CPT code 36474: Vein ablation, additional vein2026 Medicare rate & RVUs in Houston, TX
Reports mechanochemical catheter ablation of an additional incompetent vein in the same extremity, following treatment of the first vein.
In Houston, TX, Medicare pays $244.52 for 36474 in the office and $83.33 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How Houston, TX 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. Houston, TX pays $244.52. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Houston, TX · this page$244.52
- Austin, TX · Texas$249.05+$4.53
- Beaumont, TX · Texas$224.22−$20.30
- Brazoria, TX · Texas$236.61−$7.91
- Dallas, TX · Texas$238.52−$6.00
- Fort Worth, TX · Texas$236.97−$7.55
- Galveston, TX · Texas$237.57−$6.95
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $230.55 | $76.50 |
| Los Angeles, CACalifornia | $269.80 | $77.76 |
| Washington, DC areaDistrict of Columbia | $275.39 | $84.16 |
| Miami, FLFlorida | $266.89 | $97.91 |
| Chicago, ILIllinois | $258.18 | $95.04 |
| Manhattan, NYNew York | $279.23 | $90.60 |
| 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 |
| Hanford, CACalifornia | $251.95 | $74.04 |
| Madera, CACalifornia | $251.95 | $74.04 |
| Merced, CACalifornia | $251.95 | $74.04 |
| Modesto, CACalifornia | $251.95 | $74.04 |
| Napa, CACalifornia | $292.12 | $78.17 |
| Oxnard, CACalifornia | $268.36 | $76.49 |
| Redding, CACalifornia | $251.95 | $74.04 |
| Rest of CaliforniaCalifornia | $251.95 | $74.04 |
| Riverside, CACalifornia | $256.03 | $78.12 |
| Sacramento, CACalifornia | $264.47 | $75.69 |
| Salinas, CACalifornia | $263.51 | $75.37 |
| San Diego, CACalifornia | $269.84 | $75.70 |
| Marin County, CACalifornia | $309.02 | $80.14 |
| San Francisco, CACalifornia | $308.59 | $79.71 |
| San Benito County, CACalifornia | $316.32 | $82.24 |
| Santa Clara County, CACalifornia | $314.56 | $80.48 |
| San Luis Obispo, CACalifornia | $259.29 | $74.40 |
| Santa Cruz, CACalifornia | $272.49 | $75.26 |
| Santa Maria, CACalifornia | $264.53 | $75.25 |
| Santa Rosa, CACalifornia | $275.23 | $75.89 |
| Stockton, CACalifornia | $251.95 | $74.04 |
| Vallejo, CACalifornia | $291.49 | $77.55 |
| Visalia, CACalifornia | $251.95 | $74.04 |
| Yuba City, CACalifornia | $251.95 | $74.04 |
| ColoradoColorado | $249.32 | $76.60 |
| ConnecticutConnecticut | $257.44 | $82.61 |
| DelawareDelaware | $237.44 | $77.06 |
| Fort Lauderdale, FLFlorida | $252.96 | $88.52 |
| Rest of FloridaFlorida | $239.36 | $84.17 |
| Atlanta, GAGeorgia | $245.94 | $81.01 |
| Rest of GeorgiaGeorgia | $224.49 | $79.69 |
| Hawaii, Guam, HIHawaii | $258.53 | $73.96 |
| IowaIowa | $218.33 | $69.79 |
| IdahoIdaho | $220.14 | $70.80 |
| East St. Louis, ILIllinois | $239.70 | $90.36 |
| Rest of IllinoisIllinois | $232.78 | $84.58 |
| Suburban Chicago, ILIllinois | $255.29 | $88.58 |
| IndianaIndiana | $221.50 | $71.02 |
| KansasKansas | $217.81 | $71.06 |
| KentuckyKentucky | $220.46 | $76.15 |
| New Orleans, LALouisiana | $232.14 | $79.39 |
| Rest of LouisianaLouisiana | $220.33 | $76.66 |
| Metropolitan Boston, MAMassachusetts | $274.54 | $80.72 |
| Rest of MassachusettsMassachusetts | $247.87 | $76.94 |
| Baltimore area, MDMaryland | $256.87 | $82.69 |
| Rest of MarylandMaryland | $242.07 | $77.79 |
| Rest of MaineMaine | $222.03 | $72.69 |
| Southern Maine, MEMaine | $234.27 | $73.40 |
| Detroit, MIMichigan | $243.22 | $86.57 |
| Rest of MichiganMichigan | $227.27 | $79.07 |
| MinnesotaMinnesota | $236.50 | $69.46 |
| Metropolitan Kansas City, MOMissouri | $229.78 | $77.36 |
| Metropolitan St. Louis, MOMissouri | $232.32 | $77.78 |
| Rest of MissouriMissouri | $216.60 | $76.68 |
| MississippiMississippi | $213.45 | $73.68 |
| MontanaMontana | $240.46 | $78.13 |
| North CarolinaNorth Carolina | $224.47 | $73.02 |
| North DakotaNorth Dakota | $232.95 | $70.62 |
| NebraskaNebraska | $219.45 | $69.62 |
| New HampshireNew Hampshire | $245.90 | $76.91 |
| Northern New JerseyNew Jersey | $272.26 | $83.96 |
| Rest of New JerseyNew Jersey | $259.70 | $82.44 |
| New MexicoNew Mexico | $228.87 | $80.02 |
| NevadaNevada | $238.54 | $76.05 |
| NYC suburbs and Long Island, NYNew York | $287.28 | $94.27 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $261.94 | $84.19 |
| Queens, NYNew York | $280.82 | $88.94 |
| Rest of New YorkNew York | $228.18 | $73.97 |
| OhioOhio | $225.74 | $77.53 |
| OklahomaOklahoma | $219.39 | $74.43 |
| Portland, OROregon | $257.10 | $76.75 |
| Rest of OregonOregon | $236.03 | $74.36 |
| Metropolitan Philadelphia, PAPennsylvania | $250.96 | $81.98 |
| Rest of PennsylvaniaPennsylvania | $225.79 | $76.78 |
| Puerto RicoPuerto Rico | $242.17 | $78.06 |
| Rhode IslandRhode Island | $245.83 | $78.15 |
| South CarolinaSouth Carolina | $225.61 | $75.62 |
| South DakotaSouth Dakota | $232.06 | $69.73 |
| TennesseeTennessee | $219.08 | $71.52 |
| UtahUtah | $228.95 | $76.36 |
| VirginiaVirginia | $233.85 | $74.28 |
| Virgin Islands, VIUnited States Virgin Islands | $242.17 | $78.06 |
| VermontVermont | $232.51 | $71.80 |
| Rest of WashingtonWashington | $247.24 | $76.31 |
| King County, WAWashington | $279.76 | $80.59 |
| WisconsinWisconsin | $224.53 | $69.02 |
| West VirginiaWest Virginia | $223.60 | $82.53 |
| WyomingWyoming | $237.19 | $74.86 |
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.
The exact Houston, TX 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
102
- Locality
- Houston, TX
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 1.376
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.008 | 1.7237 |
| Practice expense | 5.11 | × 0.993 | 5.0742 |
| Malpractice | 0.38 | × 1.376 | 0.5229 |
| Total RVUs | 7.3208 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Houston, TX$244.52
Office: (1.71 × 1.008 + 5.11 × 0.993 + 0.38 × 1.376) × $33.4009 = $244.52
Facility: (1.71 × 1.008 + 0.25 × 0.993 + 0.38 × 1.376) × $33.4009 = $83.33
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).
How 36474 has changed in Houston, TX
36474 · Office / nonfacility
$244.52
Effective 2026-10-01
The base rate is $1.36 higher than on 2025-10-01, moving from $243.16 to $244.52 (0.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$243.16changed to$244.52
- 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 1.014 changed to 1.008
- Practice expense GPCI 1.003 changed to 0.993
- Malpractice GPCI 1.409 changed to 1.376
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$254.64changed to$243.16
- 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.
