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CPT code 36581: Catheter replacement, tunneled, without port2026 Medicare rate & RVUs in Hawaii, Guam, HI

Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality30.6K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $839.27 for 36581 in the office and $164.80 when it’s performed in a hospital or facility.

$839.27Office (non-facility)
$164.80Hospital or facility
+10.7%vs the national office rate ($757.87)

Check a contract rate as a % of Medicare · 36581 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 36581 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 36581 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 36581 covers

This service replaces a tunneled, centrally inserted venous catheter in its entirety through the existing venous access, without a subcutaneous port or pump. Imaging guidance and its associated supervision and interpretation are included. It is commonly performed by an interventional radiologist or another physician experienced in vascular access, often for a patient whose long-term infusion or hemodialysis catheter is damaged, malfunctioning, or due for exchange. The code describes replacement, not repair of a catheter that remains in place or placement through a new venous access.

Report the code when documentation supports a complete exchange of the tunneled catheter through the same access and identifies the imaging-guided service. The procedure note should establish the catheter type, absence of a port or pump, the existing access used, and the replacement performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 Hawaii, Guam, HI compares for 36581

Across 109 of 109 payment localities, the office rate for 36581 runs from $660.90 in Arkansas to $1,044.90 in San Benito County, CA. Hawaii, Guam, HI pays $839.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

36581 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$839.27
  2. Los Angeles, CA · California$874.16+$34.89
  3. Washington, DC area · District of Columbia$878.79+$39.52
  4. Miami, FL · Florida$806.00−$33.27
  5. Chicago, IL · Illinois$780.39−$58.88
  6. Manhattan, NY · New York$876.42+$37.15
  7. Alaska · Alaska$845.51+$6.24

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

Every other payment area

36581 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$671.85$152.80
ArkansasArkansas$660.90$151.34
ArizonaArizona$736.01$161.20
Bakersfield, CACalifornia$815.53$165.38
Chico, CACalifornia$814.27$164.12
El Centro, CACalifornia$814.34$164.19
Fresno, CACalifornia$814.27$164.12
Hanford, CACalifornia$814.27$164.12

36581 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.

$660.90

$929.59

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

View every state and territory as a table
36581 office rate range by state
State / territoryOffice rate rangeLocalities
AK$845.511
AL$671.851
AR$660.901
AZ$736.011
CA$814.27–$1,044.9029
CO$796.831
CT$812.141
DC$878.791
DE$749.281
FL$737.01–$806.003
GA$691.69–$771.282
GU$839.271
HI$839.271
IA$694.951
ID$699.231
IL$710.42–$786.924
IN$703.891
KS$689.471
KY$685.801
LA$683.86–$722.162
MA$790.46–$884.432
MD$765.40–$878.793
ME$701.37–$746.822
MI$704.19–$745.382
MN$766.271
MO$669.41–$727.263
MS$665.401
MT$757.841
NC$709.921
ND$749.341
NE$699.781
NH$782.241
NJ$822.19–$867.602
NM$707.781
NV$756.111
NY$721.69–$897.555
OH$702.451
OK$686.371
OR$751.05–$826.722
PA$704.74–$788.702
PR$764.671
RI$779.381
SC$707.201
SD$748.331
TN$693.131
TX$699.40–$793.468
UT$718.101
VA$742.79–$878.792
VI$764.671
VT$744.391
WA$789.63–$905.392
WI$721.121
WV$680.441
WY$754.131

See 36581 in every payment locality

How the 36581 rate is calculated

Each of 36581’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 · 36581

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.15

3.15 RVUs× 1.000 GPCI

Practice expense19.11

19.11 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

22.6900

Conversion factor

$33.4009

Medicare rate

$757.87

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,523

Code
36581
Physician work
3.15
Practice expense
19.11
Malpractice
0.43

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 36581 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work3.15× 1.0003.1500
Practice expense19.11× 1.13721.7281
Malpractice0.43× 0.5790.2490
Total RVUs25.1270
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$839.27

Office: (3.15 × 1 + 19.11 × 1.137 + 0.43 × 0.579) × $33.4009 = $839.27

Facility: (3.15 × 1 + 1.35 × 1.137 + 0.43 × 0.579) × $33.4009 = $164.80

Open 36581 in the RVU calculator

Payment rules and modifiers for 36581

36581 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36581

Catheter replacement, tunneled, without port

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 · 36581

Catheter replacement, tunneled, without 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36581 without 51 · national office

$757.87

Catheter replacement, tunneled, without port

36581-51 · Second procedure: 50%

$378.94

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 36581

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

Codes related to 36581
CodeHow it relatesOffice range, Hawaii, Guam, HI
Used instead
36578Catheter replacement, younger than 5 yearsComplete tunneled-catheter replacement through the same access without imaging guidance.$469.17
36580Central catheter replacement, non-tunneled, same accessComplete replacement through the same access for a non-tunneled central venous catheter.$210.29
36582Device replacement, with port or pumpComplete tunneled-device replacement when a subcutaneous port or pump is present.$937.49
36583Catheter replacement, tunneled central venousTunneled-device replacement with a subcutaneous port or pump and imaging guidance.$1,387.12
36575Catheter repair, tunneled, without port or pumpRepair of a tunneled or non-tunneled catheter rather than complete replacement.$163.58
36576Venous device repair, with implanted port or pumpCatheter repair option; use when repairing rather than completely replacing the catheter.$378.95

How 36581 has changed in Hawaii, Guam, HI

36581 · Office / nonfacility

$839.27

Effective 2026-10-01

The base rate is $44.99 higher than on 2025-10-01, moving from $794.28 to $839.27 (5.7%).

