CPT code 36593: Device declot, thrombolytic treatment2026 Medicare rate & RVUs in North Dakota
Reports thrombolytic treatment used to restore patency in an occluded vascular access device, such as a dialysis catheter or implanted infusion port.
In North Dakota, Medicare pays $37.68 for 36593 in the office.
Check a contract rate as a % of Medicare · 36593 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 36593 covers
This service treats an obstructed vascular access device by instilling a thrombolytic agent into the device to dissolve the material blocking flow. Examples include a central venous catheter used for dialysis or an implanted infusion port that will not flush or provide adequate blood return. The service is performed by a clinician managing the access device in settings such as an office, infusion center, dialysis unit, or hospital. It describes thrombolytic treatment rather than mechanical extraction of an obstruction or replacement of the catheter.
Report 36593 when the documented service is thrombolytic declotting of the vascular device. Documentation should identify the affected device, the patency problem, the treatment performed, and the response or outcome. If the drug is separately supplied and reportable, its drug code may also be reported. CMS classifies 36593 as a technical-component-only service; a separate code covers interpretation. The reported service therefore represents the technical work, not an interpretation component.
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 North Dakota compares for 36593
Across 109 of 109 payment localities, the office rate for 36593 runs from $32.48 in Arkansas to $54.30 in San Benito County, CA. North Dakota pays $37.68. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$37.68
- Los Angeles, CA · California$44.70+$7.02
- Washington, DC area · District of Columbia$44.81+$7.13
- Miami, FL · Florida$40.63+$2.95
- Chicago, IL · Illinois$39.13+$1.45
- Manhattan, NY · New York$44.53+$6.85
- Alaska · Alaska$40.21+$2.53
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $33.11 | — |
| ArkansasArkansas | $32.48 | — |
| ArizonaArizona | $36.82 | — |
| Bakersfield, CACalifornia | $41.41 | — |
| Chico, CACalifornia | $41.36 | — |
| El Centro, CACalifornia | $41.36 | — |
| Fresno, CACalifornia | $41.36 | — |
| Hanford, CACalifornia | $41.36 | — |
| Madera, CACalifornia | $41.36 | — |
| Merced, CACalifornia | $41.36 | — |
| Modesto, CACalifornia | $41.36 | — |
| Napa, CACalifornia | $49.64 | — |
| Oxnard, CACalifornia | $44.63 | — |
| Redding, CACalifornia | $41.36 | — |
| Rest of CaliforniaCalifornia | $41.36 | — |
| Riverside, CACalifornia | $41.57 | — |
| Sacramento, CACalifornia | $43.86 | — |
| Salinas, CACalifornia | $43.72 | — |
| San Diego, CACalifornia | $45.10 | — |
| Marin County, CACalifornia | $53.05 | — |
| San Francisco, CACalifornia | $53.03 | — |
| San Benito County, CACalifornia | $54.30 | — |
| Santa Clara County, CACalifornia | $54.21 | — |
| San Luis Obispo, CACalifornia | $42.97 | — |
| Santa Cruz, CACalifornia | $45.81 | — |
| Santa Maria, CACalifornia | $43.98 | — |
