CPT code 36474: Vein ablation, additional vein2026 Medicare rate & RVUs in Baltimore area, MD

Reports mechanochemical catheter ablation of an additional incompetent vein in the same extremity, following treatment of the first vein.

CMS RVU26DEffective Oct 1, 2026One payment locality100 Medicare services in 2024

In Baltimore area, MD, Medicare pays $256.87 for 36474 in the office and $82.69 when it’s performed in a hospital or facility.

$256.87Office (non-facility)
$82.69Hospital or facility
+6.8%vs the national office rate ($240.49)

Check a contract rate as a % of Medicare · 36474 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 36474 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Baltimore area, MD
  2. What 36474 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 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.

How Baltimore area, MD compares for 36474

Across 109 of 109 payment localities, the office rate for 36474 runs from $210.27 in Arkansas to $316.32 in San Benito County, CA. Baltimore area, MD pays $256.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

36474 in Baltimore area, MD vs other payment areas
  1. Baltimore area, MD · this page$256.87
  2. Rest of Maryland · Maryland$242.07−$14.80
  3. Los Angeles, CA · California$269.80+$12.93
  4. Washington, DC area · District of Columbia$275.39+$18.52
  5. Miami, FL · Florida$266.89+$10.02
  6. Chicago, IL · Illinois$258.18+$1.31
  7. Manhattan, NY · New York$279.23+$22.36

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

Every other payment area

36474 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$274.44$101.56
AlabamaAlabama$213.64$71.61
ArkansasArkansas$210.27$70.82
ArizonaArizona$233.37$76.07
Bakersfield, CACalifornia$252.99$75.08
Chico, CACalifornia$251.95$74.04
El Centro, CACalifornia$252.02$74.10
Fresno, CACalifornia$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
36474 office rate range by state
State / territoryOffice rate rangeLocalities
AK$274.441
AL$213.641
AR$210.271
AZ$233.371
CA$251.95–$316.3229
CO$249.321
CT$257.441
DC$275.391
DE$237.441
FL$239.36–$266.893
GA$224.49–$245.942
GU$258.531
HI$258.531
IA$218.331
ID$220.141
IL$232.78–$258.184
IN$221.501
KS$217.811
KY$220.461
LA$220.33–$232.142
MA$247.87–$274.542
MD$242.07–$275.393
ME$222.03–$234.272
MI$227.27–$243.222
MN$236.501
MO$216.60–$232.323
MS$213.451
MT$240.461
NC$224.471
ND$232.951
NE$219.451
NH$245.901
NJ$259.70–$272.262
NM$228.871
NV$238.541
NY$228.18–$287.285
OH$225.741
OK$219.391
OR$236.03–$257.102
PA$225.79–$250.962
PR$242.171
RI$245.831
SC$225.611
SD$232.061
TN$219.081
TX$224.22–$249.058
UT$228.951
VA$233.85–$275.392
VI$242.171
VT$232.511
WA$247.24–$279.762
WI$224.531
WV$223.601
WY$237.191

See 36474 in every payment locality

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

Office or facility?

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.

The exact Baltimore area, MD inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,487

Code
36474
Physician work
1.71
Practice expense
5.11
Malpractice
0.38

GPCI2026.csv

60

Locality
Baltimore area, MD
Physician work
1.016
Practice expense
1.073
Malpractice
1.237
Office calculation for 36474 in Baltimore area, MD
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0161.7374
Practice expense5.11× 1.0735.4830
Malpractice0.38× 1.2370.4701
Total RVUs7.6905
Conversion factor× 33.4009

Office rate, Baltimore area, MD$256.87

Office: (1.71 × 1.016 + 5.11 × 1.073 + 0.38 × 1.237) × $33.4009 = $256.87

Facility: (1.71 × 1.016 + 0.25 × 1.073 + 0.38 × 1.237) × $33.4009 = $82.69

Open 36474 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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

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).

When to use modifier 50

How 36474 has changed in Baltimore area, MD

36474 · Office / nonfacility

$256.87

Effective 2026-10-01

The base rate is $1.87 higher than on 2025-10-01, moving from $255.00 to $256.87 (0.7%).

