CPT code 36557: Tunneled catheter, under age five, no port2026 Medicare rate & RVUs in Missouri
Report this code for tunneled central venous catheter placement in a child younger than five when the catheter has no subcutaneous port or pump.
Medicare pays $1,114.81–$1,211.42 for 36557 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 36557 covers
This service places a central venous catheter through a subcutaneous tunnel, with the catheter exiting the skin and no implanted port or pump. It is commonly used for young children needing durable access for treatments such as chemotherapy, parenteral nutrition, or prolonged intravenous therapy. Surgeons and other qualified proceduralists may perform the placement in a hospital or surgical setting.
Select the code based on the patient’s age on the date of the procedure and whether the device is tunneled and lacks a port or pump. Documentation should identify the patient’s age, catheter type, tunneled route, and placement details. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 applies to a bilateral procedure, paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 36557 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
$1114.81 to $1211.42
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $1,196.57 | $300.83 |
| Metropolitan St. Louis, MO | $1,211.42 | $303.28 |
| Rest of Missouri | $1,114.81 | $292.52 |
How the 36557 rate is calculated
Each of 36557’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 · 36557
RVUs × geographic indexes × conversion factor
Work4.77
4.77 RVUs× 1.000 GPCI
Practice expense31.74
31.74 RVUs× 1.000 GPCI
Malpractice1.28
1.28 RVUs× 1.000 GPCI
Adjusted RVUs
37.7900
Conversion factor
$33.4009
Medicare rate
$1,262.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36557
36557 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 36557
Tunneled catheter, under age five, no port
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 36557
Tunneled catheter, under age five, no port
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
36557 without 50 · national office
$1,262.22
Tunneled catheter, under age five, no port
36557-50 · Bilateral: 150%
$1,893.33
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).
36557 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36558Tunneled catheterAge 5 years or older
- Both codes are for tunneled central catheters without a port or pump; 36557 is for children younger than five, while 36558 is for patients age five or older.
- 36560Central venous portChild younger than five
- Use 36560 for a tunneled central access device with a subcutaneous port in a patient younger than five. Code 36557 is for a catheter without a port or pump.
- 36555Central line insertionUnder age 5
- Both are for patients younger than five, but 36555 describes a non-tunneled catheter; 36557 describes a tunneled catheter without a port or pump.
- 36556Central line insertionAge 5 years or older
- Code 36556 is for non-tunneled central catheter placement in patients age five or older. Code 36557 is for tunneled placement in patients younger than five.
36557 billing questions
How does this code differ from 36558?
Both describe tunneled central venous catheter placement without a port or pump. Use 36557 for a patient younger than five and 36558 for a patient age five or older.
Can this code be used for an implanted port?
No. It describes a tunneled catheter without a subcutaneous port or pump; code selection changes when the implanted device includes a port.
What documentation supports reporting 36557?
Document the patient’s age on the procedure date, the tunneled catheter placement, and that the device has no subcutaneous port or pump.
Are related postoperative visits separately paid during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
When is an assistant at surgery payable?
CMS allows assistant-at-surgery payment only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are paid at 50%. For a bilateral procedure reported with modifier 50, CMS pays at 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
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