| Santa Rosa, CACalifornia | $46.30 | — |
| Stockton, CACalifornia | $41.36 | — |
| Vallejo, CACalifornia | $49.61 | — |
| Visalia, CACalifornia | $41.36 | — |
| Yuba City, CACalifornia | $41.36 | — |
| ColoradoColorado | $40.32 | — |
| ConnecticutConnecticut | $41.10 | — |
| DelawareDelaware | $37.56 | — |
| Fort Lauderdale, FLFlorida | $39.10 | — |
| Rest of FloridaFlorida | $36.77 | — |
| Atlanta, GAGeorgia | $38.81 | — |
| Rest of GeorgiaGeorgia | $34.17 | — |
| Hawaii, Guam, HIHawaii | $42.92 | — |
| IowaIowa | $34.49 | — |
| IdahoIdaho | $34.73 | — |
| East St. Louis, ILIllinois | $35.76 | — |
| Rest of IllinoisIllinois | $35.20 | — |
| Suburban Chicago, ILIllinois | $39.60 | — |
| IndianaIndiana | $35.00 | — |
| KansasKansas | $34.15 | — |
| KentuckyKentucky | $33.87 | — |
| New Orleans, LALouisiana | $35.96 | — |
| Rest of LouisianaLouisiana | $33.75 | — |
| Metropolitan Boston, MAMassachusetts | $45.26 | — |
| Rest of MassachusettsMassachusetts | $39.92 | — |
| Baltimore area, MDMaryland | $40.97 | — |
| Rest of MarylandMaryland | $38.47 | — |
| Rest of MaineMaine | $34.83 | — |
| Southern Maine, MEMaine | $37.49 | — |
| Detroit, MIMichigan | $37.23 | — |
| Rest of MichiganMichigan | $34.91 | — |
| MinnesotaMinnesota | $38.69 | — |
| Metropolitan Kansas City, MOMissouri | $35.78 | — |
| Metropolitan St. Louis, MOMissouri | $36.28 | — |
| Rest of MissouriMissouri | $32.90 | — |
| MississippiMississippi | $32.70 | — |
| MontanaMontana | $38.08 | — |
| North CarolinaNorth Carolina | $35.33 | — |
| NebraskaNebraska | $34.78 | — |
| New HampshireNew Hampshire | $39.53 | — |
| Northern New JerseyNew Jersey | $44.11 | — |
| Rest of New JerseyNew Jersey | $41.58 | — |
| New MexicoNew Mexico | $35.11 | — |
| NevadaNevada | $38.00 | — |
| NYC suburbs and Long Island, NYNew York | $45.72 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $41.77 | — |
| Queens, NYNew York | $45.18 | — |
| Rest of New YorkNew York | $36.01 | — |
| OhioOhio | $34.83 | — |
| OklahomaOklahoma | $33.93 | — |
| Portland, OROregon | $42.06 | — |
| Rest of OregonOregon | $37.73 | — |
| Metropolitan Philadelphia, PAPennsylvania | $39.74 | — |
| Rest of PennsylvaniaPennsylvania | $34.97 | — |
| Puerto RicoPuerto Rico | $38.48 | — |
| Rhode IslandRhode Island | $39.24 | — |
| South CarolinaSouth Carolina | $35.13 | — |
| South DakotaSouth Dakota | $37.63 | — |
| TennesseeTennessee | $34.36 | — |
| Austin, TXTexas | $40.17 | — |
| Beaumont, TXTexas | $34.66 | — |
| Brazoria, TXTexas | $37.59 | — |
| Dallas, TXTexas | $37.83 | — |
| Fort Worth, TXTexas | $37.47 | — |
| Galveston, TXTexas | $37.70 | — |
| Houston, TXTexas | $38.07 | — |
| Rest of TexasTexas | $36.10 | — |
| UtahUtah | $35.76 | — |
| VirginiaVirginia | $37.24 | — |
| Virgin Islands, VIUnited States Virgin Islands | $38.48 | — |
| VermontVermont | $37.37 | — |
| Rest of WashingtonWashington | $39.90 | — |
| King County, WAWashington | $46.45 | — |
| WisconsinWisconsin | $36.04 | — |
| West VirginiaWest Virginia | $33.46 | — |
| WyomingWyoming | $37.90 | — |
36593 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.
