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CPT code 36583: Catheter replacement, tunneled central venous2026 Medicare rate & RVUs in Puerto Rico

Reports complete replacement of a tunneled central venous catheter through the same access, commonly when an existing long-term line requires exchange.

CMS RVU26DEffective Oct 1, 2026One payment locality18 Medicare services in 2024

In Puerto Rico, Medicare pays $1,272.15 for 36583 in the office and $315.83 when it’s performed in a hospital or facility.

$1,272.15Office (non-facility)
$315.83Hospital or facility
+0.9%vs the national office rate ($1,261.22)

Check a contract rate as a % of Medicare · 36583 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 36583 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36583 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 36583 covers

This service replaces a tunneled central venous catheter through the existing venous access. It is used for long-term central access, such as a tunneled catheter used for dialysis, chemotherapy, or prolonged infusion, when the existing catheter needs complete exchange. Interventional radiologists, surgeons, and other qualified physicians typically perform the procedure in a hospital or ambulatory procedural setting. The service concerns a tunneled catheter, not a port-based device or a PICC.

Report the code when the physician completes an exchange through the same access, rather than simply repairing the existing catheter or establishing new access. Documentation should identify the catheter, the reason for exchange, the access used, and the replacement performed. The code has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures occur in the same 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 Puerto Rico compares for 36583

Across 109 of 109 payment localities, the office rate for 36583 runs from $1,091.46 in Arkansas to $1,724.59 in San Benito County, CA. Puerto Rico pays $1,272.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

36583 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,272.15
  2. Los Angeles, CA · California$1,446.02+$173.87
  3. Washington, DC area · District of Columbia$1,462.53+$190.38
  4. Miami, FL · Florida$1,371.31+$99.16
  5. Chicago, IL · Illinois$1,324.30+$52.15
  6. Manhattan, NY · New York$1,468.02+$195.87
  7. Alaska · Alaska$1,392.05+$119.90

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

Every other payment area

36583 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,110.55$282.87
ArkansasArkansas$1,091.46$278.92
ArizonaArizona$1,222.26$305.67
Bakersfield, CACalifornia$1,348.36$311.64
Chico, CACalifornia$1,344.84$308.11
El Centro, CACalifornia$1,345.05$308.33
Fresno, CACalifornia$1,344.84$308.11
Hanford, CACalifornia$1,344.84$308.11

36583 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.

$1,091.46

$1,534.72

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

View every state and territory as a table
36583 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,392.051
AL$1,110.551
AR$1,091.461
AZ$1,222.261
CA$1,344.84–$1,724.5929
CO$1,321.031
CT$1,354.801
DC$1,462.531
DE$1,244.981
FL$1,236.87–$1,371.313
GA$1,155.84–$1,287.362
GU$1,387.121
HI$1,387.121
IA$1,145.291
ID$1,153.881
IL$1,194.20–$1,324.594
IN$1,161.821
KS$1,138.381
KY$1,140.561
LA$1,138.23–$1,205.012
MA$1,310.79–$1,467.502
MD$1,271.91–$1,462.533
ME$1,160.40–$1,235.592
MI$1,175.21–$1,254.362
MN$1,260.961
MO$1,114.70–$1,210.743
MS$1,103.371
MT$1,261.131
NC$1,174.841
ND$1,235.231
NE$1,152.891
NH$1,298.941
NJ$1,368.94–$1,443.082
NM$1,182.581
NV$1,254.961
NY$1,195.55–$1,508.325
OH$1,169.921
OK$1,138.741
OR$1,244.01–$1,369.582
PA$1,172.43–$1,315.812
PR$1,272.151
RI$1,294.371
SC$1,174.591
SD$1,232.161
TN$1,145.091
TX$1,163.30–$1,317.668
UT$1,193.551
VA$1,230.45–$1,462.532
VI$1,272.151
VT$1,229.071
WA$1,308.73–$1,500.552
WI$1,186.691
WV$1,142.071
WY$1,249.841

See 36583 in every payment locality

How the 36583 rate is calculated

Each of 36583’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 · 36583

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.91

4.91 RVUs× 1.000 GPCI

Practice expense31.54

31.54 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

37.7600

Conversion factor

$33.4009

Medicare rate

$1,261.22

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,525

Code
36583
Physician work
4.91
Practice expense
31.54
Malpractice
1.31

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36583 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.91× 1.0004.9100
Practice expense31.54× 1.01131.8869
Malpractice1.31× 0.9851.2904
Total RVUs38.0873
Conversion factor× 33.4009