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

    $794.28changed to$839.27

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.23 changed to 3.15
    • Practice expense RVU 18.35 changed to 19.11
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $847.42changed to$794.28

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 19.14 changed to 18.35
    • Malpractice RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $833.58changed to$847.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $888.07changed to$833.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 19.82 changed to 19.14
    • Malpractice RVU 0.41 changed to 0.42
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $939.05changed to$888.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 20.65 changed to 19.82
    • Malpractice RVU 0.40 changed to 0.41
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $964.15changed to$939.05

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 21.09 changed to 20.65
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $922.75changed to$964.15

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.29 changed to 21.09
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $862.59changed to$922.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.85 changed to 19.29
    • Malpractice RVU 0.40 changed to 0.39
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $802.84changed to$862.59

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 16.43 changed to 17.85
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $802.75changed to$802.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 16.37 changed to 16.43
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $884.40changed to$802.75

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.48 changed to 3.23
    • Practice expense RVU 18.03 changed to 16.37
    • Malpractice RVU 0.42 changed to 0.39
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $884.30changed to$884.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 17.93 changed to 18.03
    • Malpractice RVU 0.46 changed to 0.42

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $879.90changed to$884.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $876.96changed to$879.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 17.89 changed to 17.93
    • Malpractice RVU 0.42 changed to 0.46
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $902.35changed to$876.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 19.70 changed to 17.89
    • Malpractice RVU 0.44 changed to 0.42
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$902.35

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$839.27$164.80RVU26D
2026-07-01$839.27$164.80RVU26C
2026-04-01$839.27$164.80RVU26B
2026-01-01$839.27$164.80RVU26A
2025-10-01$794.28$177.69RVU25D
2025-07-01$794.28$177.69RVU25C
2025-04-01$794.28$177.69RVU25B
2025-01-01$794.28$177.69RVU25A
2024-10-01$847.42$181.53RVU24D
2024-07-01$847.42$181.53RVU24C
2024-04-01$847.42$181.53RVU24B
2024-03-09$847.42$181.53RVU24AR
2024-01-01$833.58$178.57RVU24A
2023-10-01$888.07$185.94RVU23D
2023-07-01$888.07$185.94RVU23C
2023-04-01$888.07$185.94RVU23B
2023-01-01$888.07$185.94RVU23A
2022-10-01$939.05$190.67RVU22D
2022-07-01$939.05$190.67RVU22C
2022-04-01$939.05$190.67RVU22B
2022-01-01$939.05$190.67RVU22A
2021-10-01$964.15$191.62RVU21D
2021-07-01$964.15$191.62RVU21C
2021-04-01$964.15$191.62RVU21B
2021-01-01$964.15$191.62RVU21A
2020-10-01$922.75$195.69RVU20D
2020-07-01$922.75$195.69RVU20C
2020-04-01$922.75$195.69RVU20B
2020-01-01$922.75$195.69RVU20A
2019-10-01$862.59$194.76RVU19D
2019-07-01$862.59$194.76RVU19C
2019-04-01$862.59$194.76RVU19B
2019-01-01$862.59$194.76RVU19A
2018-10-01$802.84$194.32RVU18D
2018-07-01$802.84$194.32RVU18C
2018-04-01$802.84$194.32RVU18B
2018-01-01$802.84$194.32RVU18AR1
2017-10-01$802.75$194.77RVU17D
2017-07-01$802.75$194.77RVU17C
2017-04-01$802.75$194.77RVU17B
2017-01-01$802.75$194.77RVU17A
2016-10-01$884.40$209.15RVU16D
2016-07-01$884.40$209.15RVU16C
2016-04-01$884.40$209.15RVU16B
2016-01-01$884.40$209.15RVU16A
2015-10-01$884.30$209.96RVU15D
2015-07-01$884.30$209.96RVU15C
2015-04-01$879.90$208.92RVU15B
2015-01-01$879.90$208.92RVU15A
2014-10-01$876.96$209.91RVU14D
2014-07-01$876.96$209.91RVU14C
2014-04-01$876.96$209.91RVU14B
2014-01-01$876.96$209.91RVU14A
2013-10-01$902.35$205.83RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36581 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

36581 billing questions

How is this different from 36578?

36581 includes imaging guidance with supervision and interpretation for the complete tunneled-catheter replacement. 36578 is the corresponding replacement without imaging guidance.

Can 36581 be reported for a catheter repair?

No. It represents complete catheter replacement. For repair of a catheter that remains in place, consider the applicable repair code, such as 36575 or 36576.

Is imaging guidance separately reported?

Imaging guidance and its associated supervision and interpretation are included in 36581. Do not report them separately for the same replacement service.

When is 36582 more appropriate?

Use 36582 for complete replacement of a tunneled central venous access device with a subcutaneous port or pump. Code 36581 is for a catheter without a port or pump.

What documentation supports the replacement?

Document that the catheter is tunneled and centrally inserted, that the entire catheter was replaced through the existing venous access, and that imaging guidance was used.

Can modifier 50 be used for bilateral replacement?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

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 36581PPRRVU2026_Oct_nonQPP.csv, line 4,523 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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