CPT code 36482: Vein ablation, chemical adhesive, first vein2026 Medicare rate & RVUs in Missouri
Percutaneous catheter delivery of chemical adhesive closes the first incompetent extremity vein treated for symptomatic superficial venous reflux.
Medicare pays $1,447.16–$1,584.52 for 36482 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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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On this page 9 sections
What 36482 covers
Code 36482 represents percutaneous catheter-based closure of an incompetent extremity vein using a chemical adhesive, commonly cyanoacrylate, rather than heat or injected sclerosant. Vascular surgeons, interventional radiologists, and other appropriately trained physicians use it for symptomatic superficial venous reflux, often involving a saphenous vein, in office-based procedure rooms or hospital outpatient settings. Imaging guidance and monitoring during the ablation are included in the service.
Report 36482 for the first vein treated; code 36483 identifies each additional vein treated in the same session. The record should identify the treated vein and side, document the venous disease or reflux supporting intervention, and describe catheter delivery and closure. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others are reduced to 50%. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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 36482 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$1447.16 to $1584.52
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $1,564.15 | $156.88 |
| Metropolitan St. Louis, MO | $1,584.52 | $157.76 |
| Rest of Missouri | $1,447.16 | $155.28 |
How the 36482 rate is calculated
Each of 36482’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 · 36482
RVUs × geographic indexes × conversion factor
Work3.41
3.41 RVUs× 1.000 GPCI
Practice expense45.46
45.46 RVUs× 1.000 GPCI
Malpractice0.75
0.75 RVUs× 1.000 GPCI
Adjusted RVUs
49.6200
Conversion factor
$33.4009
Medicare rate
$1,657.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36482
The CMS indicators that decide how 36482 is paid alongside other services.
CMS payment indicators · 36482
Vein ablation, chemical adhesive, first vein
| 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) | 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
36482 without 50 · national office
$1,657.35
Vein ablation, chemical adhesive, first vein
36482-50 · Bilateral: 150%
$2,486.03
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).
36482 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36483Vein ablationAdditional vein, same extremity
- 36482 identifies the first vein treated with adhesive; 36483 is used for each additional vein treated in the same session.
- 36473Vein ablationMechanochemical, first vein
- 36473 is mechanochemical ablation using mechanical disruption and sclerosant. Use 36482 when the closure method is chemical adhesive.
- 36475Venous ablationRadiofrequency, first vein
- 36475 uses radiofrequency energy, while 36482 uses chemical adhesive for catheter-based vein closure.
- 36478Laser vein ablationFirst vein treated
- 36478 uses laser energy to ablate the vein; 36482 uses chemical adhesive.
36482 billing questions
What is reported for an additional vein treated during the session?
Report 36482 for the first vein and 36483 for each additional vein treated. The record should distinguish the veins treated.
Is imaging guidance separately reported with 36482?
Imaging guidance and monitoring for the adhesive ablation are included in 36482.
How does 36482 differ from 36473?
36482 closes the vein with chemical adhesive. Code 36473 uses mechanochemical ablation, combining mechanical disruption with a sclerosant.
How does 36482 differ from 36475 or 36478?
36482 uses chemical adhesive; 36475 uses radiofrequency energy, and 36478 uses laser energy to ablate the vein.
How is bilateral treatment handled?
CMS lists 36482 as a bilateral procedure; with modifier 50, payment is at 150%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for 36482. Co-surgeons and team surgery are not permitted.
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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