$32.48
$47.83
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 | $40.21 | 1 |
| AL | $33.11 | 1 |
| AR | $32.48 | 1 |
| AZ | $36.82 | 1 |
| CA | $41.36–$54.30 | 29 |
| CO | $40.32 | 1 |
| CT | $41.10 | 1 |
| DC | $44.81 | 1 |
| DE | $37.56 | 1 |
| FL | $36.77–$40.63 | 3 |
| GA | $34.17–$38.81 | 2 |
| GU | $42.92 | 1 |
| HI | $42.92 | 1 |
| IA | $34.49 | 1 |
| ID | $34.73 | 1 |
| IL | $35.20–$39.60 | 4 |
| IN | $35.00 | 1 |
| KS | $34.15 | 1 |
| KY | $33.87 | 1 |
| LA | $33.75–$35.96 | 2 |
| MA | $39.92–$45.26 | 2 |
| MD | $38.47–$44.81 | 3 |
| ME | $34.83–$37.49 | 2 |
| MI | $34.91–$37.23 | 2 |
| MN | $38.69 | 1 |
| MO | $32.90–$36.28 | 3 |
| MS | $32.70 | 1 |
| MT | $38.08 | 1 |
| NC | $35.33 | 1 |
| ND | $37.68 | 1 |
| NE | $34.78 | 1 |
| NH | $39.53 | 1 |
| NJ | $41.58–$44.11 | 2 |
| NM | $35.11 | 1 |
| NV | $38.00 | 1 |
| NY | $36.01–$45.72 | 5 |
| OH | $34.83 | 1 |
| OK | $33.93 | 1 |
| OR | $37.73–$42.06 | 2 |
| PA | $34.97–$39.74 | 2 |
| PR | $38.48 | 1 |
| RI | $39.24 | 1 |
| SC | $35.13 | 1 |
| SD | $37.63 | 1 |
| TN | $34.36 | 1 |
| TX | $34.66–$40.17 | 8 |
| UT | $35.76 | 1 |
| VA | $37.24–$44.81 | 2 |
| VI | $38.48 | 1 |
| VT | $37.37 | 1 |
| WA | $39.90–$46.45 | 2 |
| WI | $36.04 | 1 |
| WV | $33.46 | 1 |
| WY | $37.90 | 1 |
How the 36593 rate is calculated
Each of 36593’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 · 36593
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense1.12
1.12 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.1400
Conversion factor
$33.4009
Medicare rate
$38.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,532
- Code
- 36593
- Physician work
- 0.00
- Practice expense
- 1.12
- Malpractice
- 0.02
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 1.12 | × 1.000 | 1.1200 |
| Malpractice | 0.02 | × 0.406 | 0.0081 |
| Total RVUs | 1.1281 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$37.68
Office: (0 × 1 + 1.12 × 1 + 0.02 × 0.406) × $33.4009 = $37.68
Payment rules and modifiers for 36593
The CMS indicators that decide how 36593 is paid alongside other services.
CMS payment indicators · 36593
Device declot, thrombolytic treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 | 3 | Technical component only. |
How 36593 has changed in North Dakota
36593 · Office / nonfacility
$37.68
Effective 2026-10-01
The base rate is $4.35 higher than on 2025-10-01, moving from $33.33 to $37.68 (13.1%).
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
$33.33changed to$37.68
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.02 changed to 1.12
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$34.30changed to$33.33
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$33.74changed to$34.30
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$33.19changed to$33.74
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.97 changed to 1.02
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$33.17changed to$33.19
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.95 changed to 0.97
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$33.10changed to$33.17
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.94 changed to 0.95
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$31.75changed to$33.10
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.87 changed to 0.94
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$31.74changed to$31.75
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$32.07changed to$31.74
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.88 changed to 0.87
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$31.62changed to$32.07
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.87 changed to 0.88
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$31.19changed to$31.62
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.86 changed to 0.87
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$31.10changed to$31.19
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.01 changed to 0.02
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$30.95changed to$31.10
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$30.64changed to$30.95
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.85 changed to 0.86
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$31.48changed to$30.64
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.92 changed to 0.85
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $31.48
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $37.68 | Not available in this setting | RVU26D |
| 2026-07-01 | $37.68 | Not available in this setting | RVU26C |
| 2026-04-01 | $37.68 | Not available in this setting | RVU26B |
