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CPT 36455: Exchange transfusionMedicare rate & RVUs

Reports an exchange transfusion for a patient who is not a newborn, in which the patient’s blood is removed and replaced with donor blood.

CMS RVU26DEffective Oct 1, 2026109 payment localities15 Medicare services in 2024

Medicare pays $114.23 for 36455 nationally in a facility.

Medicare rate · 36455

Exchange transfusion

Swap in your local Medicare rate.

Work RVUs
2.37
Total RVUs
3.42
Global days
XXX

National rate · 2026

$114.23

Facility setting, before claim adjustments.

See every locality for 36455 →

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 36455 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 36455 covers

This service involves removing a patient’s blood while replacing it with donor blood as part of an exchange transfusion. It is distinct from a routine transfusion, which administers blood or blood components without exchanging the patient’s blood. Hematology, critical care, or other clinicians may perform the procedure in a hospital or another setting equipped to manage transfusion procedures. A common clinical context is exchange transfusion for a patient with sickle cell disease.

Report 36455 for an exchange transfusion in a patient who is not a newborn; use the newborn-specific codes when the patient and procedure meet those code descriptions. Documentation should identify the indication, the exchange performed, and the patient’s status as non-newborn. The code represents the exchange service, not a separate service for each portion of blood removed or infused. When other procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces the other procedures to 50% under the standard multiple procedure rule.

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 36455 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

36455 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$103.76
Alaska*Unavailable$145.96
ArizonaUnavailable$110.92
ArkansasUnavailable$102.51
AtlantaUnavailable$118.68
AustinUnavailable$113.03
BakersfieldUnavailable$109.50
Baltimore/Surr. CntysUnavailable$121.29
BeaumontUnavailable$111.45
BrazoriaUnavailable$110.39

36455 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
36455 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 36455 rate is calculated

Each of 36455’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 · 36455

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.37Practice expense 0.46Malpractice 0.59

3.4200 adjusted RVUs×$33.4009 conversion factor=$114.23

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

Payment rules and modifiers for 36455

The CMS indicators that decide how 36455 is paid alongside other services.

CMS payment indicators · 36455

Exchange transfusion

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

36455 without 51 · national facility

$114.23

Exchange transfusion

36455-51 · Second procedure: 50%

$57.12

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

36455 compared with similar codes

Compare codes

36455 vs 36450 vs 36456 vs 36430 vs 36512: national Medicare rates

Swap in your local Medicare rate.

  • 36455
    Exchange transfusion · 2.37 wRVU
    —
  • 36450
    Exchange transfusion · 3.41 wRVU
    —
  • 36456
    Blood exchange · 1.95 wRVU
    —
  • 36430
    Blood transfusion · 0 wRVU
    $47.43
  • 36512
    Red cell apheresis · 1.95 wRVU
    —

How to choose

36450Exchange transfusion
Use 36450 for exchange transfusion in a newborn; 36455 is the exchange transfusion code for patients other than newborns.
36456Blood exchange
36456 describes partial exchange transfusion for a newborn. 36455 is for an exchange transfusion in a non-newborn patient.
36430Blood transfusion
36430 is for a transfusion of blood or blood components, not an exchange of the patient’s blood.
36512Red cell apheresis
36512 describes therapeutic apheresis involving cell exchange. Select the code that matches the service and method performed, rather than using 36455 solely because blood is exchanged.

Codes related to 36455

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

Codes related to 36455
CodeHow it relatesNational office range
Used instead
36450Exchange transfusionNewborn exchange transfusion; patient category distinguishes it from 36455.No office rate
36456Blood exchangePartial exchange transfusion for a newborn, rather than a non-newborn exchange.No office rate
36430Blood transfusionRoutine transfusion service when blood or components are administered without an exchange.$40.40–$67.49
36512Red cell apheresisTherapeutic apheresis code that may describe a cell-exchange service performed by that method.No office rate

36455 billing questions

How is 36455 distinguished from 36450?

36455 is for exchange transfusion in a patient other than a newborn. Code 36450 is the newborn exchange transfusion code.

When is 36456 used instead?

36456 describes partial exchange transfusion for a newborn. It is not the code for a non-newborn exchange transfusion.

Is a routine blood transfusion reported with 36455?

A routine transfusion administers blood or components without exchanging the patient’s blood and is described by a different service. Report the procedure actually performed rather than treating an exchange as a routine transfusion.

How does CMS handle other procedures performed in the same session?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and reduces the other procedures to 50%.

What documentation supports reporting 36455?

Document the clinical indication, that an exchange transfusion was performed, and that the patient was not a newborn. The record should distinguish the exchange from a routine transfusion.

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 36455PPRRVU2026_Oct_nonQPP.csv, line 4,478 (RVU26D)

Open CMS sourceHow we calculate rates

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