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CMS RVU26D · Effective 2026-10-01

36581 in El Centro

Office / nonfacility

$814.34

Base rate per service

Facility setting

$164.19

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Vascular access

About 36581: Tunneled central venous catheter replacement with imaging

Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance.

This service replaces a tunneled, centrally inserted venous catheter in its entirety through the existing venous access, without a subcutaneous port or pump. Imaging guidance and its associated supervision and interpretation are included. It is commonly performed by an interventional radiologist or another physician experienced in vascular access, often for a patient whose long-term infusion or hemodialysis catheter is damaged, malfunctioning, or due for exchange. The code describes replacement, not repair of a catheter that remains in place or placement through a new venous access.

Report the code when documentation supports a complete exchange of the tunneled catheter through the same access and identifies the imaging-guided service. The procedure note should establish the catheter type, absence of a port or pump, the existing access used, and the replacement performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 36581

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.15 · 14%
  • Practice expense (office) RVU19.11 · 84%
  • Malpractice RVU0.43 · 2%

30.6K

Medicare services in 2024 · #971 by national volume

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.

36581 compared with similar codes

Office rates for El Centro, from the same CMS release.

36578

Catheter replacement

Younger than 5 years

$457.57

Both describe complete replacement of a tunneled central venous catheter without a port or pump through the existing access. 36581 includes imaging guidance; 36578 is used without it.

36580

Central catheter replacement

Non-tunneled, same access

$204.88

36580 is for a non-tunneled catheter replacement through the same access. 36581 is for a tunneled catheter and includes imaging guidance.

36582

Device replacement

With port or pump

$911.84

36582 applies when the tunneled central venous access device has a subcutaneous port or pump; 36581 is for a catheter without one.

36575

Catheter repair

Tunneled, without port or pump

$158.79

36575 describes catheter repair, not complete exchange. Use 36581 when the tunneled catheter is replaced in its entirety through the existing access.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 36581 is $815.53—$1.19 higher than the $814.34 rate in El Centro. Both use the same code, release and participation basis.

36581 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $814.34

  2. Bakersfield

    $815.53

    $1.19 higher than El Centro

  3. Chico

    $814.27

    $0.07 lower than El Centro

  4. Fresno

    $814.27

    $0.07 lower than El Centro

  5. Hanford-Corcoran

    $814.27

    $0.07 lower than El Centro

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $874.16

    $59.82 higher than El Centro

  7. Madera

    $814.27

    $0.07 lower than El Centro

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 36581 ranges from $660.90 in Arkansas to $1044.90 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Modesto

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Napa

    California · 36581

    Office

    $960.41

    Facility

    $178.57

    $146.07 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 36581

    Office

    $871.57

    Facility

    $170.40

    $57.23 higher than El Centro for the office setting.

  • Redding

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Rest Of California

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 36581

    Office

    $818.92

    Facility

    $168.78

    $4.58 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 36581

    Office

    $859.03

    Facility

    $169.14

    $44.69 higher than El Centro for the office setting.

  • Salinas

    California · 36581

    Office

    $855.95

    Facility

    $168.43

    $41.61 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 36581

    Office

    $879.55

    Facility

    $170.08

    $65.21 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 36581

    Office

    $1021.79

    Facility

    $185.38

    $207.45 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 36581

    Office

    $1021.30

    Facility

    $184.89

    $206.96 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 36581

    Office

    $1044.90

    Facility

    $189.51

    $230.56 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 36581

    Office

    $1042.90

    Facility

    $187.51

    $228.56 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 36581

    Office

    $841.71

    Facility

    $166.06

    $27.37 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 36581

    Office

    $890.64

    Facility

    $169.91

    $76.30 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 36581

    Office

    $860.10

    Facility

    $168.43

    $45.76 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 36581

    Office

    $899.89

    Facility

    $171.44

    $85.55 higher than El Centro for the office setting.

  • Stockton

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Vallejo

    California · 36581

    Office

    $959.70

    Facility

    $177.86

    $145.36 higher than El Centro for the office setting.