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

    $255.00changed to$256.87

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.75 changed to 1.71
    • Practice expense RVU 5.22 changed to 5.11
    • Malpractice RVU 0.36 changed to 0.38
    • Work GPCI 1.020 changed to 1.016
    • Practice expense GPCI 1.078 changed to 1.073
    • Malpractice GPCI 1.309 changed to 1.237

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $267.29changed to$255.00

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.38 changed to 5.22
    • Malpractice RVU 0.34 changed to 0.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $262.93changed to$267.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $282.85changed to$262.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.62 changed to 5.38
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.087 changed to 1.078
    • Malpractice GPCI 1.311 changed to 1.309
  5. January 1, 2023

    RVU23A

    $296.17changed to$282.85

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.76 changed to 5.62
    • Work GPCI 1.028 changed to 1.024
    • Practice expense GPCI 1.096 changed to 1.087
    • Malpractice GPCI 1.313 changed to 1.311

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $321.96changed to$296.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.37 changed to 5.76

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $323.52changed to$321.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.13 changed to 6.37
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.026 changed to 1.028
    • Practice expense GPCI 1.095 changed to 1.096
    • Malpractice GPCI 1.304 changed to 1.313

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $308.63changed to$323.52

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.76 changed to 6.13
    • Malpractice RVU 0.36 changed to 0.35
    • Work GPCI 1.023 changed to 1.026
    • Malpractice GPCI 1.295 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $308.22changed to$308.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.77 changed to 5.76
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $302.47changed to$308.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.74 changed to 5.77
    • Malpractice RVU 0.28 changed to 0.35
    • Practice expense GPCI 1.096 changed to 1.095
    • Malpractice GPCI 1.238 changed to 1.295

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$302.47

    Held through RVU17B, RVU17C, RVU17D.

  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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$256.87$82.69RVU26D
2026-07-01$256.87$82.69RVU26C
2026-04-01$256.87$82.69RVU26B
2026-01-01$256.87$82.69RVU26A
2025-10-01$255.00$91.46RVU25D
2025-07-01$255.00$91.46RVU25C
2025-04-01$255.00$91.46RVU25B
2025-01-01$255.00$91.46RVU25A
2024-10-01$267.29$92.53RVU24D
2024-07-01$267.29$92.53RVU24C
2024-04-01$267.29$92.53RVU24B
2024-03-09$267.29$92.53RVU24AR
2024-01-01$262.93$91.02RVU24A
2023-10-01$282.85$95.72RVU23D
2023-07-01$282.85$95.72RVU23C
2023-04-01$282.85$95.72RVU23B
2023-01-01$282.85$95.72RVU23A
2022-10-01$296.17$97.43RVU22D
2022-07-01$296.17$97.43RVU22C
2022-04-01$296.17$97.43RVU22B
2022-01-01$296.17$97.43RVU22A
2021-10-01$321.96$98.62RVU21D
2021-07-01$321.96$98.62RVU21C
2021-04-01$321.96$98.62RVU21B
2021-01-01$321.96$98.62RVU21A
2020-10-01$323.52$101.03RVU20D
2020-07-01$323.52$101.03RVU20C
2020-04-01$323.52$101.03RVU20B
2020-01-01$323.52$101.03RVU20A
2019-10-01$308.63$99.47RVU19D
2019-07-01$308.63$99.47RVU19C
2019-04-01$308.63$99.47RVU19B
2019-01-01$308.63$99.47RVU19A
2018-10-01$308.22$99.29RVU18D
2018-07-01$308.22$99.29RVU18C
2018-04-01$308.22$99.29RVU18B
2018-01-01$308.22$99.29RVU18AR1
2017-10-01$302.47$95.57RVU17D
2017-07-01$302.47$95.57RVU17C
2017-04-01$302.47$95.57RVU17B
2017-01-01$302.47$95.57RVU17A
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 36474 for an earlier date of service

Where the Baltimore area, MD rate applies

Baltimore area, MD is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in Maryland. Some span more than one payment area; confirm with the service ZIP.

  • Baltimore
  • Aberdeen
  • Aberdeen Proving Ground
  • Abingdon
  • Annapolis
  • Annapolis Neck
  • Arbutus
  • Arden on the Severn

Browse all communities in Maryland

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

Show the CMS file lines behind this rate
RVUs for 36474PPRRVU2026_Oct_nonQPP.csv, line 4,487 (RVU26D)
Geographic factors for Baltimore area, MDGPCI2026.csv, line 60 (RVU26D)

Open CMS sourceHow we calculate rates

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