Office rate, Puerto Rico$1272.15

Office: (4.91 × 1 + 31.54 × 1.011 + 1.31 × 0.985) × $33.4009 = $1272.15

Facility: (4.91 × 1 + 3.22 × 1.011 + 1.31 × 0.985) × $33.4009 = $315.83

Open 36583 in the RVU calculator

Payment rules and modifiers for 36583

36583 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36583

Catheter replacement, tunneled central venous

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 · 36583

Catheter replacement, tunneled central venous

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

36583 without 51 · national office

$1,261.22

Catheter replacement, tunneled central venous

36583-51 · Second procedure: 50%

$630.61

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 36583

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

Codes related to 36583
CodeHow it relatesOffice range, Puerto Rico
Same family
36581Catheter replacement, tunneled, without portRelated complete replacement code for a tunneled central venous catheter.$764.67
36582Device replacement, with port or pumpReplacement code for a tunneled central venous access device with a subcutaneous port.$864.66
Used instead
36575Catheter repair, tunneled, without port or pumpRepair of a tunneled catheter when the device is repaired rather than completely exchanged.$148.96
36576Venous device repair, with implanted port or pumpRepair code for a tunneled device with a port or pump, rather than complete replacement.$356.71
36566Tunneled catheter, two catheters, age 5+Insertion of a tunneled catheter when new access is established instead of exchanging through the same access.$4,450.75
36580Central catheter replacement, non-tunneled, same accessComplete replacement code for a non-tunneled centrally inserted catheter.$194.55

How 36583 has changed in Puerto Rico

36583 · Office / nonfacility

$1272.15

Effective 2026-10-01

The base rate is $204.31 higher than on 2025-10-01, moving from $1067.84 to $1272.15 (19.1%).

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

    $1067.84changed to$1272.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.04 changed to 4.91
    • Practice expense RVU 26.52 changed to 31.54
    • Malpractice RVU 1.29 changed to 1.31
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1133.09changed to$1067.84

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 27.54 changed to 26.52

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1114.60changed to$1133.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1184.61changed to$1114.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 28.45 changed to 27.54
    • Malpractice RVU 1.26 changed to 1.29
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $1177.58changed to$1184.61

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $1254.47changed to$1177.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 29.71 changed to 28.45
    • Malpractice RVU 1.28 changed to 1.26
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $1333.83changed to$1254.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 31.70 changed to 29.71
    • Malpractice RVU 1.25 changed to 1.28

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $1309.45changed to$1333.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 29.78 changed to 31.70
    • Malpractice RVU 1.24 changed to 1.25
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $1301.20changed to$1309.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 29.65 changed to 29.78
    • Malpractice RVU 1.22 changed to 1.24
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. July 1, 2019

    RVU19C

    $1300.85changed to$1301.20

    • Malpractice RVU 1.21 changed to 1.22

    Held through RVU19D.

  11. January 1, 2019

    RVU19A

    $1304.85changed to$1300.85

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 29.79 changed to 29.65
    • Malpractice RVU 1.22 changed to 1.21

    Held through RVU19B.

  12. January 1, 2018

    RVU18AR1

    $1105.96changed to$1304.85

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 29.22 changed to 29.79
    • Malpractice RVU 1.19 changed to 1.22
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  13. January 1, 2017

    RVU17A

    $1020.53changed to$1105.96

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 5.29 changed to 5.04
    • Practice expense RVU 32.39 changed to 29.22
    • Malpractice RVU 1.29 changed to 1.19
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  14. January 1, 2016

    RVU16A

    $1023.49changed to$1020.53

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 32.37 changed to 32.39
    • Malpractice RVU 1.27 changed to 1.29

    Held through RVU16B, RVU16C, RVU16D.

