CPT code 36581: Catheter replacement, tunneled, without port2026 Medicare rate & RVUs in Iowa
Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance.
In Iowa, Medicare pays $694.95 for 36581 in the office and $152.17 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Iowa 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. Iowa pays $694.95. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$694.95
- Los Angeles, CA · California$874.16+$179.21
- Washington, DC area · District of Columbia$878.79+$183.84
- Miami, FL · Florida$806.00+$111.05
- Chicago, IL · Illinois$780.39+$85.44
- Manhattan, NY · New York$876.42+$181.47
- Alaska · Alaska$845.51+$150.56
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $814.27 | $164.12 |
| Merced, CACalifornia | $814.27 | $164.12 |
| Modesto, CACalifornia | $814.27 | $164.12 |
| Napa, CACalifornia | $960.41 | $178.57 |
| Oxnard, CACalifornia | $871.57 | $170.40 |
| Redding, CACalifornia | $814.27 | $164.12 |
| Rest of CaliforniaCalifornia | $814.27 | $164.12 |
| Riverside, CACalifornia | $818.92 | $168.78 |
| Sacramento, CACalifornia | $859.03 | $169.14 |
| Salinas, CACalifornia | $855.95 | $168.43 |
| San Diego, CACalifornia | $879.55 | $170.08 |
| Marin County, CACalifornia | $1,021.79 | $185.38 |
| San Francisco, CACalifornia | $1,021.30 | $184.89 |
| San Benito County, CACalifornia | $1,044.90 | $189.51 |
| Santa Clara County, CACalifornia | $1,042.90 | $187.51 |
| San Luis Obispo, CACalifornia | $841.71 | $166.06 |
| Santa Cruz, CACalifornia | $890.64 | $169.91 |
| Santa Maria, CACalifornia | $860.10 | $168.43 |
| Santa Rosa, CACalifornia | $899.89 | $171.44 |
| Stockton, CACalifornia | $814.27 | $164.12 |
| Vallejo, CACalifornia | $959.70 | $177.86 |
| Visalia, CACalifornia | $814.27 | $164.12 |
| Yuba City, CACalifornia | $814.27 | $164.12 |
| ColoradoColorado | $796.83 | $165.67 |
| ConnecticutConnecticut | $812.14 | $173.26 |
| DelawareDelaware | $749.28 | $163.20 |
| Fort Lauderdale, FLFlorida | $777.77 | $176.86 |
| Rest of FloridaFlorida | $737.01 | $169.91 |
| Atlanta, GAGeorgia | $771.28 | $168.59 |
| Rest of GeorgiaGeorgia | $691.69 | $162.55 |
| Hawaii, Guam, HIHawaii | $839.27 | $164.80 |
| IdahoIdaho | $699.23 | $153.49 |
| East St. Louis, ILIllinois | $721.37 | $175.62 |
| Rest of IllinoisIllinois | $710.42 | $168.83 |
| Suburban Chicago, ILIllinois | $786.92 | $177.71 |
| IndianaIndiana | $703.89 | $153.99 |
| KansasKansas | $689.47 | $153.21 |
| KentuckyKentucky | $685.80 | $158.44 |
| New Orleans, LALouisiana | $722.16 | $163.96 |
| Rest of LouisianaLouisiana | $683.86 | $158.88 |
| Metropolitan Boston, MAMassachusetts | $884.43 | $176.15 |
| Rest of MassachusettsMassachusetts | $790.46 | $165.82 |
| Baltimore area, MDMaryland | $809.55 | $173.05 |
| Rest of MarylandMaryland | $765.40 | $165.08 |
| Rest of MaineMaine | $701.37 | $155.63 |
| Southern Maine, MEMaine | $746.82 | $158.96 |
| Detroit, MIMichigan | $745.38 | $172.94 |
| Rest of MichiganMichigan | $704.19 | $162.60 |
| MinnesotaMinnesota | $766.27 | $155.86 |
| Metropolitan Kansas City, MOMissouri | $718.60 | $161.59 |
| Metropolitan St. Louis, MOMissouri | $727.26 | $162.53 |
| Rest of MissouriMissouri | $669.41 | $158.07 |
| MississippiMississippi | $665.40 | $154.65 |
| MontanaMontana | $757.84 | $164.64 |
| North CarolinaNorth Carolina | $709.92 | $156.46 |
| North DakotaNorth Dakota | $749.34 | $156.14 |
| NebraskaNebraska | $699.78 | $152.26 |
| New HampshireNew Hampshire | $782.24 | $164.72 |
| Northern New JerseyNew Jersey | $867.60 | $179.49 |
| Rest of New JerseyNew Jersey | $822.19 | $174.42 |
| New MexicoNew Mexico | $707.78 | $163.81 |
| NevadaNevada | $756.11 | $162.31 |
| NYC suburbs and Long Island, NYNew York | $897.55 | $192.23 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $826.25 | $176.70 |
| Queens, NYNew York | $887.12 | $185.95 |
