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CPT code 36578: Catheter replacement, younger than 5 years2026 Medicare rate & RVUs in Vermont

Reports complete replacement of a tunneled central venous catheter without a port or pump, using the same venous access, in a patient younger than five.

CMS RVU26DEffective Oct 1, 2026One payment locality115 Medicare services in 2024

In Vermont, Medicare pays $422.42 for 36578 in the office and $177.72 when it’s performed in a hospital or facility.

$422.42Office (non-facility)
$177.72Hospital or facility
−3.2%vs the national office rate ($436.22)

Check a contract rate as a % of Medicare · 36578 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 36578 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 36578 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 36578 covers

This code covers complete replacement of a tunneled centrally inserted central venous catheter that has no implanted port or pump, when the patient is younger than five years and the existing venous access is used. It may describe exchange of a tunneled catheter such as a Broviac or Hickman line. A surgeon or interventional radiologist commonly performs the procedure in a hospital or other procedural setting. The key distinction is replacement through the same venous access, rather than placement at a new access site or replacement of a PICC or implanted port.

Report the code for the completed exchange, documenting the patient’s age, the catheter’s tunneled status and device type, and use of the same venous access. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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.

How Vermont compares for 36578

Across 109 of 109 payment localities, the office rate for 36578 runs from $382.36 in Arkansas to $573.76 in San Benito County, CA. Vermont pays $422.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

36578 in Vermont vs other payment areas
  1. Vermont · this page$422.42
  2. Los Angeles, CA · California$489.55+$67.13
  3. Washington, DC area · District of Columbia$499.16+$76.74
  4. Miami, FL · Florida$482.01+$59.59
  5. Chicago, IL · Illinois$466.62+$44.20
  6. Manhattan, NY · New York$505.58+$83.16
  7. Alaska · Alaska$500.05+$77.63

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

Every other payment area

36578 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$388.38$172.11
ArkansasArkansas$382.36$170.04
ArizonaArizona$423.56$184.06
Bakersfield, CACalifornia$459.26$188.37
Chico, CACalifornia$457.46$186.57
El Centro, CACalifornia$457.57$186.68
Fresno, CACalifornia$457.46$186.57
Hanford, CACalifornia$457.46$186.57

36578 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.

$382.36

$515.61

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

View every state and territory as a table
36578 office rate range by state
State / territoryOffice rate rangeLocalities
AK$500.051
AL$388.381
AR$382.361
AZ$423.561
CA$457.46–$573.7629
CO$452.411
CT$466.581
DC$499.161
DE$430.871
FL$433.62–$482.013
GA$407.20–$445.822
GU$469.171
HI$469.171
IA$397.001
ID$400.191
IL$421.70–$466.624
IN$402.621
KS$395.951
KY$400.261
LA$399.97–$421.042
MA$449.81–$497.842
MD$439.20–$499.163
ME$403.43–$425.442
MI$412.28–$440.352
MN$429.841
MO$393.25–$421.513
MS$387.841
MT$436.171
NC$407.791
ND$423.321
NE$399.051
NH$446.101
NJ$470.88–$493.612
NM$415.071
NV$432.901
NY$414.40–$519.765
OH$409.661
OK$398.491
OR$428.54–$466.482
PA$409.82–$454.932
PR$439.271
RI$446.051
SC$409.611
SD$421.801
TN$398.201
TX$407.02–$451.788
UT$415.561
VA$424.61–$499.162
VI$439.271
VT$422.421
WA$448.71–$507.362
WI$408.291
WV$405.321
WY$430.571

See 36578 in every payment locality

How the 36578 rate is calculated

Each of 36578’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 · 36578

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.21

3.21 RVUs× 1.000 GPCI

Practice expense9.20

9.20 RVUs× 1.000 GPCI

Malpractice0.65

0.65 RVUs× 1.000 GPCI

Adjusted RVUs

13.0600

Conversion factor

$33.4009

Medicare rate

$436.22

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

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,521

Code
36578
Physician work
3.21
Practice expense
9.20
Malpractice
0.65

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 36578 in Vermont
ComponentRVULocality factorAdjusted
Physician work3.21× 1.0003.2100
Practice expense9.20× 0.9909.1080
Malpractice0.65× 0.5060.3289
Total RVUs12.6469
Conversion factor× 33.4009

Office rate, Vermont$422.42

Office: (3.21 × 1 + 9.2 × 0.99 + 0.65 × 0.506) × $33.4009 = $422.42

Facility: (3.21 × 1 + 1.8 × 0.99 + 0.65 × 0.506) × $33.4009 = $177.72

Open 36578 in the RVU calculator

Payment rules and modifiers for 36578

36578 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36578

Catheter replacement, younger than 5 years

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 36578

Catheter replacement, younger than 5 years

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36578 without 51 · national office

$436.22

Catheter replacement, younger than 5 years

36578-51 · Second procedure: 50%

$218.11

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 36578

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

Codes related to 36578
CodeHow it relatesOffice range, Vermont
Same family
36581Catheter replacement, tunneled, without portSame-access replacement of a tunneled catheter without a port or pump for patients five years and older.$744.39
Used instead
36580Central catheter replacement, non-tunneled, same accessComplete replacement through the same access when the centrally inserted catheter is not tunneled.$188.64
36582Device replacement, with port or pumpComplete same-access replacement of a tunneled central device with a subcutaneous port.$837.37
36575Catheter repair, tunneled, without port or pumpRepair of a tunneled central catheter when it is repaired rather than completely replaced.$145.24
36557Tunneled catheter, under age five, no portInsertion of a tunneled central catheter without a port or pump for a patient younger than five.$1,230.50

How 36578 has changed in Vermont

36578 · Office / nonfacility

$422.42

Effective 2026-10-01

The base rate is $37.88 higher than on 2025-10-01, moving from $384.54 to $422.42 (9.9%).

