Billing code 36476: Vein ablationMedicare rate & RVUs
Reports radiofrequency catheter ablation of each additional incompetent vein treated in the same extremity after the primary vein procedure.
Medicare pays $278.90 for 36476 nationally in the office and $117.57 in a hospital or facility. Local office rates run $245.17–$356.31.
Medicare rate · 36476
Vein ablation
Swap in your local Medicare rate.
- Work RVUs
- 2.58
- Total RVUs
- 8.35
- Global days
- ZZZ
National rate · 2026
$278.90
Office setting, before claim adjustments.
See every locality for 36476 → · 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 36476 covers
This add-on reports percutaneous radiofrequency ablation of an additional incompetent vein in the same extremity after the first vein is treated. A vascular surgeon, interventional radiologist, or other qualified physician typically uses a catheter and imaging guidance to close refluxing superficial veins in patients with chronic venous insufficiency or varicose veins. Imaging guidance and monitoring are included in the endovenous ablation service.
Report 36476 for each additional vein treated, alongside 36475 for the first vein treated with radiofrequency in that extremity. Document the treated vein, side, ablation method, and number of additional veins so the unit count is supported. CMS identifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period. For a bilateral procedure reported with modifier 50, CMS pays 150%.
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 36476 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
$245.17 to $356.31
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $248.92 | $107.76 |
| Alaska* | $324.73 | $152.91 |
| Arizona | $270.77 | $114.45 |
| Arkansas | $245.17 | $106.59 |
| Atlanta | $285.76 | $121.85 |
| Austin | $286.97 | $116.29 |
| Bakersfield | $289.76 | $112.95 |
| Baltimore/Surr. Cntys | $297.47 | $124.36 |
| Beaumont | $261.91 | $115.11 |
| Brazoria | $273.84 | $113.96 |
| Chicago | $305.02 | $142.89 |
| Chico | $288.20 | $111.39 |
| Colorado | $286.88 | $115.23 |
| Connecticut | $297.99 | $124.24 |
| Dallas | $276.27 | $115.59 |
| Dc + Md/Va Suburbs | $316.62 | $126.58 |
| Delaware | $275.32 | $115.93 |
| Detroit | $285.88 | $130.20 |
| East St. Louis | $284.31 | $135.89 |
| El Centro | $288.30 | $111.48 |
| Fort Lauderdale | $296.54 | $133.11 |
| Fort Worth | $274.79 | $115.72 |
| Fresno | $288.20 | $111.39 |
| Galveston | $275.10 | $114.90 |
| Hanford-Corcoran | $288.20 | $111.39 |
| Hawaii, Guam | $294.68 | $111.25 |
| Houston | $285.53 | $125.33 |
| Idaho | $254.97 | $106.55 |
| Indiana | $256.43 | $106.88 |
| Iowa | $252.65 | $105.04 |
| Kansas | $252.78 | $106.94 |
| Kentucky | $258.00 | $114.58 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $307.82 | $116.97 |
| Madera | $288.20 | $111.39 |
| Manhattan | $323.71 | $136.24 |
| Merced | $288.20 | $111.39 |
| Metropolitan Boston | $314.03 | $121.41 |
| Metropolitan Kansas City | $267.86 | $116.38 |
| Metropolitan Philadelphia | $291.24 | $123.30 |
| Metropolitan St. Louis | $270.60 | $117.02 |
| Miami | $315.13 | $147.19 |
| Minnesota | $270.53 | $104.53 |
| Mississippi | $249.79 | $110.88 |
| Modesto | $288.20 | $111.39 |
| Montana** | $278.86 | $117.53 |
| Napa | $330.19 | $117.56 |
| Nebraska | $253.68 | $104.78 |
| Nevada** | $275.89 | $114.40 |
| New Hampshire | $283.64 | $115.70 |
| New Mexico | $268.31 | $120.37 |
| New Orleans | $271.24 | $119.43 |
| North Carolina | $260.39 | $109.87 |
| North Dakota** | $267.59 | $106.26 |
| Northern Nj | $313.41 | $126.27 |
| Nyc Suburbs/Long Island | $333.56 | $141.74 |
| Ohio | $263.94 | $116.65 |
| Oklahoma | $256.07 | $112.00 |
| Oxnard-Thousand Oaks-Ventura | $305.74 | $115.06 |
| Portland | $294.68 | $115.45 |
| Poughkpsie/N Nyc Suburbs | $303.27 | $126.62 |
| Puerto Rico | $280.52 | $117.42 |
| Queens | $324.44 | $133.75 |
| Redding | $288.20 | $111.39 |
| Rest Of California | $288.20 | $111.39 |
| Rest Of Florida | $280.83 | $126.60 |
| Rest Of Georgia | $263.79 | $119.89 |
| Rest Of Illinois | $274.51 | $127.21 |
| Rest Of Louisiana | $258.12 | $115.35 |
| Rest Of Maine | $257.81 | $109.39 |
| Rest Of Maryland | $280.28 | $117.02 |
| Rest Of Massachusetts | $285.62 | $115.74 |
| Rest Of Michigan | $266.24 | $118.95 |
| Rest Of Missouri | $254.43 | $115.37 |
| Rest Of New Jersey | $300.17 | $124.00 |
| Rest Of New York | $264.56 | $111.30 |
| Rest Of Oregon | $272.55 | $111.87 |
| Rest Of Pennsylvania | $263.61 | $115.51 |
| Rest Of Texas | $268.19 | $115.09 |
| Rest Of Washington | $284.67 | $114.80 |
| Rhode Island | $284.21 | $117.56 |
| Riverside-San Bernardino-Ontario | $294.32 | $117.51 |
| Sacramento-Roseville-Folsom | $301.48 | $113.85 |
| Salinas | $300.35 | $113.37 |
| San Diego-Chula Vista-Carlsbad | $306.81 | $113.86 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $347.99 | $120.52 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $347.35 | $119.88 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $356.31 | $123.68 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $353.67 | $121.03 |
| San Luis Obispo-Paso Robles | $295.67 | $111.92 |
| Santa Cruz-Watsonville | $309.22 | $113.20 |
| Santa Maria-Santa Barbara | $301.31 | $113.20 |
| Santa Rosa-Petaluma | $312.25 | $114.14 |
| Seattle (King Cnty) | $319.15 | $121.20 |
| South Carolina | $262.84 | $113.78 |
| South Dakota** | $266.26 | $104.93 |
| Southern Maine | $270.31 | $110.43 |
| Stockton | $288.20 | $111.39 |
| Suburban Chicago | $298.89 | $133.21 |
| Tennessee | $254.28 | $107.63 |
| Utah | $266.53 | $114.89 |
| Vallejo | $329.26 | $116.63 |
| Vermont | $267.76 | $108.04 |
| Virgin Islands | $280.52 | $117.42 |
| Virginia | $270.35 | $111.76 |
| Visalia | $288.20 | $111.39 |
| West Virginia | $264.35 | $124.16 |
| Wisconsin | $258.43 | $103.88 |
| Wyoming** | $273.95 | $112.62 |
| Yuba City | $288.20 | $111.39 |
36476 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.
