Billing code 36430: Blood transfusionMedicare rate & RVUs
Administration of blood or blood components during a transfusion encounter, rather than an age-specific push transfusion or an exchange procedure.
Medicare pays $47.43 for 36430 nationally in the office. Local office rates run $40.40–$67.49.
Medicare rate · 36430
Blood transfusion
- Work RVUs
- 0
- Total RVUs
- 1.42
- Global days
- XXX
National rate · 2026
$47.43
Office setting, before claim adjustments.
See every locality for 36430 →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
What 36430 covers
36430 represents administration of donated blood or a blood component, most often by intravenous infusion for anemia, bleeding, surgery-related blood loss, or a hematologic disorder. Outpatient infusion clinics, physician offices, and hospital teams may use it to report transfusion of red blood cells, platelets, plasma, or another component. The code describes the transfusion service, not the blood product itself.
Use 36430 for routine transfusion administration; select a specialized code for a push transfusion or an exchange transfusion. Report the service once for the transfusion encounter rather than once for each unit. Documentation should identify the clinical reason, component and units administered, and the administration and monitoring performed. CMS assigns no physician-work RVU to this service and identifies it as incident-to: it may be billed only when performed under physician supervision.
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 36430 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$40.40 to $67.49
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $41.19 | Unavailable |
| Alaska* | $50.00 | Unavailable |
| Arizona | $45.85 | Unavailable |
| Arkansas | $40.40 | Unavailable |
| Atlanta | $48.37 | Unavailable |
| Austin | $50.01 | Unavailable |
| Bakersfield | $51.49 | Unavailable |
| Baltimore/Surr. Cntys | $51.06 | Unavailable |
| Beaumont | $43.18 | Unavailable |
| Brazoria | $46.79 | Unavailable |
| Chicago | $48.96 | Unavailable |
| Chico | $51.42 | Unavailable |
| Colorado | $50.18 | Unavailable |
| Connecticut | $51.21 | Unavailable |
| Dallas | $47.10 | Unavailable |
| Dc + Md/Va Suburbs | $55.81 | Unavailable |
| Delaware | $46.77 | Unavailable |
| Detroit | $46.49 | Unavailable |
| East St. Louis | $44.73 | Unavailable |
| El Centro | $51.43 | Unavailable |
| Fort Lauderdale | $48.84 | Unavailable |
| Fort Worth | $46.65 | Unavailable |
| Fresno | $51.42 | Unavailable |
| Galveston | $46.93 | Unavailable |
| Hanford-Corcoran | $51.42 | Unavailable |
| Hawaii, Guam | $53.37 | Unavailable |
| Houston | $47.48 | Unavailable |
| Idaho | $43.19 | Unavailable |
| Indiana | $43.53 | Unavailable |
| Iowa | $42.88 | Unavailable |
| Kansas | $42.48 | Unavailable |
| Kentucky | $42.19 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $55.59 | Unavailable |
| Madera | $51.42 | Unavailable |
| Manhattan | $55.54 | Unavailable |
| Merced | $51.42 | Unavailable |
| Metropolitan Boston | $56.33 | Unavailable |
| Metropolitan Kansas City | $44.57 | Unavailable |
| Metropolitan Philadelphia | $49.53 | Unavailable |
| Metropolitan St. Louis | $45.20 | Unavailable |
| Miami | $50.86 | Unavailable |
| Minnesota | $48.07 | Unavailable |
| Mississippi | $40.71 | Unavailable |
| Modesto | $51.42 | Unavailable |
| Montana** | $47.43 | Unavailable |
| Napa | $61.70 | Unavailable |
| Nebraska | $43.23 | Unavailable |
| Nevada** | $47.31 | Unavailable |
| New Hampshire | $49.21 | Unavailable |
| New Mexico | $43.78 | Unavailable |
| New Orleans | $44.83 | Unavailable |
| North Carolina | $43.96 | Unavailable |
| North Dakota** | $46.83 | Unavailable |
| Northern Nj | $54.93 | Unavailable |
| Nyc Suburbs/Long Island | $57.06 | Unavailable |
| Ohio | $43.40 | Unavailable |
| Oklahoma | $42.24 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $55.50 | Unavailable |
| Portland | $52.33 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $52.05 | Unavailable |
| Puerto Rico | $47.92 | Unavailable |
| Queens | $56.32 | Unavailable |
| Redding | $51.42 | Unavailable |
| Rest Of California | $51.42 | Unavailable |
| Rest Of Florida | $45.89 | Unavailable |
| Rest Of Georgia | $42.61 | Unavailable |
| Rest Of Illinois | $43.95 | Unavailable |
| Rest Of Louisiana | $42.05 | Unavailable |
| Rest Of Maine | $43.34 | Unavailable |
| Rest Of Maryland | $47.90 | Unavailable |
| Rest Of Massachusetts | $49.69 | Unavailable |
| Rest Of Michigan | $43.52 | Unavailable |
| Rest Of Missouri | $41.00 | Unavailable |
| Rest Of New Jersey | $51.80 | Unavailable |
| Rest Of New York | $44.81 | Unavailable |
| Rest Of Oregon | $46.95 | Unavailable |
| Rest Of Pennsylvania | $43.57 | Unavailable |
| Rest Of Texas | $44.96 | Unavailable |
| Rest Of Washington | $49.65 | Unavailable |
| Rhode Island | $48.85 | Unavailable |
| Riverside-San Bernardino-Ontario | $51.74 | Unavailable |
| Sacramento-Roseville-Folsom | $54.53 | Unavailable |
| Salinas | $54.35 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $56.07 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $65.92 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $65.89 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $67.49 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $67.35 | Unavailable |
| San Luis Obispo-Paso Robles | $53.42 | Unavailable |
| Santa Cruz-Watsonville | $56.95 | Unavailable |
| Santa Maria-Santa Barbara | $54.67 | Unavailable |
| Santa Rosa-Petaluma | $57.55 | Unavailable |
| Seattle (King Cnty) | $57.78 | Unavailable |
| South Carolina | $43.75 | Unavailable |
| South Dakota** | $46.76 | Unavailable |
| Southern Maine | $46.64 | Unavailable |
| Stockton | $51.42 | Unavailable |
| Suburban Chicago | $49.46 | Unavailable |
| Tennessee | $42.74 | Unavailable |
| Utah | $44.54 | Unavailable |
| Vallejo | $61.65 | Unavailable |
| Vermont | $46.47 | Unavailable |
| Virgin Islands | $47.92 | Unavailable |
| Virginia | $46.35 | Unavailable |
| Visalia | $51.42 | Unavailable |
| West Virginia | $41.78 | Unavailable |
| Wisconsin | $44.79 | Unavailable |
| Wyoming** | $47.17 | Unavailable |
| Yuba City | $51.42 | Unavailable |
36430 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.
