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CPT code 36589: Catheter removal, tunneled catheter, no port2026 Medicare rate & RVUs in Puerto Rico

Removal of a tunneled central venous catheter without a subcutaneous port or pump, such as when access is no longer needed or the catheter is infected.

CMS RVU26DEffective Oct 1, 2026One payment locality66.7K Medicare services in 2024

In Puerto Rico, Medicare pays $167.05 for 36589 in the office and $125.51 when it’s performed in a hospital or facility.

$167.05Office (non-facility)
$125.51Hospital or facility
+0.4%vs the national office rate ($166.34)

Check a contract rate as a % of Medicare · 36589 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 36589 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36589 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 36589 covers

This service removes a tunneled central venous catheter that has no implanted port or pump. A surgeon, interventional radiologist, or other qualified clinician typically frees the catheter cuff and withdraws the catheter through an incision at the exit site. Common situations include removal of a tunneled dialysis catheter after treatment ends, or removal of a tunneled line because of infection or malfunction. The procedure may take place in a hospital, ambulatory setting, or procedural suite.

Report this code when the service is removal alone; identify the catheter type and document the reason for removal and the work performed. For a complete catheter exchange, use the applicable replacement code rather than reporting removal alone. Medicare assigns a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 36589

Across 109 of 109 payment localities, the office rate for 36589 runs from $149.32 in Arkansas to $204.65 in San Benito County, CA. Puerto Rico pays $167.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

36589 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$167.05
  2. Los Angeles, CA · California$180.18+$13.13
  3. Washington, DC area · District of Columbia$185.99+$18.94
  4. Miami, FL · Florida$187.51+$20.46
  5. Chicago, IL · Illinois$182.40+$15.35
  6. Manhattan, NY · New York$190.97+$23.92
  7. Alaska · Alaska$203.39+$36.34

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

Every other payment area

36589 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$151.20$115.25
ArkansasArkansas$149.32$114.03
ArizonaArizona$162.16$122.35
Bakersfield, CACalifornia$170.90$125.87
Chico, CACalifornia$169.90$124.87
El Centro, CACalifornia$169.96$124.93
Fresno, CACalifornia$169.90$124.87
Hanford, CACalifornia$169.90$124.87

36589 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.

$149.32

$203.39

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

View every state and territory as a table
36589 office rate range by state
State / territoryOffice rate rangeLocalities
AK$203.391
AL$151.201
AR$149.321
AZ$162.161
CA$169.90–$204.6529
CO$169.821
CT$176.471
DC$185.991
DE$164.561
FL$168.67–$187.513
GA$159.89–$170.202
GU$172.441
HI$172.441
IA$152.451
ID$153.741
IL$165.91–$182.404
IN$154.451
KS$152.811
KY$156.411
LA$156.59–$163.182
MA$169.42–$183.712
MD$167.09–$185.993
ME$155.48–$161.302
MI$160.84–$171.542
MN$160.441
MO$154.92–$162.503
MS$152.101
MT$166.311
NC$156.721
ND$159.391
NE$152.871
NH$168.181
NJ$177.84–$184.682
NM$162.011
NV$164.461
NY$158.84–$196.315
OH$159.431
OK$155.121
OR$162.54–$173.472
PA$159.09–$173.232
PR$167.051
RI$169.141
SC$158.471
SD$158.571
TN$153.601
TX$158.26–$170.768
UT$160.311
VA$161.53–$185.992
VI$167.051
VT$159.761
WA$168.77–$186.182
WI$154.871
WV$160.831
WY$163.301

See 36589 in every payment locality

How the 36589 rate is calculated

Each of 36589’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 · 36589

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.22

2.22 RVUs× 1.000 GPCI

Practice expense2.41

2.41 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

4.9800

Conversion factor

$33.4009

Medicare rate

$166.34

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

4,528

Code
36589
Physician work
2.22
Practice expense
2.41
Malpractice
0.35

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36589 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.22× 1.0002.2200
Practice expense2.41× 1.0112.4365
Malpractice0.35× 0.9850.3448
Total RVUs5.0013
Conversion factor× 33.4009

Office rate, Puerto Rico$167.05

Office: (2.22 × 1 + 2.41 × 1.011 + 0.35 × 0.985) × $33.4009 = $167.05

Facility: (2.22 × 1 + 1.18 × 1.011 + 0.35 × 0.985) × $33.4009 = $125.51

Open 36589 in the RVU calculator

Payment rules and modifiers for 36589

36589 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36589

Catheter removal, tunneled catheter, no 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 · 36589

Catheter removal, tunneled catheter, no 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

36589 without 51 · national office

$166.34

Catheter removal, tunneled catheter, no port

36589-51 · Second procedure: 50%

$83.17

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 36589

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

Codes related to 36589
CodeHow it relatesOffice range, Puerto Rico
Same family
36590Port removal, tunneled device with portRemoval code for a tunneled central venous access device with a subcutaneous port or pump.$226.03
Used instead
36578Catheter replacement, younger than 5 yearsUse the applicable replacement service when a tunneled catheter is exchanged rather than removed alone.$439.27
36575Catheter repair, tunneled, without port or pumpRepair may be appropriate when a tunneled catheter is repaired and remains in place.$148.96

How 36589 has changed in Puerto Rico

36589 · Office / nonfacility

$167.05

Effective 2026-10-01

The base rate is $7.91 higher than on 2025-10-01, moving from $159.14 to $167.05 (5.0%).