  • Visalia

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Yuba City

    California · 36581

    Office

    $814.27

    Facility

    $164.12

    $0.07 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 36581

    Office

    $878.79

    Facility

    $180.00

    $64.45 higher than El Centro for the office setting.

  • Miami

    Florida · 36581

    Office

    $806.00

    Facility

    $188.48

    $8.34 lower than El Centro for the office setting.

  • Chicago

    Illinois · 36581

    Office

    $780.39

    Facility

    $184.23

    $33.95 lower than El Centro for the office setting.

  • Manhattan

    New York · 36581

    Office

    $876.42

    Facility

    $187.12

    $62.08 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 36581

    Office

    $845.51

    Facility

    $213.76

    $31.17 higher than El Centro for the office setting.

  • Alabama

    Alabama · 36581

    Office

    $671.85

    Facility

    $152.80

    $142.49 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 36581

    Office

    $660.90

    Facility

    $151.34

    $153.44 lower than El Centro for the office setting.

  • Arizona

    Arizona · 36581

    Office

    $736.01

    Facility

    $161.20

    $78.33 lower than El Centro for the office setting.

  • Colorado

    Colorado · 36581

    Office

    $796.83

    Facility

    $165.67

    $17.51 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 36581

    Office

    $812.14

    Facility

    $173.26

    $2.20 lower than El Centro for the office setting.

  • Delaware

    Delaware · 36581

    Office

    $749.28

    Facility

    $163.20

    $65.06 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 36581

    Office

    $777.77

    Facility

    $176.86

    $36.57 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 36581

    Office

    $737.01

    Facility

    $169.91

    $77.33 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 36581

    Office

    $771.28

    Facility

    $168.59

    $43.06 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 36581

    Office

    $691.69

    Facility

    $162.55

    $122.65 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 36581

    Office

    $839.27

    Facility

    $164.80

    $24.93 higher than El Centro for the office setting.

  • Iowa

    Iowa · 36581

    Office

    $694.95

    Facility

    $152.17

    $119.39 lower than El Centro for the office setting.

  • Idaho

    Idaho · 36581

    Office

    $699.23

    Facility

    $153.49

    $115.11 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 36581

    Office

    $721.37

    Facility

    $175.62

    $92.97 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 36581

    Office

    $710.42

    Facility

    $168.83

    $103.92 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 36581

    Office

    $786.92

    Facility

    $177.71

    $27.42 lower than El Centro for the office setting.

  • Indiana

    Indiana · 36581

    Office

    $703.89

    Facility

    $153.99

    $110.45 lower than El Centro for the office setting.

  • Kansas

    Kansas · 36581

    Office

    $689.47

    Facility

    $153.21

    $124.87 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 36581

    Office

    $685.80

    Facility

    $158.44

    $128.54 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 36581

    Office

    $722.16

    Facility

    $163.96

    $92.18 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 36581

    Office

    $683.86

    Facility

    $158.88

    $130.48 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 36581

    Office

    $884.43

    Facility

    $176.15

    $70.09 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 36581

    Office

    $790.46

    Facility

    $165.82

    $23.88 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 36581

    Office

    $809.55

    Facility

    $173.05

    $4.79 lower than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 36581

    Office

    $765.40

    Facility

    $165.08

    $48.94 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 36581

    Office

    $701.37

    Facility

    $155.63

    $112.97 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 36581

    Office

    $746.82

    Facility

    $158.96

    $67.52 lower than El Centro for the office setting.

  • Detroit

    Michigan · 36581

    Office

    $745.38

    Facility

    $172.94

    $68.96 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 36581

    Office

    $704.19

    Facility

    $162.60

    $110.15 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 36581

    Office

    $766.27

    Facility

    $155.86

    $48.07 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 36581

    Office

    $718.60

    Facility

    $161.59

    $95.74 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 36581

    Office

    $727.26

    Facility

    $162.53

    $87.08 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 36581

    Office

    $669.41

    Facility

    $158.07

    $144.93 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 36581

    Office

    $665.40

    Facility

    $154.65

    $148.94 lower than El Centro for the office setting.

