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CPT code 36596: Catheter declotting, mechanical, thrombotic obstruction2026 Medicare rate & RVUs in Santa Clara County, CA

Report 36596 for percutaneous mechanical removal of a thrombotic obstruction inside a central venous catheter or other central venous access device.

CMS RVU26DEffective Oct 1, 2026One payment locality577 Medicare services in 2024

In Santa Clara County, CA, Medicare pays $157.60 for 36596 in the office and $47.31 when it’s performed in a hospital or facility.

$157.60Office (non-facility)
$47.31Hospital or facility
+34.0%vs the national office rate ($117.57)

Check a contract rate as a % of Medicare · 36596 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 36596 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Santa Clara County, CA
  2. What 36596 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 36596 covers

This service uses a percutaneous mechanical technique to clear thrombus obstructing the lumen of a central venous access device. It may be performed when a tunneled central venous catheter, such as one used for dialysis or infusion therapy, is occluded by clot. The procedure can include fluoroscopic guidance when performed. It addresses the obstruction; it is distinct from removing or replacing the catheter itself.

Report 36596 when documentation supports a thrombotic intraluminal obstruction and mechanical removal. A record of the affected device, the obstructing clot, and the technique used supports code selection over treatment with a thrombolytic agent alone or removal of a nonthrombotic obstruction. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is 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. Medicare does not pay an assistant at surgery for this service, and 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 Santa Clara County, CA compares for 36596

Across 109 of 109 payment localities, the office rate for 36596 runs from $103.17 in Arkansas to $158.11 in San Benito County, CA. Santa Clara County, CA pays $157.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

36596 in Santa Clara County, CA vs other payment areas
  1. Santa Clara County, CA · this page$157.60
  2. Bakersfield, CA · California$125.19−$32.41
  3. Chico, CA · California$124.87−$32.73
  4. El Centro, CA · California$124.89−$32.71
  5. Fresno, CA · California$124.87−$32.73
  6. Hanford, CA · California$124.87−$32.73
  7. Los Angeles, CA · California$133.72−$23.88

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

Every other payment area

36596 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$124.87$41.04
Merced, CACalifornia$124.87$41.04
Modesto, CACalifornia$124.87$41.04
Napa, CACalifornia$145.77$44.95
Oxnard, CACalifornia$133.16$42.75
Redding, CACalifornia$124.87$41.04
Rest of CaliforniaCalifornia$124.87$41.04
Riverside, CACalifornia$126.06$42.23

36596 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.

$103.17

$141.49

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

View every state and territory as a table
36596 office rate range by state
State / territoryOffice rate rangeLocalities
AK$133.931
AL$104.791
AR$103.171
AZ$114.271
CA$124.87–$158.1129
CO$122.791
CT$125.721
DC$135.241
DE$116.251
FL$115.48–$126.863
GA$108.61–$119.822
GU$128.291
HI$128.291
IA$107.751
ID$108.471
IL$111.85–$123.004
IN$109.151
KS$107.161
KY$107.321
LA$107.12–$112.792
MA$121.96–$135.532
MD$118.59–$135.243
ME$109.02–$115.412
MI$110.26–$116.962
MN$117.581
MO$105.12–$113.283
MS$104.171
MT$117.561
NC$110.251
ND$115.391
NE$108.391
NH$120.781
NJ$127.14–$133.682
NM$110.881
NV$117.051
NY$112.00–$139.205
OH$109.811
OK$107.171
OR$116.12–$126.962
PA$110.03–$122.392
PR$118.501
RI$120.591
SC$110.221
SD$115.131
TN$107.721
TX$109.25–$122.398
UT$111.831
VA$114.97–$135.242
VI$118.501
VT$114.861
WA$121.75–$138.442
WI$111.271
WV$107.431
WY$116.621

See 36596 in every payment locality

How the 36596 rate is calculated

Each of 36596’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 · 36596

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense2.68

2.68 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

3.5200

Conversion factor

$33.4009

Medicare rate

$117.57

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

The exact Santa Clara County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,534