| 2026-01-01 | $37.68 | Not available in this setting | RVU26A |
| 2025-10-01 | $33.33 | Not available in this setting | RVU25D |
| 2025-07-01 | $33.33 | Not available in this setting | RVU25C |
| 2025-04-01 | $33.33 | Not available in this setting | RVU25B |
| 2025-01-01 | $33.33 | Not available in this setting | RVU25A |
| 2024-10-01 | $34.30 | Not available in this setting | RVU24D |
| 2024-07-01 | $34.30 | Not available in this setting | RVU24C |
| 2024-04-01 | $34.30 | Not available in this setting | RVU24B |
| 2024-03-09 | $34.30 | Not available in this setting | RVU24AR |
| 2024-01-01 | $33.74 | Not available in this setting | RVU24A |
| 2023-10-01 | $33.19 | Not available in this setting | RVU23D |
| 2023-07-01 | $33.19 | Not available in this setting | RVU23C |
| 2023-04-01 | $33.19 | Not available in this setting | RVU23B |
| 2023-01-01 | $33.19 | Not available in this setting | RVU23A |
| 2022-10-01 | $33.17 | Not available in this setting | RVU22D |
| 2022-07-01 | $33.17 | Not available in this setting | RVU22C |
| 2022-04-01 | $33.17 | Not available in this setting | RVU22B |
| 2022-01-01 | $33.17 | Not available in this setting | RVU22A |
| 2021-10-01 | $33.10 | Not available in this setting | RVU21D |
| 2021-07-01 | $33.10 | Not available in this setting | RVU21C |
| 2021-04-01 | $33.10 | Not available in this setting | RVU21B |
| 2021-01-01 | $33.10 | Not available in this setting | RVU21A |
| 2020-10-01 | $31.75 | Not available in this setting | RVU20D |
| 2020-07-01 | $31.75 | Not available in this setting | RVU20C |
| 2020-04-01 | $31.75 | Not available in this setting | RVU20B |
| 2020-01-01 | $31.75 | Not available in this setting | RVU20A |
| 2019-10-01 | $31.74 | Not available in this setting | RVU19D |
| 2019-07-01 | $31.74 | Not available in this setting | RVU19C |
| 2019-04-01 | $31.74 | Not available in this setting | RVU19B |
| 2019-01-01 | $31.74 | Not available in this setting | RVU19A |
| 2018-10-01 | $32.07 | Not available in this setting | RVU18D |
| 2018-07-01 | $32.07 | Not available in this setting | RVU18C |
| 2018-04-01 | $32.07 | Not available in this setting | RVU18B |
| 2018-01-01 | $32.07 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $31.62 | Not available in this setting | RVU17D |
| 2017-07-01 | $31.62 | Not available in this setting | RVU17C |
| 2017-04-01 | $31.62 | Not available in this setting | RVU17B |
| 2017-01-01 | $31.62 | Not available in this setting | RVU17A |
| 2016-10-01 | $31.19 | Not available in this setting | RVU16D |
| 2016-07-01 | $31.19 | Not available in this setting | RVU16C |
| 2016-04-01 | $31.19 | Not available in this setting | RVU16B |
| 2016-01-01 | $31.19 | Not available in this setting | RVU16A |
| 2015-10-01 | $31.10 | Not available in this setting | RVU15D |
| 2015-07-01 | $31.10 | Not available in this setting | RVU15C |
| 2015-04-01 | $30.95 | Not available in this setting | RVU15B |
| 2015-01-01 | $30.95 | Not available in this setting | RVU15A |
| 2014-10-01 | $30.64 | Not available in this setting | RVU14D |
| 2014-07-01 | $30.64 | Not available in this setting | RVU14C |
| 2014-04-01 | $30.64 | Not available in this setting | RVU14B |
| 2014-01-01 | $30.64 | Not available in this setting | RVU14A |
| 2013-10-01 | $31.48 | Not available in this setting | RVU13D |
| 2013-07-01 | $31.48 | Not available in this setting | RVU13C |
| 2013-04-01 | $31.48 | Not available in this setting | RVU13B |
| 2013-01-01 | $31.48 | Not available in this setting | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
36593 billing questions
When should 36593 be used instead of 36595 or 36596?
Use 36593 for thrombolytic treatment of an obstructed vascular device. Codes 36595 and 36596 describe mechanical removal of an intraluminal obstruction, using different approaches.
Does 36593 include the thrombolytic drug?
The service is the thrombolytic treatment of the device. When the drug is separately supplied and reportable, report the applicable drug code as well, supported by the medication record.
Does 36593 include interpretation?
No. CMS identifies 36593 as technical-component-only; a separate code covers interpretation.
What documentation supports reporting 36593?
Document which vascular device was obstructed, the clinical patency problem, the thrombolytic treatment performed, and the treatment response.
Is 36593 appropriate for a catheter exchange?
No. It represents thrombolytic declotting, not catheter replacement. Report the applicable replacement service when the catheter is exchanged.
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
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