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Billing code 36425: Venous cutdownMedicare rate & RVUs

Reports venous access obtained by surgically exposing a vein through a cutdown in a patient who is at least one year old.

CMS RVU26DEffective Oct 1, 2026109 payment localities370 Medicare services in 2024

Medicare pays $33.07 for 36425 nationally in a facility.

Medicare rate · 36425

Venous cutdown

Swap in your local Medicare rate.

Work RVUs
0.74
Total RVUs
0.99
Global days
XXX

National rate · 2026

$33.07

Facility setting, before claim adjustments.

See every locality for 36425 → · 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 36425 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 36425 covers

This service involves making an incision to expose a vein and obtain venous access in a patient age one year or older. It may be used when access is needed but a vein cannot be reached by ordinary percutaneous venipuncture. Physicians or other qualified clinicians perform it in settings equipped for procedural vascular access, including hospitals and offices.

Report 36425 when the documented method is a cutdown, not simply a difficult needle puncture. The record should support the patient’s age and describe the incision, vein exposure, and access performed. A routine blood draw or specimen collection alone does not describe this service. Under the CMS multiple-procedure rule, when this and other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% 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 36425 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

36425 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$31.09
Alaska*Unavailable$44.42
ArizonaUnavailable$32.47
ArkansasUnavailable$30.86
AtlantaUnavailable$33.83
AustinUnavailable$33.08
BakersfieldUnavailable$32.87
Baltimore/Surr. CntysUnavailable$34.56
BeaumontUnavailable$32.37
BrazoriaUnavailable$32.56

36425 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
36425 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 36425 rate is calculated

Each of 36425’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 · 36425

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.74Practice expense 0.16Malpractice 0.09

0.9900 adjusted RVUs×$33.4009 conversion factor=$33.07

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

Payment rules and modifiers for 36425

The CMS indicators that decide how 36425 is paid alongside other services.

CMS payment indicators · 36425

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)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

36425 without 51 · national facility

$33.07

Venous cutdown

36425-51 · Second procedure: 50%

$16.54

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

36425 compared with similar codes

Compare codes

36425 vs 36420 vs 36410 vs 36415: national Medicare rates

Swap in your local Medicare rate.

  • 36425
    Venous cutdown · 0.74 wRVU
    —
  • 36420
    Venous cutdown · 0.98 wRVU
    —
  • 36410
    Skilled venipuncture · 0.18 wRVU
    $19.04
  • 36415
    · 0 wRVU
    —

How to choose

36420Venous cutdown
Both codes describe cutdown access; 36420 is for patients younger than one year, while 36425 is for patients age one year or older.
36410Skilled venipuncture
Use 36410 for difficult venipuncture in a patient age three or older when access is obtained without a cutdown. Use 36425 when the vein is surgically exposed.
36415Coll venous bld venipuncture
Use 36415 for routine venous blood collection. It does not describe the incision and vein exposure involved in a cutdown.

Codes related to 36425

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

Codes related to 36425
CodeHow it relatesNational office range
Same family
36420Venous cutdownCutdown venous access for patients younger than one year.No office rate
Used instead
36410Skilled venipunctureDifficult venipuncture for patients age three or older without a cutdown.$16.97–$24.85
36415Coll venous bld venipunctureRoutine venous blood collection by venipuncture, rather than cutdown access.No office rate
36400VenipunctureVenipuncture for a child younger than three using a femoral or jugular vein.$25.04–$34.79

36425 billing questions

How does 36425 differ from difficult venipuncture code 36410?

36425 describes access obtained by surgically exposing a vein through a cutdown. Code 36410 is for difficult venipuncture in patients age three or older without a cutdown.

Can a routine blood collection code also be reported?

A routine collection alone is not a cutdown. Do not report a separate routine collection code for the same access merely because blood was drawn through it.

What documentation supports 36425?

Document the patient's age and that an incision was used to expose a vein and obtain access. A note describing only a difficult or unsuccessful needle attempt does not establish a cutdown.

How does CMS apply the multiple-procedure reduction?

For procedures performed in the same session, CMS pays the highest-valued procedure in full and reduces the others by 50%.

Is 36425 selected by the vein used?

The defining distinction is the cutdown method in a patient age one year or older. Do not select it solely because access was obtained from a particular vein.

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 36425PPRRVU2026_Oct_nonQPP.csv, line 4,474 (RVU26D)

Open CMS sourceHow we calculate rates

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