Code
36596
Physician work
0.73
Practice expense
2.68
Malpractice
0.11

GPCI2026.csv

28

Locality
Santa Clara County, CA
Physician work
1.110
Practice expense
1.442
Malpractice
0.397
Office calculation for 36596 in Santa Clara County, CA
ComponentRVULocality factorAdjusted
Physician work0.73× 1.1100.8103
Practice expense2.68× 1.4423.8646
Malpractice0.11× 0.3970.0437
Total RVUs4.7185
Conversion factor× 33.4009

Office rate, Santa Clara County, CA$157.60

Office: (0.73 × 1.11 + 2.68 × 1.442 + 0.11 × 0.397) × $33.4009 = $157.60

Facility: (0.73 × 1.11 + 0.39 × 1.442 + 0.11 × 0.397) × $33.4009 = $47.31

Open 36596 in the RVU calculator

Payment rules and modifiers for 36596

The CMS indicators that decide how 36596 is paid alongside other services.

CMS payment indicators · 36596

Catheter declotting, mechanical, thrombotic obstruction

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36596 without 51 · national office

$117.57

Catheter declotting, mechanical, thrombotic obstruction

36596-51 · Second procedure: 50%

$58.79

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 36596

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

Codes related to 36596
CodeHow it relatesOffice range, Santa Clara County, CA
Same family
36595Catheter removal, mechanical, no port or pumpMechanical removal of a nonthrombotic intraluminal obstruction; 36596 is for thrombotic obstruction.$783.14
Used instead
36593Device declot, thrombolytic treatmentDeclotting by thrombolytic agent rather than mechanical removal.$54.21
36589Catheter removal, tunneled catheter, no portRemoval of a tunneled central venous catheter when removal, not mechanical declotting, is performed.$203.02
36590Port removal, tunneled device with portRemoval of a tunneled central venous access device with a subcutaneous port.$272.64
36581Catheter replacement, tunneled, without portReplacement of a tunneled central venous catheter rather than mechanical clearance of its obstruction.$1,042.90

How 36596 has changed in Santa Clara County, CA

36596 · Office / nonfacility

$157.60

Effective 2026-10-01

The base rate is $10.92 higher than on 2025-10-01, moving from $146.68 to $157.60 (7.4%).

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

    $146.68changed to$157.60

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 2.55 changed to 2.68
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.100 changed to 1.110
    • Practice expense GPCI 1.435 changed to 1.442
    • Malpractice GPCI 0.420 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $152.24changed to$146.68

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.58 changed to 2.55
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $149.76changed to$152.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $152.03changed to$149.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.57 changed to 2.58
    • Malpractice RVU 0.10 changed to 0.11
    • Work GPCI 1.098 changed to 1.100
    • Practice expense GPCI 1.409 changed to 1.435
    • Malpractice GPCI 0.417 changed to 0.420

  5. January 1, 2023

    RVU23A

    $152.40changed to$152.03

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.56 changed to 2.57
    • Work GPCI 1.096 changed to 1.098
    • Practice expense GPCI 1.383 changed to 1.409
    • Malpractice GPCI 0.414 changed to 0.417

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $158.97changed to$152.40

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.67 changed to 2.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $160.72changed to$158.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.63 changed to 2.67
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.089 changed to 1.096
    • Practice expense GPCI 1.369 changed to 1.383
    • Malpractice GPCI 0.401 changed to 0.414

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $163.40changed to$160.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.72 changed to 2.63
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.083 changed to 1.089
    • Practice expense GPCI 1.354 changed to 1.369
    • Malpractice GPCI 0.388 changed to 0.401

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $171.02changed to$163.40

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.88 changed to 2.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $171.14changed to$171.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.90 changed to 2.88
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.086 changed to 1.083
    • Practice expense GPCI 1.351 changed to 1.354
    • Malpractice GPCI 0.402 changed to 0.388

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.98changed to$171.14

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.95 changed to 2.90
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.088 changed to 1.086
    • Practice expense GPCI 1.347 changed to 1.351
    • Malpractice GPCI 0.416 changed to 0.402

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $173.60changed to$172.98

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $172.74changed to$173.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $173.07changed to$172.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.96 changed to 2.95
    • Work GPCI 1.083 changed to 1.088
    • Practice expense GPCI 1.342 changed to 1.347
    • Malpractice GPCI 0.466 changed to 0.416

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $176.62changed to$173.07

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.24 changed to 2.96
    • Work GPCI 1.077 changed to 1.083
    • Practice expense GPCI 1.337 changed to 1.342
    • Malpractice GPCI 0.516 changed to 0.466

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$176.62

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$157.60$47.31RVU26D
2026-07-01$157.60$47.31RVU26C
2026-04-01$157.60$47.31RVU26B
2026-01-01$157.60$47.31RVU26A
2025-10-01$146.68$51.06RVU25D
2025-07-01$146.68$51.06RVU25C
2025-04-01$146.68$51.06RVU25B
2025-01-01$146.68$51.06RVU25A
2024-10-01$152.24$51.45RVU24D
2024-07-01$152.24$51.45RVU24C
2024-04-01$152.24$51.45RVU24B
2024-03-09$152.24$51.45RVU24AR
2024-01-01$149.76$50.61RVU24A
2023-10-01$152.03$50.81RVU23D
2023-07-01$152.03$50.81RVU23C
2023-04-01$152.03$50.81RVU23B
2023-01-01$152.03$50.81RVU23A
2022-10-01$152.40$50.94RVU22D
2022-07-01$152.40$50.94RVU22C
2022-04-01$152.40$50.94RVU22B
2022-01-01$152.40$50.94RVU22A
2021-10-01$158.97$50.39RVU21D
2021-07-01$158.97$50.39RVU21C
2021-04-01$158.97$50.39RVU21B
2021-01-01$158.97$50.39RVU21A
2020-10-01$160.72$51.53RVU20D
2020-07-01$160.72$51.53RVU20C
2020-04-01$160.72$51.53RVU20B
2020-01-01$160.72$51.53RVU20A
2019-10-01$163.40$51.65RVU19D
2019-07-01$163.40$51.65RVU19C
2019-04-01$163.40$51.65RVU19B
2019-01-01$163.40$51.65RVU19A
2018-10-01$171.02$52.08RVU18D
2018-07-01$171.02$52.08RVU18C
2018-04-01$171.02$52.08RVU18B
2018-01-01$171.02$52.08RVU18AR1
2017-10-01$171.14$52.35RVU17D
2017-07-01$171.14$52.35RVU17C
2017-04-01$171.14$52.35RVU17B
2017-01-01$171.14$52.35RVU17A
2016-10-01$172.98$52.41RVU16D
2016-07-01$172.98$52.41RVU16C
2016-04-01$172.98$52.41RVU16B
2016-01-01$172.98$52.41RVU16A
2015-10-01$173.60$52.60RVU15D
2015-07-01$173.60$52.60RVU15C
2015-04-01$172.74$52.34RVU15B
2015-01-01$172.74$52.34RVU15A
2014-10-01$173.07$52.88RVU14D
2014-07-01$173.07$52.88RVU14C
2014-04-01$173.07$52.88RVU14B
2014-01-01$173.07$52.88RVU14A
2013-10-01$176.62$51.53RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36596 for an earlier date of service

Where the Santa Clara County, CA rate applies

Santa Clara County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • San Jose
  • Santa Clara
  • Sunnyvale
  • Alum Rock
  • Burbank
  • Cambrian Park
  • Campbell
  • Cupertino

Browse all communities in California

36596 billing questions

How does 36596 differ from 36595?

36596 is for mechanical removal of a thrombotic obstruction. 36595 is for mechanical removal of a nonthrombotic obstruction.

Is 36596 appropriate when a thrombolytic agent clears the catheter?

No. 36596 describes mechanical removal of thrombus; declotting by thrombolytic agent is represented by 36593.

Can catheter removal or replacement be reported instead?

Use a removal or replacement code when the catheter is taken out or exchanged. 36596 represents mechanical clearance of an obstruction, not removal or replacement of the device.

Is fluoroscopic guidance separately reported?

Fluoroscopic guidance is included in 36596 when performed; do not report it separately as guidance for this service.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for 36596. Medicare does not pay an assistant at surgery for this service.

What documentation supports 36596?

Document the central venous access device, the thrombotic intraluminal obstruction, and the mechanical technique used to clear it.

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 36596PPRRVU2026_Oct_nonQPP.csv, line 4,534 (RVU26D)
Geographic factors for Santa Clara County, CAGPCI2026.csv, line 28 (RVU26D)

Open CMS sourceHow we calculate rates

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