$245.17
$324.73
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 | $324.73 | 1 |
| AL | $248.92 | 1 |
| AR | $245.17 | 1 |
| AZ | $270.77 | 1 |
| CA | $288.20–$356.31 | 29 |
| CO | $286.88 | 1 |
| CT | $297.99 | 1 |
| DC | $316.62 | 1 |
| DE | $275.32 | 1 |
| FL | $280.83–$315.13 | 3 |
| GA | $263.79–$285.76 | 2 |
| GU | $294.68 | 1 |
| HI | $294.68 | 1 |
| IA | $252.65 | 1 |
| ID | $254.97 | 1 |
| IL | $274.51–$305.02 | 4 |
| IN | $256.43 | 1 |
| KS | $252.78 | 1 |
| KY | $258.00 | 1 |
| LA | $258.12–$271.24 | 2 |
| MA | $285.62–$314.03 | 2 |
| MD | $280.28–$316.62 | 3 |
| ME | $257.81–$270.31 | 2 |
| MI | $266.24–$285.88 | 2 |
| MN | $270.53 | 1 |
| MO | $254.43–$270.60 | 3 |
| MS | $249.79 | 1 |
| MT | $278.86 | 1 |
| NC | $260.39 | 1 |
| ND | $267.59 | 1 |
| NE | $253.68 | 1 |
| NH | $283.64 | 1 |
| NJ | $300.17–$313.41 | 2 |
| NM | $268.31 | 1 |
| NV | $275.89 | 1 |
| NY | $264.56–$333.56 | 5 |
| OH | $263.94 | 1 |
| OK | $256.07 | 1 |
| OR | $272.55–$294.68 | 2 |
| PA | $263.61–$291.24 | 2 |
| PR | $280.52 | 1 |
| RI | $284.21 | 1 |
| SC | $262.84 | 1 |
| SD | $266.26 | 1 |
| TN | $254.28 | 1 |
| TX | $261.91–$286.97 | 8 |
| UT | $266.53 | 1 |
| VA | $270.35–$316.62 | 2 |
| VI | $280.52 | 1 |
| VT | $267.76 | 1 |
| WA | $284.67–$319.15 | 2 |
| WI | $258.43 | 1 |
| WV | $264.35 | 1 |
| WY | $273.95 | 1 |
How the 36476 rate is calculated
Each of 36476’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 · 36476
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.58Practice expense 5.20Malpractice 0.57
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36476
The CMS indicators that decide how 36476 is paid alongside other services.
CMS payment indicators · 36476
Vein ablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
36476 without 50 · national office
$278.90
Vein ablation
36476-50 · Bilateral: 150%
$418.35
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
36476 compared with similar codes
Compare codes
36476 vs 36475 vs 36474 vs 36479 vs 36483: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36475Venous ablation
- 36475 covers the first vein treated with radiofrequency in an extremity. Use 36476 only for additional veins treated in that same extremity.
- 36474Vein ablation
- Both are add-on services for additional vein treatment, but 36474 uses mechanochemical ablation; 36476 uses radiofrequency.
- 36479Laser vein ablation
- Both report additional vein treatment, but 36479 uses laser ablation while 36476 uses radiofrequency.
- 36483Vein ablation
- 36483 reports a subsequent vein treated with chemical adhesive. Choose 36476 when the additional vein is treated with radiofrequency.
36476 billing questions
When is 36476 reported instead of 36475?
Use 36475 for the first vein treated with radiofrequency in an extremity. Report 36476 for each additional vein treated in that same extremity.
Can 36476 be billed by itself?
No. It is an add-on code and must be reported with the appropriate primary procedure, such as 36475 for radiofrequency treatment of the first vein.
What supports the units reported?
Document each additional vein treated, the extremity and side, and the radiofrequency method. The number of units should match the additional veins treated.
Is imaging guidance separately reported with 36476?
Imaging guidance and monitoring are included in the endovenous ablation service; they are not separate components of 36476.
How does CMS handle bilateral reporting?
For a bilateral procedure reported with modifier 50, the CMS payment rule is 150%.
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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