Billing code 36456: Blood exchangeMedicare rate & RVUs

Medicare pays $82.17 for 36456 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 36456 covers

Code 36456 represents a partial exchange transfusion in a newborn: measured portions of the infant’s blood are withdrawn and replaced, commonly with isotonic fluid, to reduce an elevated hematocrit without performing a full-volume exchange. A classic setting is neonatal polycythemia with concern for hyperviscosity. A neonatologist or other qualified physician typically performs the procedure in a hospital nursery or neonatal intensive care unit, often using umbilical venous access and clinical monitoring.

Report this code when the procedure is partial and the patient meets the code’s newborn description; a full exchange in a newborn is reported with the newborn exchange code. Documentation should support the indication, partial-exchange plan, amounts removed and infused, access used, and the patient’s response. CMS applies the standard multiple-procedure reduction when this service and other procedures subject to that rule occur in the same session: 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.

Where 36456 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

36456 rates by state

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

How the 36456 rate is calculated

Each of 36456’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.

Payment rules and modifiers for 36456

The CMS indicators that decide how 36456 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

36456 compared with similar codes

How to choose

36450Exchange transfusion

Both concern exchange transfusion in a newborn. Choose 36456 for a partial exchange and 36450 for a full exchange.

36455Exchange transfusion

This exchange-transfusion code is for a patient other than a newborn; 36456 is the partial-exchange code for a newborn.

36430Blood transfusion

Code 36430 covers transfusion of blood or blood components; 36456 describes a partial exchange that removes and replaces portions of the newborn’s blood.

36440Blood transfusion

Code 36440 describes blood transfusion by push technique in a young child. It is not the partial exchange-transfusion service reported with 36456.

Codes related to 36456

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

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

Open CMS sourceHow we calculate rates