| Rest of New YorkNew York | $721.69 | $158.15 |
| OhioOhio | $702.45 | $160.86 |
| OklahomaOklahoma | $686.37 | $156.64 |
| Portland, OROregon | $826.72 | $167.68 |
| Rest of OregonOregon | $751.05 | $160.22 |
| Metropolitan Philadelphia, PAPennsylvania | $788.70 | $171.18 |
| Rest of PennsylvaniaPennsylvania | $704.74 | $160.18 |
| Puerto RicoPuerto Rico | $764.67 | $164.95 |
| Rhode IslandRhode Island | $779.38 | $166.60 |
| South CarolinaSouth Carolina | $707.20 | $159.09 |
| South DakotaSouth Dakota | $748.33 | $155.13 |
| TennesseeTennessee | $693.13 | $153.91 |
| Austin, TXTexas | $793.46 | $165.85 |
| Beaumont, TXTexas | $699.40 | $159.59 |
| Brazoria, TXTexas | $749.80 | $161.94 |
| Dallas, TXTexas | $754.22 | $163.39 |
| Fort Worth, TXTexas | $748.02 | $163.13 |
| Galveston, TXTexas | $751.77 | $162.72 |
| Houston, TXTexas | $759.64 | $170.59 |
| Rest of TexasTexas | $723.92 | $160.97 |
| UtahUtah | $718.10 | $160.50 |
| VirginiaVirginia | $742.79 | $159.68 |
| Virgin Islands, VIUnited States Virgin Islands | $764.67 | $164.95 |
| VermontVermont | $744.39 | $157.12 |
| Rest of WashingtonWashington | $789.63 | $164.99 |
| King County, WAWashington | $905.39 | $177.53 |
| WisconsinWisconsin | $721.12 | $152.83 |
| West VirginiaWest Virginia | $680.44 | $164.95 |
| WyomingWyoming | $754.13 | $160.93 |
36581 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $845.51 | 1 |
| AL | $671.85 | 1 |
| AR | $660.90 | 1 |
| AZ | $736.01 | 1 |
| CA | $814.27–$1,044.90 | 29 |
| CO | $796.83 | 1 |
| CT | $812.14 | 1 |
| DC | $878.79 | 1 |
| DE | $749.28 | 1 |
| FL | $737.01–$806.00 | 3 |
| GA | $691.69–$771.28 | 2 |
| GU | $839.27 | 1 |
| HI | $839.27 | 1 |
| IA | $694.95 | 1 |
| ID | $699.23 | 1 |
| IL | $710.42–$786.92 | 4 |
| IN | $703.89 | 1 |
| KS | $689.47 | 1 |
| KY | $685.80 | 1 |
| LA | $683.86–$722.16 | 2 |
| MA | $790.46–$884.43 | 2 |
| MD | $765.40–$878.79 | 3 |
| ME | $701.37–$746.82 | 2 |
| MI | $704.19–$745.38 | 2 |
| MN | $766.27 | 1 |
| MO | $669.41–$727.26 | 3 |
| MS | $665.40 | 1 |
| MT | $757.84 | 1 |
| NC | $709.92 | 1 |
| ND | $749.34 | 1 |
| NE | $699.78 | 1 |
| NH | $782.24 | 1 |
| NJ | $822.19–$867.60 | 2 |
| NM | $707.78 | 1 |
| NV | $756.11 | 1 |
| NY | $721.69–$897.55 | 5 |
| OH | $702.45 | 1 |
| OK | $686.37 | 1 |
| OR | $751.05–$826.72 | 2 |
| PA | $704.74–$788.70 | 2 |
| PR | $764.67 | 1 |
| RI | $779.38 | 1 |
| SC | $707.20 | 1 |
| SD | $748.33 | 1 |
| TN | $693.13 | 1 |
| TX | $699.40–$793.46 | 8 |
| UT | $718.10 | 1 |
| VA | $742.79–$878.79 | 2 |
| VI | $764.67 | 1 |
| VT | $744.39 | 1 |
| WA | $789.63–$905.39 | 2 |
| WI | $721.12 | 1 |
| WV | $680.44 | 1 |
| WY | $754.13 | 1 |
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
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 Iowa 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
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.15 | × 1.000 | 3.1500 |
| Practice expense | 19.11 | × 0.915 | 17.4856 |
| Malpractice | 0.43 | × 0.397 | 0.1707 |
| Total RVUs | 20.8064 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$694.95
Office: (3.15 × 1 + 19.11 × 0.915 + 0.43 × 0.397) × $33.4009 = $694.95
Facility: (3.15 × 1 + 1.35 × 0.915 + 0.43 × 0.397) × $33.4009 = $152.17
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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 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.
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%).
How 36581 has changed in Iowa
36581 · Office / nonfacility
$694.95
Effective 2026-10-01
The base rate is $42.20 higher than on 2025-10-01, moving from $652.75 to $694.95 (6.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$652.75changed to$694.95
- 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 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$695.60changed to$652.75
- 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.
