CPT code 36581: Catheter replacement, tunneled, without port2026 Medicare rate & RVUs in Missouri
Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance.
Medicare pays $669.41–$727.26 for 36581 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.
Your location
On this page 9 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.
Where 36581 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
$669.41 to $727.26
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $718.60 | $161.59 |
| Metropolitan St. Louis, MO | $727.26 | $162.53 |
| Rest of Missouri | $669.41 | $158.07 |
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.
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%).
36581 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36578Catheter replacementYounger than 5 years
- Both describe complete replacement of a tunneled central venous catheter without a port or pump through the existing access. 36581 includes imaging guidance; 36578 is used without it.
- 36580Central catheter replacementNon-tunneled, same access
- 36580 is for a non-tunneled catheter replacement through the same access. 36581 is for a tunneled catheter and includes imaging guidance.
- 36582Device replacementWith port or pump
- 36582 applies when the tunneled central venous access device has a subcutaneous port or pump; 36581 is for a catheter without one.
- 36575Catheter repairTunneled, without port or pump
- 36575 describes catheter repair, not complete exchange. Use 36581 when the tunneled catheter is replaced in its entirety through the existing access.
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
Fee sheets
Put 36581 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet