CPT code 36600: Arterial blood draw, percutaneous puncture2026 Medicare rate & RVUs in Puerto Rico

Reports a percutaneous arterial puncture to collect blood, commonly for blood-gas testing when an arterial specimen is clinically needed.

CMS RVU26DEffective Oct 1, 2026One payment locality9K Medicare services in 2024

In Puerto Rico, Medicare pays $27.56 for 36600 in the office and $13.04 when it’s performed in a hospital or facility.

$27.56Office (non-facility)
$13.04Hospital or facility
+0.6%vs the national office rate ($27.39)

Check a contract rate as a % of Medicare · 36600 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 36600 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36600 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 36600 covers

This service covers obtaining an arterial specimen by puncturing an artery, commonly the radial artery, with a needle. It is often performed at the bedside in an emergency department, hospital, or outpatient setting when arterial blood is needed for blood-gas or other diagnostic testing. A physician or other qualified clinician may perform the collection; the laboratory analysis is a separate service.

Report the puncture when arterial blood is actually collected, not for venous sampling or simply because an arterial catheter is present. Documentation should identify the reason for arterial sampling and support that an arterial specimen was obtained. Report the applicable laboratory analysis separately when performed and separately reportable. Under the CMS multiple-procedure reduction rule, when this service is performed in the same session as other procedures subject to that reduction, the highest-valued procedure is paid in full and the others are paid at 50%.

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 36600

Across 109 of 109 payment localities, the office rate for 36600 runs from $24.76 in Arkansas to $35.45 in San Benito County, CA. Puerto Rico pays $27.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

36600 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$27.56
  2. Los Angeles, CA · California$30.58+$3.02
  3. Washington, DC area · District of Columbia$30.94+$3.38
  4. Miami, FL · Florida$29.08+$1.52
  5. Chicago, IL · Illinois$28.41+$0.85
  6. Manhattan, NY · New York$31.09+$3.53
  7. Alaska · Alaska$33.33+$5.77

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

Every other payment area

36600 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$25.05$12.49
ArkansasArkansas$24.76$12.42
ArizonaArizona$26.79$12.87
Bakersfield, CACalifornia$28.90$13.15
Chico, CACalifornia$28.83$13.08
El Centro, CACalifornia$28.83$13.09
Fresno, CACalifornia$28.83$13.08
Hanford, CACalifornia$28.83$13.08

36600 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.

$24.76

$33.33

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

View every state and territory as a table
36600 office rate range by state
State / territoryOffice rate rangeLocalities
AK$33.331
AL$25.051
AR$24.761
AZ$26.791
CA$28.83–$35.4529
CO$28.411
CT$29.001
DC$30.941
DE$27.181
FL$27.00–$29.083
GA$25.75–$27.822
GU$29.351
HI$29.351
IA$25.591
ID$25.731
IL$26.34–$28.424
IN$25.851
KS$25.491
KY$25.521
LA$25.48–$26.512
MA$28.29–$30.912
MD$27.63–$30.943
ME$25.83–$26.992
MI$26.05–$27.272
MN$27.391
MO$25.11–$26.603
MS$24.941
MT$27.391
NC$26.051
ND$26.991
NE$25.711
NH$27.981
NJ$29.37–$30.712
NM$26.161
NV$27.291
NY$26.37–$31.725
OH$25.971
OK$25.491
OR$27.12–$29.202
PA$26.01–$28.382
PR$27.561
RI$28.051
SC$26.041
SD$26.951
TN$25.591
TX$25.87–$28.288
UT$26.341
VA$26.91–$30.942
VI$27.561
VT$26.901
WA$28.23–$31.502
WI$26.241
WV$25.531
WY$27.221

See 36600 in every payment locality

How the 36600 rate is calculated

Each of 36600’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 · 36600

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.31

0.31 RVUs× 1.000 GPCI

Practice expense0.49

0.49 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.8200

Conversion factor

$33.4009

Medicare rate

$27.39

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

4,537

Code
36600
Physician work
0.31
Practice expense
0.49
Malpractice
0.02

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36600 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.31× 1.0000.3100
Practice expense0.49× 1.0110.4954
Malpractice0.02× 0.9850.0197
Total RVUs0.8251
Conversion factor× 33.4009

Office rate, Puerto Rico$27.56

Office: (0.31 × 1 + 0.49 × 1.011 + 0.02 × 0.985) × $33.4009 = $27.56

Facility: (0.31 × 1 + 0.06 × 1.011 + 0.02 × 0.985) × $33.4009 = $13.04

Open 36600 in the RVU calculator

Payment rules and modifiers for 36600

The CMS indicators that decide how 36600 is paid alongside other services.

CMS payment indicators · 36600

Arterial blood draw, percutaneous puncture

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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

36600 without 51 · national office

$27.39

Arterial blood draw, percutaneous puncture

36600-51 · Second procedure: 50%

$13.70

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 36600 has changed in Puerto Rico

36600 · Office / nonfacility

$27.56

Effective 2026-10-01

The base rate is $0.94 higher than on 2025-10-01, moving from $26.62 to $27.56 (3.5%).

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

    $26.62changed to$27.56

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.32 changed to 0.31
    • Practice expense RVU 0.48 changed to 0.49
    • 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

    $27.40changed to$26.62

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $26.95changed to$27.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $27.91changed to$26.95

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $27.79changed to$27.91

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $29.53changed to$27.79

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.49 changed to 0.48
    • Malpractice RVU 0.04 changed to 0.02
    • 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

    $30.48changed to$29.53

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.51 changed to 0.49

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $31.17changed to$30.48

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice RVU 0.03 changed to 0.04
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $31.47changed to$31.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.52 changed to 0.51
    • 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

    $33.61changed to$31.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.58 changed to 0.52

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $28.84changed to$33.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.55 changed to 0.58
    • Malpractice RVU 0.02 changed to 0.03
    • 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

    $25.66changed to$28.84

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.03 changed to 0.02
    • 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

    $25.90changed to$25.66

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.56 changed to 0.55
    • Malpractice RVU 0.02 changed to 0.03

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $25.77changed to$25.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $24.89changed to$25.77

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.53 changed to 0.56
    • Malpractice RVU 0.03 changed to 0.02
    • 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

    $24.75changed to$24.89

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.59 changed to 0.53
    • 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: $24.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$27.56$13.04RVU26D
2026-07-01$27.56$13.04RVU26C
2026-04-01$27.56$13.04RVU26B
2026-01-01$27.56$13.04RVU26A
2025-10-01$26.62$14.24RVU25D
2025-07-01$26.62$14.24RVU25C
2025-04-01$26.62$14.24RVU25B
2025-01-01$26.62$14.24RVU25A
2024-10-01$27.40$14.66RVU24D
2024-07-01$27.40$14.66RVU24C
2024-04-01$27.40$14.66RVU24B
2024-03-09$27.40$14.66RVU24AR
2024-01-01$26.95$14.42RVU24A
2023-10-01$27.91$14.93RVU23D
2023-07-01$27.79$14.91RVU23C
2023-04-01$27.79$14.91RVU23B
2023-01-01$27.79$14.91RVU23A
2022-10-01$29.53$15.93RVU22D
2022-07-01$29.53$15.93RVU22C
2022-04-01$29.53$15.93RVU22B
2022-01-01$29.53$15.93RVU22A
2021-10-01$30.48$16.06RVU21D
2021-07-01$30.48$16.06RVU21C
2021-04-01$30.48$16.06RVU21B
2021-01-01$30.48$16.06RVU21A
2020-10-01$31.17$16.26RVU20D
2020-07-01$31.17$16.26RVU20C
2020-04-01$31.17$16.26RVU20B
2020-01-01$31.17$16.26RVU20A
2019-10-01$31.47$16.23RVU19D
2019-07-01$31.47$16.23RVU19C
2019-04-01$31.47$16.23RVU19B
2019-01-01$31.47$16.23RVU19A
2018-10-01$33.61$16.21RVU18D
2018-07-01$33.61$16.21RVU18C
2018-04-01$33.61$16.21RVU18B
2018-01-01$33.61$16.21RVU18AR1
2017-10-01$28.84$15.02RVU17D
2017-07-01$28.84$15.02RVU17C
2017-04-01$28.84$15.02RVU17B
2017-01-01$28.84$15.02RVU17A
2016-10-01$25.66$14.30RVU16D
2016-07-01$25.66$14.30RVU16C
2016-04-01$25.66$14.30RVU16B
2016-01-01$25.66$14.30RVU16A
2015-10-01$25.90$14.24RVU15D
2015-07-01$25.90$14.24RVU15C
2015-04-01$25.77$14.17RVU15B
2015-01-01$25.77$14.17RVU15A
2014-10-01$24.89$14.23RVU14D
2014-07-01$24.89$14.23RVU14C
2014-04-01$24.89$14.23RVU14B
2014-01-01$24.89$14.23RVU14A
2013-10-01$24.75$13.68RVU13D
2013-07-01$24.75$13.68RVU13C
2013-04-01$24.75$13.68RVU13B
2013-01-01$24.75$13.68RVU13AR

Price 36600 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

36600 billing questions

When should 36600 be reported instead of 36620?

Use 36600 for a percutaneous arterial puncture to collect a specimen. Code 36620 describes placement of an arterial catheter, generally for ongoing access or monitoring.

Does 36600 include blood-gas analysis?

No. The puncture collects the specimen; report the applicable laboratory analysis separately when performed and separately reportable.

Is 36600 reported for venous blood collection?

No. It represents collection from an artery; venous collection is coded according to the venipuncture service performed.

How many units should be reported for multiple tests from one draw?

The code represents the arterial collection, not each analyte tested. Do not count separate blood-gas results as separate arterial punctures.

How does the multiple-procedure reduction affect 36600?

When the reduction applies to procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 36600PPRRVU2026_Oct_nonQPP.csv, line 4,537 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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