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

    $159.14changed to$167.05

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.28 changed to 2.22
    • Practice expense RVU 2.29 changed to 2.41
    • Malpractice RVU 0.34 changed to 0.35
    • 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

    $163.77changed to$159.14

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $161.10changed to$163.77

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $167.51changed to$161.10

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.31 changed to 2.29
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $167.06changed to$167.51

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

  6. January 1, 2023

    RVU23A

    $171.79changed to$167.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.34 changed to 2.31
    • Malpractice RVU 0.33 changed to 0.34
    • 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

    $172.86changed to$171.79

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.33 changed to 2.34

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $172.27changed to$172.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.16 changed to 2.33
    • Malpractice RVU 0.32 changed to 0.33
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $170.16changed to$172.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.11 changed to 2.16
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $168.89changed to$170.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.09 changed to 2.11
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $153.41changed to$168.89

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $138.61changed to$153.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.12 changed to 2.09
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $139.21changed to$138.61

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.34 changed to 0.33

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $138.52changed to$139.21

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $137.13changed to$138.52

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.10 changed to 2.12
    • Malpractice RVU 0.35 changed to 0.34
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $134.92changed to$137.13

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.35 changed to 2.10
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $134.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$167.05$125.51RVU26D
2026-07-01$167.05$125.51RVU26C
2026-04-01$167.05$125.51RVU26B
2026-01-01$167.05$125.51RVU26A
2025-10-01$159.14$131.45RVU25D
2025-07-01$159.14$131.45RVU25C
2025-04-01$159.14$131.45RVU25B
2025-01-01$159.14$131.45RVU25A
2024-10-01$163.77$134.27RVU24D
2024-07-01$163.77$134.27RVU24C
2024-04-01$163.77$134.27RVU24B
2024-03-09$163.77$134.27RVU24AR
2024-01-01$161.10$132.08RVU24A
2023-10-01$167.51$137.10RVU23D
2023-07-01$167.06$136.90RVU23C
2023-04-01$167.06$136.90RVU23B
2023-01-01$167.06$136.90RVU23A
2022-10-01$171.79$139.70RVU22D
2022-07-01$171.79$139.70RVU22C
2022-04-01$171.79$139.70RVU22B
2022-01-01$171.79$139.70RVU22A
2021-10-01$172.86$140.85RVU21D
2021-07-01$172.86$140.85RVU21C
2021-04-01$172.86$140.85RVU21B
2021-01-01$172.86$140.85RVU21A
2020-10-01$172.27$143.53RVU20D
2020-07-01$172.27$143.53RVU20C
2020-04-01$172.27$143.53RVU20B
2020-01-01$172.27$143.53RVU20A
2019-10-01$170.16$142.94RVU19D
2019-07-01$170.16$142.94RVU19C
2019-04-01$170.16$142.94RVU19B
2019-01-01$170.16$142.94RVU19A
2018-10-01$168.89$142.43RVU18D
2018-07-01$168.89$142.43RVU18C
2018-04-01$168.89$142.43RVU18B
2018-01-01$168.89$142.43RVU18AR1
2017-10-01$153.41$131.29RVU17D
2017-07-01$153.41$131.29RVU17C
2017-04-01$153.41$131.29RVU17B
2017-01-01$153.41$131.29RVU17A
2016-10-01$138.61$119.93RVU16D
2016-07-01$138.61$119.93RVU16C
2016-04-01$138.61$119.93RVU16B
2016-01-01$138.61$119.93RVU16A
2015-10-01$139.21$120.72RVU15D
2015-07-01$139.21$120.72RVU15C
2015-04-01$138.52$120.12RVU15B
2015-01-01$138.52$120.12RVU15A
2014-10-01$137.13$119.28RVU14D
2014-07-01$137.13$119.28RVU14C
2014-04-01$137.13$119.28RVU14B
2014-01-01$137.13$119.28RVU14A
2013-10-01$134.92$116.23RVU13D
2013-07-01$134.92$116.23RVU13C
2013-04-01$134.92$116.23RVU13B
2013-01-01$134.92$116.23RVU13AR

Price 36589 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

36589 billing questions

How is this different from 36590?

Code 36589 is for removing a tunneled catheter without a subcutaneous port or pump. Code 36590 is the removal code to consider when the device includes a port or pump.

Should removal be reported separately during a catheter exchange?

For a complete catheter exchange, use the applicable replacement code rather than reporting 36589 as removal alone.

Does the code include related postoperative visits?

Yes. Medicare assigns a 10-day global period that includes related postoperative visits during those 10 days.

Can modifier 50 be used for removal on both sides?

No. CMS specifies that bilateral adjustment does not apply and modifier 50 is inappropriate for this service.

When is assistant-at-surgery payment allowed?

Medicare pays an assistant at surgery 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 36589PPRRVU2026_Oct_nonQPP.csv, line 4,528 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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