CPT code 36596: Catheter declotting, mechanical, thrombotic obstruction2026 Medicare rate & RVUs in Vermont

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 Vermont, Medicare pays $114.86 for 36596 in the office and $39.14 when it’s performed in a hospital or facility.

$114.86Office (non-facility)
$39.14Hospital or facility
−2.3%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 Vermont
  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 Vermont 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. Vermont pays $114.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

36596 in Vermont vs other payment areas
  1. Vermont · this page$114.86
  2. Los Angeles, CA · California$133.72+$18.86
  3. Washington, DC area · District of Columbia$135.24+$20.38
  4. Miami, FL · Florida$126.86+$12.00
  5. Chicago, IL · Illinois$122.95+$8.09
  6. Manhattan, NY · New York$135.79+$20.93
  7. Alaska · Alaska$133.93+$19.07

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

Every other payment area

36596 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$104.79$37.86
ArkansasArkansas$103.17$37.46
ArizonaArizona$114.27$40.15
Bakersfield, CACalifornia$125.19$41.36
Chico, CACalifornia$124.87$41.04
El Centro, CACalifornia$124.89$41.06
Fresno, CACalifornia$124.87$41.04
Hanford, CACalifornia$124.87$41.04

36596 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.

$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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 36596 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense2.68× 0.9902.6532
Malpractice0.11× 0.5060.0557
Total RVUs3.4389
Conversion factor× 33.4009

Office rate, Vermont$114.86

Office: (0.73 × 1 + 2.68 × 0.99 + 0.11 × 0.506) × $33.4009 = $114.86

Facility: (0.73 × 1 + 0.39 × 0.99 + 0.11 × 0.506) × $33.4009 = $39.14

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

How 36596 has changed in Vermont

36596 · Office / nonfacility

$114.86

Effective 2026-10-01

The base rate is $6.68 higher than on 2025-10-01, moving from $108.18 to $114.86 (6.2%).

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

    $108.18changed to$114.86

    • 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
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $112.14changed to$108.18

    • 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

    $110.31changed to$112.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $114.08changed to$110.31

    • 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
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $116.60changed to$114.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.56 changed to 2.57
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.41changed to$116.60

    • 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

    $124.63changed to$121.41

    • 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
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $128.67changed to$124.63

    • 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
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $134.38changed to$128.67

    • 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

    $134.10changed to$134.38

    • 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
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $135.34changed to$134.10

    • 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
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $135.83changed to$135.34

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $135.15changed to$135.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $135.75changed to$135.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.96 changed to 2.95
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$135.75

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$114.86$39.14RVU26D
2026-07-01$114.86$39.14RVU26C
2026-04-01$114.86$39.14RVU26B
2026-01-01$114.86$39.14RVU26A
2025-10-01$108.18$42.01RVU25D
2025-07-01$108.18$42.01RVU25C
2025-04-01$108.18$42.01RVU25B
2025-01-01$108.18$42.01RVU25A
2024-10-01$112.14$42.40RVU24D
2024-07-01$112.14$42.40RVU24C
2024-04-01$112.14$42.40RVU24B
2024-03-09$112.14$42.40RVU24AR
2024-01-01$110.31$41.71RVU24A
2023-10-01$114.08$42.46RVU23D
2023-07-01$114.08$42.46RVU23C
2023-04-01$114.08$42.46RVU23B
2023-01-01$114.08$42.46RVU23A
2022-10-01$116.60$43.17RVU22D
2022-07-01$116.60$43.17RVU22C
2022-04-01$116.60$43.17RVU22B
2022-01-01$116.60$43.17RVU22A
2021-10-01$121.41$42.82RVU21D
2021-07-01$121.41$42.82RVU21C
2021-04-01$121.41$42.82RVU21B
2021-01-01$121.41$42.82RVU21A
2020-10-01$124.63$44.24RVU20D
2020-07-01$124.63$44.24RVU20C
2020-04-01$124.63$44.24RVU20B
2020-01-01$124.63$44.24RVU20A
2019-10-01$128.67$44.90RVU19D
2019-07-01$128.67$44.90RVU19C
2019-04-01$128.67$44.90RVU19B
2019-01-01$128.67$44.90RVU19A
2018-10-01$134.38$45.22RVU18D
2018-07-01$134.38$45.22RVU18C
2018-04-01$134.38$45.22RVU18B
2018-01-01$134.38$45.22RVU18AR1
2017-10-01$134.10$45.29RVU17D
2017-07-01$134.10$45.29RVU17C
2017-04-01$134.10$45.29RVU17B
2017-01-01$134.10$45.29RVU17A
2016-10-01$135.34$45.47RVU16D
2016-07-01$135.34$45.47RVU16C
2016-04-01$135.34$45.47RVU16B
2016-01-01$135.34$45.47RVU16A
2015-10-01$135.83$45.64RVU15D
2015-07-01$135.83$45.64RVU15C
2015-04-01$135.15$45.41RVU15B
2015-01-01$135.15$45.41RVU15A
2014-10-01$135.75$45.66RVU14D
2014-07-01$135.75$45.66RVU14C
2014-04-01$135.75$45.66RVU14B
2014-01-01$135.75$45.66RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
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 Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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