  • Montana**

    Montana · 36581

    Office

    $757.84

    Facility

    $164.64

    $56.50 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 36581

    Office

    $709.92

    Facility

    $156.46

    $104.42 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 36581

    Office

    $749.34

    Facility

    $156.14

    $65.00 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 36581

    Office

    $699.78

    Facility

    $152.26

    $114.56 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 36581

    Office

    $782.24

    Facility

    $164.72

    $32.10 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 36581

    Office

    $867.60

    Facility

    $179.49

    $53.26 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 36581

    Office

    $822.19

    Facility

    $174.42

    $7.85 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 36581

    Office

    $707.78

    Facility

    $163.81

    $106.56 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 36581

    Office

    $756.11

    Facility

    $162.31

    $58.23 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 36581

    Office

    $897.55

    Facility

    $192.23

    $83.21 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 36581

    Office

    $826.25

    Facility

    $176.70

    $11.91 higher than El Centro for the office setting.

  • Queens

    New York · 36581

    Office

    $887.12

    Facility

    $185.95

    $72.78 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 36581

    Office

    $721.69

    Facility

    $158.15

    $92.65 lower than El Centro for the office setting.

  • Ohio

    Ohio · 36581

    Office

    $702.45

    Facility

    $160.86

    $111.89 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 36581

    Office

    $686.37

    Facility

    $156.64

    $127.97 lower than El Centro for the office setting.

  • Portland

    Oregon · 36581

    Office

    $826.72

    Facility

    $167.68

    $12.38 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 36581

    Office

    $751.05

    Facility

    $160.22

    $63.29 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 36581

    Office

    $788.70

    Facility

    $171.18

    $25.64 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 36581

    Office

    $704.74

    Facility

    $160.18

    $109.60 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 36581

    Office

    $764.67

    Facility

    $164.95

    $49.67 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 36581

    Office

    $779.38

    Facility

    $166.60

    $34.96 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 36581

    Office

    $707.20

    Facility

    $159.09

    $107.14 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 36581

    Office

    $748.33

    Facility

    $155.13

    $66.01 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 36581

    Office

    $693.13

    Facility

    $153.91

    $121.21 lower than El Centro for the office setting.

  • Austin

    Texas · 36581

    Office

    $793.46

    Facility

    $165.85

    $20.88 lower than El Centro for the office setting.

  • Beaumont

    Texas · 36581

    Office

    $699.40

    Facility

    $159.59

    $114.94 lower than El Centro for the office setting.

  • Brazoria

    Texas · 36581

    Office

    $749.80

    Facility

    $161.94

    $64.54 lower than El Centro for the office setting.

  • Dallas

    Texas · 36581

    Office

    $754.22

    Facility

    $163.39

    $60.12 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 36581

    Office

    $748.02

    Facility

    $163.13

    $66.32 lower than El Centro for the office setting.

  • Galveston

    Texas · 36581

    Office

    $751.77

    Facility

    $162.72

    $62.57 lower than El Centro for the office setting.

  • Houston

    Texas · 36581

    Office

    $759.64

    Facility

    $170.59

    $54.70 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 36581

    Office

    $723.92

    Facility

    $160.97

    $90.42 lower than El Centro for the office setting.

  • Utah

    Utah · 36581

    Office

    $718.10

    Facility

    $160.50

    $96.24 lower than El Centro for the office setting.

  • Virginia

    Virginia · 36581

    Office

    $742.79

    Facility

    $159.68

    $71.55 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 36581

    Office

    $764.67

    Facility

    $164.95

    $49.67 lower than El Centro for the office setting.

  • Vermont

    Vermont · 36581

    Office

    $744.39

    Facility

    $157.12

    $69.95 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 36581

    Office

    $789.63

    Facility

    $164.99

    $24.71 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 36581

    Office

    $905.39

    Facility

    $177.53

    $91.05 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 36581

    Office

    $721.12

    Facility

    $152.83

    $93.22 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 36581

    Office

    $680.44

    Facility

    $164.95

    $133.90 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 36581

    Office

    $754.13

    Facility

    $160.93

    $60.21 lower than El Centro for the office setting.