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

    $384.54changed to$422.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.29 changed to 3.21
    • Practice expense RVU 8.33 changed to 9.20
    • Malpractice RVU 0.63 changed to 0.65
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $411.45changed to$384.54

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.79 changed to 8.33
    • Malpractice RVU 0.66 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $404.73changed to$411.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $430.56changed to$404.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.09 changed to 8.79
    • Malpractice RVU 0.65 changed to 0.66
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $455.65changed to$430.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.52 changed to 9.09
    • Malpractice RVU 0.61 changed to 0.65
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $474.40changed to$455.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.96 changed to 9.52
    • Malpractice RVU 0.59 changed to 0.61

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $478.64changed to$474.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.57 changed to 9.96
    • Malpractice RVU 0.56 changed to 0.59
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $467.78changed to$478.64

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.23 changed to 9.57
    • Malpractice RVU 0.54 changed to 0.56
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $457.55changed to$467.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.97 changed to 9.23
    • Malpractice RVU 0.53 changed to 0.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $454.05changed to$457.55

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.94 changed to 8.97
    • Malpractice RVU 0.52 changed to 0.53
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $526.25changed to$454.05

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.54 changed to 3.29
    • Practice expense RVU 10.74 changed to 8.94
    • Malpractice RVU 0.55 changed to 0.52
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $530.07changed to$526.25

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.80 changed to 10.74
    • Malpractice RVU 0.54 changed to 0.55

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $527.43changed to$530.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $528.03changed to$527.43

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.82 changed to 10.80
    • Malpractice RVU 0.51 changed to 0.54
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$528.03

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$422.42$177.72RVU26D
2026-07-01$422.42$177.72RVU26C
2026-04-01$422.42$177.72RVU26B
2026-01-01$422.42$177.72RVU26A
2025-10-01$384.54$183.46RVU25D
2025-07-01$384.54$183.46RVU25C
2025-04-01$384.54$183.46RVU25B
2025-01-01$384.54$183.46RVU25A
2024-10-01$411.45$189.98RVU24D
2024-07-01$411.45$189.98RVU24C
2024-04-01$411.45$189.98RVU24B
2024-03-09$411.45$189.98RVU24AR
2024-01-01$404.73$186.88RVU24A
2023-10-01$430.56$193.72RVU23D
2023-07-01$430.56$193.72RVU23C
2023-04-01$430.56$193.72RVU23B
2023-01-01$430.56$193.72RVU23A
2022-10-01$455.65$197.92RVU22D
2022-07-01$455.65$197.92RVU22C
2022-04-01$455.65$197.92RVU22B
2022-01-01$455.65$197.92RVU22A
2021-10-01$474.40$197.77RVU21D
2021-07-01$474.40$197.77RVU21C
2021-04-01$474.40$197.77RVU21B
2021-01-01$474.40$197.77RVU21A
2020-10-01$478.64$204.71RVU20D
2020-07-01$478.64$204.71RVU20C
2020-04-01$478.64$204.71RVU20B
2020-01-01$478.64$204.71RVU20A
2019-10-01$467.78$204.40RVU19D
2019-07-01$467.78$204.40RVU19C
2019-04-01$467.78$204.40RVU19B
2019-01-01$467.78$204.40RVU19A
2018-10-01$457.55$204.70RVU18D
2018-07-01$457.55$204.70RVU18C
2018-04-01$457.55$204.70RVU18B
2018-01-01$457.55$204.70RVU18AR1
2017-10-01$454.05$205.03RVU17D
2017-07-01$454.05$205.03RVU17C
2017-04-01$454.05$205.03RVU17B
2017-01-01$454.05$205.03RVU17A
2016-10-01$526.25$218.90RVU16D
2016-07-01$526.25$218.90RVU16C
2016-04-01$526.25$218.90RVU16B
2016-01-01$526.25$218.90RVU16A
2015-10-01$530.07$220.89RVU15D
2015-07-01$530.07$220.89RVU15C
2015-04-01$527.43$219.79RVU15B
2015-01-01$527.43$219.79RVU15A
2014-10-01$528.03$217.75RVU14D
2014-07-01$528.03$217.75RVU14C
2014-04-01$528.03$217.75RVU14B
2014-01-01$528.03$217.75RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36578 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

36578 billing questions

Can this be reported for a new catheter placed at a different site?

No. This replacement code is for an exchange using the same venous access. A new-site placement is not the same-access replacement described by this code.

Is replacement of a catheter with an implanted port included?

No. This code is for a tunneled catheter without a subcutaneous port or pump. Replacement of a device with a port is represented by a different code.

When is repair more appropriate than replacement?

Use a repair code when the existing tunneled catheter is repaired rather than completely replaced. Document whether the service repaired the catheter or exchanged it.

What documentation supports reporting this code?

Document the patient’s age, that the catheter is tunneled and has no port or pump, that a complete replacement was performed, and that the same venous access was used.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. Assistant-at-surgery payment is available only when medical necessity is documented.

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 36578PPRRVU2026_Oct_nonQPP.csv, line 4,521 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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