$40.40
$59.46
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $50.00 | 1 |
| AL | $41.19 | 1 |
| AR | $40.40 | 1 |
| AZ | $45.85 | 1 |
| CA | $51.42–$67.49 | 29 |
| CO | $50.18 | 1 |
| CT | $51.21 | 1 |
| DC | $55.81 | 1 |
| DE | $46.77 | 1 |
| FL | $45.89–$50.86 | 3 |
| GA | $42.61–$48.37 | 2 |
| GU | $53.37 | 1 |
| HI | $53.37 | 1 |
| IA | $42.88 | 1 |
| ID | $43.19 | 1 |
| IL | $43.95–$49.46 | 4 |
| IN | $43.53 | 1 |
| KS | $42.48 | 1 |
| KY | $42.19 | 1 |
| LA | $42.05–$44.83 | 2 |
| MA | $49.69–$56.33 | 2 |
| MD | $47.90–$55.81 | 3 |
| ME | $43.34–$46.64 | 2 |
| MI | $43.52–$46.49 | 2 |
| MN | $48.07 | 1 |
| MO | $41.00–$45.20 | 3 |
| MS | $40.71 | 1 |
| MT | $47.43 | 1 |
| NC | $43.96 | 1 |
| ND | $46.83 | 1 |
| NE | $43.23 | 1 |
| NH | $49.21 | 1 |
| NJ | $51.80–$54.93 | 2 |
| NM | $43.78 | 1 |
| NV | $47.31 | 1 |
| NY | $44.81–$57.06 | 5 |
| OH | $43.40 | 1 |
| OK | $42.24 | 1 |
| OR | $46.95–$52.33 | 2 |
| PA | $43.57–$49.53 | 2 |
| PR | $47.92 | 1 |
| RI | $48.85 | 1 |
| SC | $43.75 | 1 |
| SD | $46.76 | 1 |
| TN | $42.74 | 1 |
| TX | $43.18–$50.01 | 8 |
| UT | $44.54 | 1 |
| VA | $46.35–$55.81 | 2 |
| VI | $47.92 | 1 |
| VT | $46.47 | 1 |
| WA | $49.65–$57.78 | 2 |
| WI | $44.79 | 1 |
| WV | $41.78 | 1 |
| WY | $47.17 | 1 |
How the 36430 rate is calculated
Each of 36430’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 · 36430
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense1.39
1.39 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.4200
Conversion factor
$33.4009
Medicare rate
$47.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36430
The CMS indicators that decide how 36430 is paid alongside other services.
CMS payment indicators · 36430
Blood transfusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
36430 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36440Blood transfusion
- Use 36440 for a blood push transfusion in a patient age 2 years or younger; 36430 is for routine transfusion administration.
- 36450Exchange transfusion
- 36450 reports exchange transfusion in a newborn, rather than routine transfusion administration.
- 36455Exchange transfusion
- 36455 reports exchange transfusion in a patient other than a newborn; 36430 describes routine transfusion administration.
36430 billing questions
How is 36430 different from 36440?
36430 describes routine transfusion administration. 36440 is for a blood push transfusion in a patient age 2 years or younger.
Does 36430 include the blood product?
No. The code reports the administration service; report the blood product separately using the applicable product code.
Is 36430 reported for each unit transfused?
No. Report it once for the transfusion encounter, not once per unit. Record the units administered in the clinical documentation.
What documentation supports 36430?
Document the indication, the blood component and units administered, and the administration and monitoring performed.
What supervision is required for billing?
CMS identifies 36430 as an incident-to service. It may be billed only when performed under physician supervision.
Should a modifier identify the component or number of units?
Do not use a modifier to represent the component or unit count. Identify the component and units in the record and report the applicable product code separately.
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
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