See how rates vary across the country

36581 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$660.90

$929.59

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$845.511
AL$671.851
AR$660.901
AZ$736.011
CA$814.27–$1,044.9029
CO$796.831
CT$812.141
DC$878.791
DE$749.281
FL$737.01–$806.003
GA$691.69–$771.282
GU$839.271
HI$839.271
IA$694.951
ID$699.231
IL$710.42–$786.924
IN$703.891
KS$689.471
KY$685.801
LA$683.86–$722.162
MA$790.46–$884.432
MD$765.40–$878.793
ME$701.37–$746.822
MI$704.19–$745.382
MN$766.271
MO$669.41–$727.263
MS$665.401
MT$757.841
NC$709.921
ND$749.341
NE$699.781
NH$782.241
NJ$822.19–$867.602
NM$707.781
NV$756.111
NY$721.69–$897.555
OH$702.451
OK$686.371
OR$751.05–$826.722
PA$704.74–$788.702
PR$764.671
RI$779.381
SC$707.201
SD$748.331
TN$693.131
TX$699.40–$793.468
UT$718.101
VA$742.79–$878.792
VI$764.671
VT$744.391
WA$789.63–$905.392
WI$721.121
WV$680.441
WY$754.131

Explore 36581 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 36581 in El Centro, the physician’s office rate is $814.34 and the facility-setting rate is $164.19: a difference of $650.15.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 36581 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$895.77

$814.34 × 110% = $895.77

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 36581 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

4,523

Code
36581
Physician work
3.15
Practice expense
19.11
Malpractice
0.43

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 36581 in El Centro
ComponentRVULocality factorAdjusted
Physician work3.15× 1.0173.2035
Practice expense19.11× 1.09620.9446
Malpractice0.43× 0.5410.2326
Total RVUs24.3807
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$814.34

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 36581 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.151.017
Practice expense19.111.096
Malpractice0.430.541

(3.15 × 1.017 + 19.11 × 1.096 + 0.43 × 0.541) × $33.4009 = $814.34

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.151.017
Practice expense1.351.096
Malpractice0.430.541

(3.15 × 1.017 + 1.35 × 1.096 + 0.43 × 0.541) × $33.4009 = $164.19

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

36581 · Office / nonfacility

$814.34

Effective 2026-10-01

The base rate is $51.71 higher than on 2025-10-01, moving from $762.63 to $814.34 (6.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $762.63changed to$814.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.23 changed to 3.15
    • Practice expense RVU 18.35 changed to 19.11
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $762.63

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$814.34$164.19RVU26D
2026-07-01$814.34$164.19RVU26C
2026-04-01$814.34$164.19RVU26B
2026-01-01$814.34$164.19RVU26A
2025-10-01$762.63$176.09RVU25D
2025-07-01$762.63$176.09RVU25C
2025-04-01$762.63$176.09RVU25B
2025-01-01$762.63$176.09RVU25A

36581 billing questions

How is this different from 36578?

36581 includes imaging guidance with supervision and interpretation for the complete tunneled-catheter replacement. 36578 is the corresponding replacement without imaging guidance.

Can 36581 be reported for a catheter repair?

No. It represents complete catheter replacement. For repair of a catheter that remains in place, consider the applicable repair code, such as 36575 or 36576.

Is imaging guidance separately reported?

Imaging guidance and its associated supervision and interpretation are included in 36581. Do not report them separately for the same replacement service.

When is 36582 more appropriate?

Use 36582 for complete replacement of a tunneled central venous access device with a subcutaneous port or pump. Code 36581 is for a catheter without a port or pump.

What documentation supports the replacement?

Document that the catheter is tunneled and centrally inserted, that the entire catheter was replaced through the existing venous access, and that imaging guidance was used.

Can modifier 50 be used for bilateral replacement?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 36581PPRRVU2026_Oct_nonQPP.csv, line 4,523 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet