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CPT code 36476: Vein ablation, additional vein, radiofrequency2026 Medicare rate & RVUs in Iowa

Reports radiofrequency catheter ablation of each additional incompetent vein treated in the same extremity after the primary vein procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Iowa, Medicare pays $252.65 for 36476 in the office and $105.04 when it’s performed in a hospital or facility.

$252.65Office (non-facility)
$105.04Hospital or facility
−9.4%vs the national office rate ($278.90)

Check a contract rate as a % of Medicare · 36476 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 36476 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 36476 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 36476 covers

This add-on reports percutaneous radiofrequency ablation of an additional incompetent vein in the same extremity after the first vein is treated. A vascular surgeon, interventional radiologist, or other qualified physician typically uses a catheter and imaging guidance to close refluxing superficial veins in patients with chronic venous insufficiency or varicose veins. Imaging guidance and monitoring are included in the endovenous ablation service.

Report 36476 for each additional vein treated, alongside 36475 for the first vein treated with radiofrequency in that extremity. Document the treated vein, side, ablation method, and number of additional veins so the unit count is supported. CMS identifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period. For a bilateral procedure reported with modifier 50, CMS pays 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 Iowa compares for 36476

Across 109 of 109 payment localities, the office rate for 36476 runs from $245.17 in Arkansas to $356.31 in San Benito County, CA. Iowa pays $252.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

36476 in Iowa vs other payment areas
  1. Iowa · this page$252.65
  2. Los Angeles, CA · California$307.82+$55.17
  3. Washington, DC area · District of Columbia$316.62+$63.97
  4. Miami, FL · Florida$315.13+$62.48
  5. Chicago, IL · Illinois$305.02+$52.37
  6. Manhattan, NY · New York$323.71+$71.06
  7. Alaska · Alaska$324.73+$72.08

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

Every other payment area

36476 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$248.92$107.76
ArkansasArkansas$245.17$106.59
ArizonaArizona$270.77$114.45
Bakersfield, CACalifornia$289.76$112.95
Chico, CACalifornia$288.20$111.39
El Centro, CACalifornia$288.30$111.48
Fresno, CACalifornia$288.20$111.39
Hanford, CACalifornia$288.20$111.39

36476 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$245.17

$324.73

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

View every state and territory as a table
36476 office rate range by state
State / territoryOffice rate rangeLocalities
AK$324.731
AL$248.921
AR$245.171
AZ$270.771
CA$288.20–$356.3129
CO$286.881
CT$297.991
DC$316.621
DE$275.321
FL$280.83–$315.133
GA$263.79–$285.762
GU$294.681
HI$294.681
IA$252.651
ID$254.971
IL$274.51–$305.024
IN$256.431
KS$252.781
KY$258.001
LA$258.12–$271.242
MA$285.62–$314.032
MD$280.28–$316.623
ME$257.81–$270.312
MI$266.24–$285.882
MN$270.531
MO$254.43–$270.603
MS$249.791
MT$278.861
NC$260.391
ND$267.591
NE$253.681
NH$283.641
NJ$300.17–$313.412
NM$268.311
NV$275.891
NY$264.56–$333.565
OH$263.941
OK$256.071
OR$272.55–$294.682
PA$263.61–$291.242
PR$280.521
RI$284.211
SC$262.841
SD$266.261
TN$254.281
TX$261.91–$286.978
UT$266.531
VA$270.35–$316.622
VI$280.521
VT$267.761
WA$284.67–$319.152
WI$258.431
WV$264.351
WY$273.951

See 36476 in every payment locality

How the 36476 rate is calculated

Each of 36476’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 · 36476

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.58

2.58 RVUs× 1.000 GPCI

Practice expense5.20

5.20 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

8.3500

Conversion factor

$33.4009

Medicare rate

$278.90

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,489

Code
36476
Physician work
2.58
Practice expense
5.20
Malpractice
0.57

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 36476 in Iowa
ComponentRVULocality factorAdjusted
Physician work2.58× 1.0002.5800
Practice expense5.20× 0.9154.7580
Malpractice0.57× 0.3970.2263
Total RVUs7.5643
Conversion factor× 33.4009

Office rate, Iowa$252.65

Office: (2.58 × 1 + 5.2 × 0.915 + 0.57 × 0.397) × $33.4009 = $252.65

Facility: (2.58 × 1 + 0.37 × 0.915 + 0.57 × 0.397) × $33.4009 = $105.04

Open 36476 in the RVU calculator

Payment rules and modifiers for 36476

The CMS indicators that decide how 36476 is paid alongside other services.

CMS payment indicators · 36476

Vein ablation, additional vein, radiofrequency

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

36476 without 50 · national office

$278.90

Vein ablation, additional vein, radiofrequency

36476-50 · Bilateral: 150%

$418.35

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

Codes related to 36476

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 36476
CodeHow it relatesOffice range, Iowa
Add-on codes
36475Venous ablation, radiofrequency, first veinRadiofrequency treatment of the first vein; 36476 reports each additional vein.$961.15
Used instead
36474Vein ablation, additional veinAdd-on for additional vein treatment using mechanochemical ablation rather than radiofrequency.$218.33
36479Laser vein ablation, each additional veinAdd-on for additional vein treatment using laser ablation rather than radiofrequency.$281.90
36473Vein ablation, mechanochemical, first veinFirst-vein mechanochemical treatment, rather than radiofrequency treatment.$1,070.95
36478Laser vein ablation, first vein treatedFirst-vein laser treatment, rather than radiofrequency treatment.$892.81
36483Vein ablation, additional vein, same extremitySubsequent-vein treatment using chemical adhesive rather than radiofrequency.$127.21

How 36476 has changed in Iowa

36476 · Office / nonfacility

$252.65

Effective 2026-10-01

The base rate is $11.29 higher than on 2025-10-01, moving from $241.36 to $252.65 (4.7%).

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

    $241.36changed to$252.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.65 changed to 2.58
    • Practice expense RVU 4.98 changed to 5.20
    • Malpractice RVU 0.58 changed to 0.57
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.94changed to$241.36

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.14 changed to 4.98
    • Malpractice RVU 0.56 changed to 0.58

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $248.81changed to$252.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $261.61changed to$248.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.30 changed to 5.14
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $271.78changed to$261.61

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.47 changed to 5.30
    • Malpractice RVU 0.57 changed to 0.56
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $283.08changed to$271.78

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.77 changed to 5.47
    • Malpractice RVU 0.54 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $287.86changed to$283.08

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.62 changed to 5.77
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $278.77changed to$287.86

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.35 changed to 5.62
    • Malpractice RVU 0.55 changed to 0.54
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $272.08changed to$278.77

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.15 changed to 5.35
    • Malpractice RVU 0.56 changed to 0.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $271.99changed to$272.08

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.18 changed to 5.15
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $274.79changed to$271.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.30 changed to 5.18
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $274.00changed to$274.79

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.25 changed to 5.30
    • Malpractice RVU 0.55 changed to 0.56

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $272.63changed to$274.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $347.87changed to$272.63

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 3.38 changed to 2.65
    • Practice expense RVU 6.73 changed to 5.25
    • Malpractice RVU 0.69 changed to 0.55
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $359.75changed to$347.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.74 changed to 6.73
    • Malpractice RVU 0.72 changed to 0.69
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $359.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$252.65$105.04RVU26D
2026-07-01$252.65$105.04RVU26C
2026-04-01$252.65$105.04RVU26B
2026-01-01$252.65$105.04RVU26A
2025-10-01$241.36$114.96RVU25D
2025-07-01$241.36$114.96RVU25C
2025-04-01$241.36$114.96RVU25B
2025-01-01$241.36$114.96RVU25A
2024-10-01$252.94$117.70RVU24D
2024-07-01$252.94$117.70RVU24C
2024-04-01$252.94$117.70RVU24B
2024-03-09$252.94$117.70RVU24AR
2024-01-01$248.81$115.78RVU24A
2023-10-01$261.61$120.06RVU23D
2023-07-01$261.61$120.06RVU23C
2023-04-01$261.61$120.06RVU23B
2023-01-01$261.61$120.06RVU23A
2022-10-01$271.78$122.69RVU22D
2022-07-01$271.78$122.69RVU22C
2022-04-01$271.78$122.69RVU22B
2022-01-01$271.78$122.69RVU22A
2021-10-01$283.08$123.26RVU21D
2021-07-01$283.08$123.26RVU21C
2021-04-01$283.08$123.26RVU21B
2021-01-01$283.08$123.26RVU21A
2020-10-01$287.86$127.80RVU20D
2020-07-01$287.86$127.80RVU20C
2020-04-01$287.86$127.80RVU20B
2020-01-01$287.86$127.80RVU20A
2019-10-01$278.77$127.75RVU19D
2019-07-01$278.77$127.75RVU19C
2019-04-01$278.77$127.75RVU19B
2019-01-01$278.77$127.75RVU19A
2018-10-01$272.08$128.09RVU18D
2018-07-01$272.08$128.09RVU18C
2018-04-01$272.08$128.09RVU18B
2018-01-01$272.08$128.09RVU18AR1
2017-10-01$271.99$128.91RVU17D
2017-07-01$271.99$128.91RVU17C
2017-04-01$271.99$128.91RVU17B
2017-01-01$271.99$128.91RVU17A
2016-10-01$274.79$129.47RVU16D
2016-07-01$274.79$129.47RVU16C
2016-04-01$274.79$129.47RVU16B
2016-01-01$274.79$129.47RVU16A
2015-10-01$274.00$129.44RVU15D
2015-07-01$274.00$129.44RVU15C
2015-04-01$272.63$128.79RVU15B
2015-01-01$272.63$128.79RVU15A
2014-10-01$347.87$165.10RVU14D
2014-07-01$347.87$165.10RVU14C
2014-04-01$347.87$165.10RVU14B
2014-01-01$347.87$165.10RVU14A
2013-10-01$359.75$159.67RVU13D
2013-07-01$359.75$159.67RVU13C
2013-04-01$359.75$159.67RVU13B
2013-01-01$359.75$159.67RVU13AR

Price 36476 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

36476 billing questions

When is 36476 reported instead of 36475?

Use 36475 for the first vein treated with radiofrequency in an extremity. Report 36476 for each additional vein treated in that same extremity.

Can 36476 be billed by itself?

No. It is an add-on code and must be reported with the appropriate primary procedure, such as 36475 for radiofrequency treatment of the first vein.

What supports the units reported?

Document each additional vein treated, the extremity and side, and the radiofrequency method. The number of units should match the additional veins treated.

Is imaging guidance separately reported with 36476?

Imaging guidance and monitoring are included in the endovenous ablation service; they are not separate components of 36476.

How does CMS handle bilateral reporting?

For a bilateral procedure reported with modifier 50, the CMS payment rule is 150%.

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 36476PPRRVU2026_Oct_nonQPP.csv, line 4,489 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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