March 9, 2024
RVU24AR
$684.25changed to$695.60
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$726.78changed to$684.25
- 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
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$765.82changed to$726.78
- 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
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$785.95changed to$765.82
- 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.
January 1, 2021
RVU21A
$753.96changed to$785.95
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 19.29 changed to 21.09
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$705.98changed to$753.96
- 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
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$658.68changed to$705.98
- 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.
January 1, 2018
RVU18AR1
$652.25changed to$658.68
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 16.37 changed to 16.43
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$710.43changed to$652.25
- 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
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$710.48changed to$710.43
- 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.
July 1, 2015
RVU15C
$706.94changed to$710.48
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$703.47changed to$706.94
- 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
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$719.74changed to$703.47
- 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
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $719.74
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $694.95 | $152.17 | RVU26D |
| 2026-07-01 | $694.95 | $152.17 | RVU26C |
| 2026-04-01 | $694.95 | $152.17 | RVU26B |
| 2026-01-01 | $694.95 | $152.17 | RVU26A |
| 2025-10-01 | $652.75 | $162.81 | RVU25D |
| 2025-07-01 | $652.75 | $162.81 | RVU25C |
| 2025-04-01 | $652.75 | $162.81 | RVU25B |
| 2025-01-01 | $652.75 | $162.81 | RVU25A |
| 2024-10-01 | $695.60 | $166.49 | RVU24D |
| 2024-07-01 | $695.60 | $166.49 | RVU24C |
| 2024-04-01 | $695.60 | $166.49 | RVU24B |
| 2024-03-09 | $695.60 | $166.49 | RVU24AR |
| 2024-01-01 | $684.25 | $163.77 | RVU24A |
| 2023-10-01 | $726.78 | $169.24 | RVU23D |
| 2023-07-01 | $726.78 | $169.24 | RVU23C |
| 2023-04-01 | $726.78 | $169.24 | RVU23B |
| 2023-01-01 | $726.78 | $169.24 | RVU23A |
| 2022-10-01 | $765.82 | $171.96 | RVU22D |
| 2022-07-01 | $765.82 | $171.96 | RVU22C |
| 2022-04-01 | $765.82 | $171.96 | RVU22B |
| 2022-01-01 | $765.82 | $171.96 | RVU22A |
| 2021-10-01 | $785.95 | $172.92 | RVU21D |
| 2021-07-01 | $785.95 | $172.92 | RVU21C |
| 2021-04-01 | $785.95 | $172.92 | RVU21B |
| 2021-01-01 | $785.95 | $172.92 | RVU21A |
| 2020-10-01 | $753.96 | $177.53 | RVU20D |
| 2020-07-01 | $753.96 | $177.53 | RVU20C |
| 2020-04-01 | $753.96 | $177.53 | RVU20B |
| 2020-01-01 | $753.96 | $177.53 | RVU20A |
| 2019-10-01 | $705.98 | $177.42 | RVU19D |
| 2019-07-01 | $705.98 | $177.42 | RVU19C |
| 2019-04-01 | $705.98 | $177.42 | RVU19B |
| 2019-01-01 | $705.98 | $177.42 | RVU19A |
| 2018-10-01 | $658.68 | $177.07 | RVU18D |
| 2018-07-01 | $658.68 | $177.07 | RVU18C |
| 2018-04-01 | $658.68 | $177.07 | RVU18B |
| 2018-01-01 | $658.68 | $177.07 | RVU18AR1 |
| 2017-10-01 | $652.25 | $177.04 | RVU17D |
| 2017-07-01 | $652.25 | $177.04 | RVU17C |
| 2017-04-01 | $652.25 | $177.04 | RVU17B |
| 2017-01-01 | $652.25 | $177.04 | RVU17A |
| 2016-10-01 | $710.43 | $189.76 | RVU16D |
| 2016-07-01 | $710.43 | $189.76 | RVU16C |
| 2016-04-01 | $710.43 | $189.76 | RVU16B |
| 2016-01-01 | $710.43 | $189.76 | RVU16A |
| 2015-10-01 | $710.48 | $190.51 | RVU15D |
| 2015-07-01 | $710.48 | $190.51 | RVU15C |
| 2015-04-01 | $706.94 | $189.56 | RVU15B |
| 2015-01-01 | $706.94 | $189.56 | RVU15A |
| 2014-10-01 | $703.47 | $189.65 | RVU14D |
| 2014-07-01 | $703.47 | $189.65 | RVU14C |
| 2014-04-01 | $703.47 | $189.65 | RVU14B |
| 2014-01-01 | $703.47 | $189.65 | RVU14A |
| 2013-10-01 | $719.74 | $184.38 | RVU13D |
| 2013-07-01 | $719.74 | $184.38 | RVU13C |
| 2013-04-01 | $719.74 | $184.38 | RVU13B |
| 2013-01-01 | $719.74 | $184.38 | RVU13AR |
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
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
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