, CA | $259.29 | $74.40 |
| Santa Clara County, CA | $314.56 | $80.48 |
| Santa Cruz, CA | $272.49 | $75.26 |
| Santa Maria, CA | $264.53 | $75.25 |
| Santa Rosa, CA | $275.23 | $75.89 |
| South Carolina | $225.61 | $75.62 |
| South Dakota | $232.06 | $69.73 |
| Southern Maine, ME | $234.27 | $73.40 |
| Stockton, CA | $251.95 | $74.04 |
| Suburban Chicago, IL | $255.29 | $88.58 |
| Tennessee | $219.08 | $71.52 |
| Utah | $228.95 | $76.36 |
| Vallejo, CA | $291.49 | $77.55 |
| Vermont | $232.51 | $71.80 |
| Virgin Islands, VI | $242.17 | $78.06 |
| Virginia | $233.85 | $74.28 |
| Visalia, CA | $251.95 | $74.04 |
| Washington, DC area | $275.39 | $84.16 |
| West Virginia | $223.60 | $82.53 |
| Wisconsin | $224.53 | $69.02 |
| Wyoming | $237.19 | $74.86 |
| Yuba City, CA | $251.95 | $74.04 |
36474 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.
$210.27
$284.14
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 | $274.44 | 1 |
| AL | $213.64 | 1 |
| AR | $210.27 | 1 |
| AZ | $233.37 | 1 |
| CA | $251.95–$316.32 | 29 |
| CO | $249.32 | 1 |
| CT | $257.44 | 1 |
| DC | $275.39 | 1 |
| DE | $237.44 | 1 |
| FL | $239.36–$266.89 | 3 |
| GA | $224.49–$245.94 | 2 |
| GU | $258.53 | 1 |
| HI | $258.53 | 1 |
| IA | $218.33 | 1 |
| ID | $220.14 | 1 |
| IL | $232.78–$258.18 | 4 |
| IN | $221.50 | 1 |
| KS | $217.81 | 1 |
| KY | $220.46 | 1 |
| LA | $220.33–$232.14 | 2 |
| MA | $247.87–$274.54 | 2 |
| MD | $242.07–$275.39 | 3 |
| ME | $222.03–$234.27 | 2 |
| MI | $227.27–$243.22 | 2 |
| MN | $236.50 | 1 |
| MO | $216.60–$232.32 | 3 |
| MS | $213.45 | 1 |
| MT | $240.46 | 1 |
| NC | $224.47 | 1 |
| ND | $232.95 | 1 |
| NE | $219.45 | 1 |
| NH | $245.90 | 1 |
| NJ | $259.70–$272.26 | 2 |
| NM | $228.87 | 1 |
| NV | $238.54 | 1 |
| NY | $228.18–$287.28 | 5 |
| OH | $225.74 | 1 |
| OK | $219.39 | 1 |
| OR | $236.03–$257.10 | 2 |
| PA | $225.79–$250.96 | 2 |
| PR | $242.17 | 1 |
| RI | $245.83 | 1 |
| SC | $225.61 | 1 |
| SD | $232.06 | 1 |
| TN | $219.08 | 1 |
| TX | $224.22–$249.05 | 8 |
| UT | $228.95 | 1 |
| VA | $233.85–$275.39 | 2 |
| VI | $242.17 | 1 |
| VT | $232.51 | 1 |
| WA | $247.24–$279.76 | 2 |
| WI | $224.53 | 1 |
| WV | $223.60 | 1 |
| WY | $237.19 | 1 |
How the 36474 rate is calculated
Each of 36474’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 · 36474
RVUs × geographic indexes × conversion factor
Work1.71
1.71 RVUs× 1.000 GPCI
Practice expense5.11
5.11 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
7.2000
Conversion factor
$33.4009
Medicare rate
$240.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36474
The CMS indicators that decide how 36474 is paid alongside other services.
CMS payment indicators · 36474
Vein ablation, additional vein
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
36474 without 50 · national office
$240.49
Vein ablation, additional vein
36474-50 · Bilateral: 150%
$360.74
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).
36474 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36473Vein ablationMechanochemical, first vein
- 36473 reports mechanochemical treatment of the first vein. Use 36474 for an additional vein in the same extremity through a separate access site.
- 36476Vein ablationAdditional vein, radiofrequency
- Both are additional-vein codes, but 36476 describes radiofrequency ablation; 36474 describes mechanochemical ablation.
- 36479Laser vein ablationEach additional vein
- 36479 reports laser ablation of an additional vein. Choose 36474 when the additional vein is treated with the mechanochemical method.
- 36483Vein ablationAdditional vein, same extremity
- 36483 is for an additional vein treated with chemical adhesive. Code 36474 is for mechanochemical treatment.
36474 billing questions
When should 36474 be reported instead of 36473?
Use 36473 for the first vein treated with mechanochemical ablation. Report 36474 for each qualifying additional vein in the same extremity, treated through a separate access site.
Can 36474 be billed by itself?
No. It is an add-on code and must be reported with 36473 for the primary vein treatment.
What documentation supports the additional-vein service?
Document the mechanochemical method, the first and additional veins treated, the extremity, and the separate access site for the additional vein.
How is bilateral treatment handled?
CMS pays a bilateral procedure reported with modifier 50 at 150%. The add-on remains linked to the primary mechanochemical ablation service.
How does this differ from 36476?
36474 is for an additional vein treated by mechanochemical ablation. Code 36476 is the additional-vein code for radiofrequency ablation.
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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