March 9, 2024
RVU24AR
$250.48changed to$254.64
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$267.46changed to$250.48
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.62 changed to 5.38
- Work GPCI 1.023 changed to 1.014
- Practice expense GPCI 1.016 changed to 1.003
- Malpractice GPCI 1.154 changed to 1.409
January 1, 2023
RVU23A
$278.20changed to$267.46
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.76 changed to 5.62
- Work GPCI 1.032 changed to 1.023
- Practice expense GPCI 1.029 changed to 1.016
- Malpractice GPCI 0.900 changed to 1.154
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$302.41changed to$278.20
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 6.37 changed to 5.76
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$302.05changed to$302.41
- 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 1.032
- Practice expense GPCI 1.020 changed to 1.029
- Malpractice GPCI 0.918 changed to 0.900
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$286.55changed to$302.05
- 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 1.020 changed to 1.026
- Practice expense GPCI 1.012 changed to 1.020
- Malpractice GPCI 0.936 changed to 0.918
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$286.26changed to$286.55
- 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.
January 1, 2018
RVU18AR1
$281.42changed to$286.26
- 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 1.009 changed to 1.012
- Malpractice GPCI 0.946 changed to 0.936
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$281.42
Held through RVU17B, RVU17C, RVU17D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $244.52 | $83.33 | RVU26D |
| 2026-07-01 | $244.52 | $83.33 | RVU26C |
| 2026-04-01 | $244.52 | $83.33 | RVU26B |
| 2026-01-01 | $244.52 | $83.33 | RVU26A |
| 2025-10-01 | $243.16 | $91.00 | RVU25D |
| 2025-07-01 | $243.16 | $91.00 | RVU25C |
| 2025-04-01 | $243.16 | $91.00 | RVU25B |
| 2025-01-01 | $243.16 | $91.00 | RVU25A |
| 2024-10-01 | $254.64 | $92.04 | RVU24D |
| 2024-07-01 | $254.64 | $92.04 | RVU24C |
| 2024-04-01 | $254.64 | $92.04 | RVU24B |
| 2024-03-09 | $254.64 | $92.04 | RVU24AR |
| 2024-01-01 | $250.48 | $90.54 | RVU24A |
| 2023-10-01 | $267.46 | $92.55 | RVU23D |
| 2023-07-01 | $267.46 | $92.55 | RVU23C |
| 2023-04-01 | $267.46 | $92.55 | RVU23B |
| 2023-01-01 | $267.46 | $92.55 | RVU23A |
| 2022-10-01 | $278.20 | $91.61 | RVU22D |
| 2022-07-01 | $278.20 | $91.61 | RVU22C |
| 2022-04-01 | $278.20 | $91.61 | RVU22B |
| 2022-01-01 | $278.20 | $91.61 | RVU22A |
| 2021-10-01 | $302.41 | $92.72 | RVU21D |
| 2021-07-01 | $302.41 | $92.72 | RVU21C |
| 2021-04-01 | $302.41 | $92.72 | RVU21B |
| 2021-01-01 | $302.41 | $92.72 | RVU21A |
| 2020-10-01 | $302.05 | $94.80 | RVU20D |
| 2020-07-01 | $302.05 | $94.80 | RVU20C |
| 2020-04-01 | $302.05 | $94.80 | RVU20B |
| 2020-01-01 | $302.05 | $94.80 | RVU20A |
| 2019-10-01 | $286.55 | $93.25 | RVU19D |
| 2019-07-01 | $286.55 | $93.25 | RVU19C |
| 2019-04-01 | $286.55 | $93.25 | RVU19B |
| 2019-01-01 | $286.55 | $93.25 | RVU19A |
| 2018-10-01 | $286.26 | $93.18 | RVU18D |
| 2018-07-01 | $286.26 | $93.18 | RVU18C |
| 2018-04-01 | $286.26 | $93.18 | RVU18B |
| 2018-01-01 | $286.26 | $93.18 | RVU18AR1 |
| 2017-10-01 | $281.42 | $90.95 | RVU17D |
| 2017-07-01 | $281.42 | $90.95 | RVU17C |
| 2017-04-01 | $281.42 | $90.95 | RVU17B |
| 2017-01-01 | $281.42 | $90.95 | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Houston, TX rate applies
Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 36474 in Houston · multiple payment areas
- Aldine
- Atascocita
- Barrett
- 36474 in Baytown · multiple payment areas
- Bellaire
- Bunker Hill Village
- Channelview
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
Fee sheets · Coming soon
Put 36474 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist