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Billing code 36420: Venous cutdownMedicare rate & RVUs

Surgical venous access by cutdown in an infant younger than one year, reported when incision and vein exposure are needed for venipuncture.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $46.09 for 36420 nationally in a facility.

Medicare rate · 36420

Venous cutdown

Swap in your local Medicare rate.

Work RVUs
0.98
Total RVUs
1.38
Global days
XXX

National rate · 2026

$46.09

Facility setting, before claim adjustments.

See every locality for 36420 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 36420 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 36420 covers

This service provides venous access in an infant younger than one year by making an incision and exposing a vein for needle or catheter entry. It is used when access is needed but a percutaneous puncture is not the approach performed. Physicians or other qualified practitioners may perform the procedure in settings such as a hospital or emergency department, including for infants who need urgent vascular access.

Report the code only when the patient is under one year old and the documented technique involves surgical exposure of a vein, rather than needle puncture through intact skin. The record should support the infant’s age, the clinical need for access, and the cutdown technique performed. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure reduction.

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.

Where 36420 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

36420 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$41.95
Alaska*Unavailable$59.21
ArizonaUnavailable$44.77
ArkansasUnavailable$41.45
AtlantaUnavailable$47.89
AustinUnavailable$45.55
BakersfieldUnavailable$44.09
Baltimore/Surr. CntysUnavailable$48.91
BeaumontUnavailable$45.04
BrazoriaUnavailable$44.54

36420 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
36420 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 36420 rate is calculated

Each of 36420’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 · 36420

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.98Practice expense 0.16Malpractice 0.24

1.3800 adjusted RVUs×$33.4009 conversion factor=$46.09

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 36420

The CMS indicators that decide how 36420 is paid alongside other services.

CMS payment indicators · 36420

Venous cutdown

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)0Not paid without supporting documentation.
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

36420 without 51 · national facility

$46.09

Venous cutdown

36420-51 · Second procedure: 50%

$23.05

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

36420 compared with similar codes

Compare codes

36420 vs 36425 vs 36405 vs 36415: national Medicare rates

Swap in your local Medicare rate.

  • 36420
    Venous cutdown · 0.98 wRVU
    —
  • 36425
    Venous cutdown · 0.74 wRVU
    —
  • 36405
    Scalp venipuncture · 0.3 wRVU
    $24.05
  • 36415
    · 0 wRVU
    —

How to choose

36425Venous cutdown
Both describe venous access by cutdown; choose based on age. Code 36420 is for patients under one year, while 36425 is for patients one year or older.
36405Scalp venipuncture
Code 36405 is percutaneous venipuncture at a scalp vein in a child under three. Code 36420 requires an incision to expose a vein and is limited to infants under one year.
36415Coll venous bld venipuncture
Code 36415 is for routine venous blood collection. Code 36420 describes surgical venous access in an infant, not an ordinary blood draw.

Codes related to 36420

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

Codes related to 36420
CodeHow it relatesNational office range
Same family
36425Venous cutdownVenous cutdown code for patients one year or older.No office rate
Used instead
36400VenipuncturePercutaneous femoral or jugular venipuncture in a child under three.$25.04–$34.79
36405Scalp venipuncturePercutaneous scalp-vein venipuncture in a child under three.$21.84–$30.75
36406Pediatric venipuncturePercutaneous venipuncture at another site in a child under three.$16.51–$24.19

36420 billing questions

How does this code differ from percutaneous venipuncture codes?

This code describes access using an incision to expose a vein in an infant under one year. Codes such as 36400, 36405, and 36406 describe needle venipuncture without a cutdown.

Does the patient’s age determine whether to use this code or 36425?

Yes. Use 36420 for a patient younger than one year and 36425 for a patient who is one year or older, when a venous cutdown is performed.

What documentation supports reporting a cutdown?

Document the patient’s age, the need for venous access, and that an incision was made to expose the vein for access. A record of needle puncture alone does not support this code.

How does the multiple procedure reduction affect this service?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can this code be used for routine blood collection?

No. This code represents surgical venous access by cutdown in an infant, not routine venous blood collection such as a standard blood draw.

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 36420PPRRVU2026_Oct_nonQPP.csv, line 4,473 (RVU26D)

Open CMS sourceHow we calculate rates

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