  15. July 1, 2015

    RVU15C

    $1018.40changed to$1023.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  16. January 1, 2015

    RVU15A

    $995.08changed to$1018.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 32.07 changed to 32.37
    • Malpractice RVU 1.09 changed to 1.27
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  17. January 1, 2014

    RVU14A

    $1033.45changed to$995.08

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 36.58 changed to 32.07
    • Malpractice RVU 1.14 changed to 1.09
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: $1033.45

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,272.15$315.83RVU26D
2026-07-01$1,272.15$315.83RVU26C
2026-04-01$1,272.15$315.83RVU26B
2026-01-01$1,272.15$315.83RVU26A
2025-10-01$1,067.84$320.94RVU25D
2025-07-01$1,067.84$320.94RVU25C
2025-04-01$1,067.84$320.94RVU25B
2025-01-01$1,067.84$320.94RVU25A
2024-10-01$1,133.09$327.59RVU24D
2024-07-01$1,133.09$327.59RVU24C
2024-04-01$1,133.09$327.59RVU24B
2024-03-09$1,133.09$327.59RVU24AR
2024-01-01$1,114.60$322.25RVU24A
2023-10-01$1,184.61$331.34RVU23D
2023-07-01$1,177.58$331.08RVU23C
2023-04-01$1,177.58$331.08RVU23B
2023-01-01$1,177.58$331.08RVU23A
2022-10-01$1,254.47$338.79RVU22D
2022-07-01$1,254.47$338.79RVU22C
2022-04-01$1,254.47$338.79RVU22B
2022-01-01$1,254.47$338.79RVU22A
2021-10-01$1,333.83$338.45RVU21D
2021-07-01$1,333.83$338.45RVU21C
2021-04-01$1,333.83$338.45RVU21B
2021-01-01$1,333.83$338.45RVU21A
2020-10-01$1,309.45$343.61RVU20D
2020-07-01$1,309.45$343.61RVU20C
2020-04-01$1,309.45$343.61RVU20B
2020-01-01$1,309.45$343.61RVU20A
2019-10-01$1,301.20$340.93RVU19D
2019-07-01$1,301.20$340.93RVU19C
2019-04-01$1,300.85$340.58RVU19B
2019-01-01$1,300.85$340.58RVU19A
2018-10-01$1,304.85$340.20RVU18D
2018-07-01$1,304.85$340.20RVU18C
2018-04-01$1,304.85$340.20RVU18B
2018-01-01$1,304.85$340.20RVU18AR1
2017-10-01$1,105.96$305.07RVU17D
2017-07-01$1,105.96$305.07RVU17C
2017-04-01$1,105.96$305.07RVU17B
2017-01-01$1,105.96$305.07RVU17A
2016-10-01$1,020.53$285.48RVU16D
2016-07-01$1,020.53$285.48RVU16C
2016-04-01$1,020.53$285.48RVU16B
2016-01-01$1,020.53$285.48RVU16A
2015-10-01$1,023.49$286.05RVU15D
2015-07-01$1,023.49$286.05RVU15C
2015-04-01$1,018.40$284.62RVU15B
2015-01-01$1,018.40$284.62RVU15A
2014-10-01$995.08$281.39RVU14D
2014-07-01$995.08$281.39RVU14C
2014-04-01$995.08$281.39RVU14B
2014-01-01$995.08$281.39RVU14A
2013-10-01$1,033.45$274.07RVU13D
2013-07-01$1,033.45$274.07RVU13C
2013-04-01$1,033.45$274.07RVU13B
2013-01-01$1,033.45$274.07RVU13AR

Price 36583 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

36583 billing questions

How does this differ from 36581 or 36582?

Choose among the tunneled-catheter replacement codes based on the specific device and service described by the applicable code. Code 36582 is for replacement of a tunneled device with a subcutaneous port; confirm the distinction between 36581 and 36583 in the current code descriptor.

Can catheter removal be billed separately during the exchange?

This code represents a complete replacement through the same access, rather than a standalone removal followed by a separately coded insertion. The record should support that a complete exchange was performed.

When is repair more appropriate than replacement?

Use a repair code when the existing tunneled catheter is repaired rather than completely exchanged. Codes 36575 and 36576 distinguish repair services by device type.

Does modifier 50 apply if two catheters are replaced?

No. CMS identifies bilateral adjustment as inappropriate for this code. Document each service performed and apply the multiple procedure rule when procedures are performed in the same session.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure's payment.

When may an assistant-at-surgery be paid?

Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.

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 36583PPRRVU2026_Oct_nonQPP.csv, line 4,525 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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