36000
No office ratePlace needle in vein
Use 36680 when the access needle enters a bone marrow cavity; 36000 describes introduction of a needle or catheter into a vein.
On this page
CMS RVU26D · Effective 2026-10-01
36680 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$55.79
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 36680: Intraosseous needle placement for infusion
Reports placement of an intraosseous needle to establish access for infusion when urgent treatment requires access through the bone marrow cavity.
This service establishes intraosseous access by inserting a needle into a bone marrow cavity so fluids or medications can be delivered when urgent vascular access is needed. It is commonly performed by emergency physicians and other qualified clinicians in hospital emergency departments or other acute-care settings, such as when a patient in shock or cardiac arrest cannot be accessed promptly through a peripheral vein. The proximal tibia is a familiar access site; the actual bone and side should be documented.
Report the insertion, not each fluid or medication subsequently delivered through the access. The record should identify the clinical need, insertion site, and whether access was successfully established. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Do not use modifier 50 for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 36680
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.17 · 68%
- Practice expense (office) RVU0.33 · 19%
- Malpractice RVU0.23 · 13%
2.9K
Medicare services in 2024 · #2192 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.
36680 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
$212.04
36555 is for centrally inserted, non-tunneled central venous catheter placement in a patient younger than five, not intraosseous access.
$235.82
36556 is for centrally inserted, non-tunneled central venous catheter placement in a patient age five or older; 36680 accesses the marrow cavity.
No office rate
36620 describes arterial catheter placement, commonly for arterial monitoring or sampling. It does not establish intraosseous infusion access.
The same code, a different location
How does Wyoming** compare?
36680 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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
Alabama
Alabama · 36680
Office
Unavailable
Facility
$53.07
No comparable office rate is available.
Arkansas
Arkansas · 36680
Office
Unavailable
Facility
$52.50
No comparable office rate is available.
Arizona
Arizona · 36680
Office
Unavailable
Facility
$56.34
No comparable office rate is available.
Bakersfield
California · 36680
Office
Unavailable
Facility
$56.58
No comparable office rate is available.
Chico
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
El Centro
California · 36680
Office
Unavailable
Facility
$55.98
No comparable office rate is available.
Fresno
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Hanford-Corcoran
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Madera
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Merced
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Modesto
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Napa
California · 36680
Office
Unavailable
Facility
$59.97
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 36680
Office
Unavailable
Facility
$57.99
No comparable office rate is available.
Redding
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Rest Of California
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 36680
Office
Unavailable
Facility
$58.42
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 36680
Office
Unavailable
Facility
$57.42
No comparable office rate is available.
Salinas
California · 36680
Office
Unavailable
Facility
$57.18
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 36680
Office
Unavailable
Facility
$57.60
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 36680
Office
Unavailable
Facility
$61.86
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 36680
Office
Unavailable
Facility
$61.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 36680
Office
Unavailable
Facility
$63.39
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 36680
Office
Unavailable
Facility
$62.32
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 36680
Office
Unavailable
Facility
$56.42
No comparable office rate is available.
Santa Cruz-Watsonville
California · 36680
Office
Unavailable
Facility
$57.41
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 36680
Office
Unavailable
Facility
$57.14
No comparable office rate is available.
Santa Rosa-Petaluma
California · 36680
Office
Unavailable
Facility
$57.90
No comparable office rate is available.
Stockton
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Vallejo
California · 36680
Office
Unavailable
Facility
$59.59
No comparable office rate is available.
Visalia
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Yuba City
California · 36680
Office
Unavailable
Facility
$55.94
No comparable office rate is available.
Colorado
Colorado · 36680
Office
Unavailable
Facility
$57.28
No comparable office rate is available.
Connecticut
Connecticut · 36680
Office
Unavailable
Facility
$61.03
No comparable office rate is available.
Delaware
Delaware · 36680
Office
Unavailable
Facility
$57.07
No comparable office rate is available.
Fort Lauderdale
Florida · 36680
Office
Unavailable
Facility
$64.13
No comparable office rate is available.
Rest Of Florida
Florida · 36680
Office
Unavailable
Facility
$61.16
No comparable office rate is available.
Atlanta
Georgia · 36680
Office
Unavailable
Facility
$59.62
No comparable office rate is available.
Rest Of Georgia
Georgia · 36680
Office
Unavailable
Facility
$58.07
No comparable office rate is available.
Hawaii, Guam
Hawaii · 36680
Office
Unavailable
Facility
$56.06
No comparable office rate is available.
Iowa
Iowa · 36680
Office
Unavailable
Facility
$52.21
No comparable office rate is available.
Idaho
Idaho · 36680
Office
Unavailable
Facility
$52.85
No comparable office rate is available.
East St. Louis
Illinois · 36680
Office
Unavailable
Facility
$64.69
No comparable office rate is available.
Rest Of Illinois
Illinois · 36680
Office
Unavailable
Facility
$61.15
No comparable office rate is available.
Suburban Chicago
Illinois · 36680
Office
Unavailable
Facility
$64.29
No comparable office rate is available.
Indiana
Indiana · 36680
Office
Unavailable
Facility
$53.03
No comparable office rate is available.
Kansas
Kansas · 36680
Office
Unavailable
Facility
$52.92
No comparable office rate is available.
Kentucky
Kentucky · 36680
Office
Unavailable
Facility
$55.91
No comparable office rate is available.
New Orleans
Louisiana · 36680
Office
Unavailable
Facility
$58.18
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 36680
Office
Unavailable
Facility
$56.19
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 36680
Office
Unavailable
Facility
$60.68
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 36680
Office
Unavailable
Facility
$57.43
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 36680
Office
Unavailable
Facility
$61.03
No comparable office rate is available.
Rest Of Maryland
Maryland · 36680
Office
Unavailable
Facility
$57.68
No comparable office rate is available.
Rest Of Maine
Maine · 36680
Office
Unavailable
Facility
$54.00
No comparable office rate is available.
Southern Maine
Maine · 36680
Office
Unavailable
Facility
$54.85
No comparable office rate is available.
Detroit
Michigan · 36680
Office
Unavailable
Facility
$62.67
No comparable office rate is available.
Rest Of Michigan
Michigan · 36680
Office
Unavailable
Facility
$57.82
No comparable office rate is available.
Minnesota
Minnesota · 36680
Office
Unavailable
Facility
$52.69
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 36680
Office
Unavailable
Facility
$56.93
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 36680
Office
Unavailable
Facility
$57.27
No comparable office rate is available.
Rest Of Missouri
Missouri · 36680
Office
Unavailable
Facility
$56.06
No comparable office rate is available.
Mississippi
Mississippi · 36680
Office
Unavailable
Facility
$54.25
No comparable office rate is available.
Montana**
Montana · 36680
Office
Unavailable
Facility
$57.77
No comparable office rate is available.
North Carolina
North Carolina · 36680
Office
Unavailable
Facility
$54.27
No comparable office rate is available.
North Dakota**
North Dakota · 36680
Office
Unavailable
Facility
$53.22
No comparable office rate is available.
Nebraska
Nebraska · 36680
Office
Unavailable
Facility
$52.16
No comparable office rate is available.
New Hampshire
New Hampshire · 36680
Office
Unavailable
Facility
$57.28
No comparable office rate is available.
Northern Nj
New Jersey · 36680
Office
Unavailable
Facility
$62.53
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 36680
Office
Unavailable
Facility
$61.11
No comparable office rate is available.
New Mexico
New Mexico · 36680
Office
Unavailable
Facility
$58.41
No comparable office rate is available.
Nevada**
Nevada · 36680
Office
Unavailable
Facility
$56.51
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 36680
Office
Unavailable
Facility
$68.95
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 36680
Office
Unavailable
Facility
$62.20
No comparable office rate is available.
Queens
New York · 36680
Office
Unavailable
Facility
$65.69
No comparable office rate is available.
Rest Of New York
New York · 36680
Office
Unavailable
Facility
$54.95
No comparable office rate is available.
Ohio
Ohio · 36680
Office
Unavailable
Facility
$56.89
No comparable office rate is available.
Oklahoma
Oklahoma · 36680
Office
Unavailable
Facility
$54.89
No comparable office rate is available.
Portland
Oregon · 36680
Office
Unavailable
Facility
$57.67
No comparable office rate is available.
Rest Of Oregon
Oregon · 36680
Office
Unavailable
Facility
$55.46
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 36680
Office
Unavailable
Facility
$60.42
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 36680
Office
Unavailable
Facility
$56.46
No comparable office rate is available.
Puerto Rico
Puerto Rico · 36680
Office
Unavailable
Facility
$57.79
No comparable office rate is available.
Rhode Island
Rhode Island · 36680
Office
Unavailable
Facility
$58.06
No comparable office rate is available.
South Carolina
South Carolina · 36680
Office
Unavailable
Facility
$55.79
No comparable office rate is available.
South Dakota**
South Dakota · 36680
Office
Unavailable
Facility
$52.68
No comparable office rate is available.
Tennessee
Tennessee · 36680
Office
Unavailable
Facility
$53.22
No comparable office rate is available.
Austin
Texas · 36680
Office
Unavailable
Facility
$57.63
No comparable office rate is available.
Beaumont
Texas · 36680
Office
Unavailable
Facility
$56.25
No comparable office rate is available.
Brazoria
Texas · 36680
Office
Unavailable
Facility
$56.31
No comparable office rate is available.
Dallas
Texas · 36680
Office
Unavailable
Facility
$57.00
No comparable office rate is available.
Fort Worth
Texas · 36680
Office
Unavailable
Facility
$56.99
No comparable office rate is available.
Galveston
Texas · 36680
Office
Unavailable
Facility
$56.70
No comparable office rate is available.
Houston
Texas · 36680
Office
Unavailable
Facility
$60.91
No comparable office rate is available.
Rest Of Texas
Texas · 36680
Office
Unavailable
Facility
$56.48
No comparable office rate is available.
Utah
Utah · 36680
Office
Unavailable
Facility
$56.34
No comparable office rate is available.
Virginia
Virginia · 36680
Office
Unavailable
Facility
$55.34
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 36680
Office
Unavailable
Facility
$57.79
No comparable office rate is available.
Vermont
Vermont · 36680
Office
Unavailable
Facility
$53.88
No comparable office rate is available.
Rest Of Washington
Washington · 36680
Office
Unavailable
Facility
$57.04
No comparable office rate is available.
Seattle (King Cnty)
Washington · 36680
Office
Unavailable
Facility
$60.83
No comparable office rate is available.
Wisconsin
Wisconsin · 36680
Office
Unavailable
Facility
$52.00
No comparable office rate is available.
West Virginia
West Virginia · 36680
Office
Unavailable
Facility
$59.65
No comparable office rate is available.
See how rates vary across the country
36680 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 36680 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$61.37
$55.79 × 110% = $61.37
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.
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 36680 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,542
- Code
- 36680
- Physician work
- 1.17
- Practice expense
- 0.33
- Malpractice
- 0.23
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 0.33 | × 1.000 | 0.3300 |
| Malpractice | 0.23 | × 0.740 | 0.1702 |
| Total RVUs | 1.6702 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$55.79
Open 36680 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 0.33 | 1 |
| Malpractice | 0.23 | 0.74 |
(1.17 × 1 + 0.33 × 1 + 0.23 × 0.74) × $33.4009 = $55.79
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
36680 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $55.79 | RVU26D |
| 2026-07-01 | Not available in this setting | $55.79 | RVU26C |
| 2026-04-01 | Not available in this setting | $55.79 | RVU26B |
| 2026-01-01 | Not available in this setting | $55.79 | RVU26A |
| 2025-10-01 | Not available in this setting | $55.80 | RVU25D |
| 2025-07-01 | Not available in this setting | $55.80 | RVU25C |
| 2025-04-01 | Not available in this setting | $55.80 | RVU25B |
| 2025-01-01 | Not available in this setting | $55.80 | RVU25A |
36680 billing questions
When should I report 36680 instead of peripheral IV access?
Report 36680 for needle placement into a bone marrow cavity to establish infusion access, commonly in an urgent situation when peripheral venous access is unavailable or inadequate. Ordinary access through a peripheral vein is not intraosseous placement.
Can the fluids or medications infused through the needle be reported as additional units of 36680?
No. The code reports insertion of the intraosseous needle, not each fluid or medication delivered through the established access.
What should the documentation identify?
Document the clinical reason for intraosseous access, the bone and side used, and whether placement successfully established access.
Should modifier 50 be appended for access on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
How does the multiple-procedure reduction affect 36680?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and subjects the other procedures to the standard 50% reduction.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
4,53936625,,Insertion catheter artery,A,,2.06,0.47,NA,0.47,,0.33,2.86,2.86,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54036640,,Insertion catheter artery,A,,2.05,0.83,NA,0.83,,0.14,3.02,3.02,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54136660,,Insertion catheter artery,A,,1.37,0.28,NA,0.28,,0.07,1.72,1.72,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54236680,,Insert needle bone cavity,A,,1.17,0.33,NA,0.33,,0.23,1.73,1.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54336800,,Insertion of cannula,A,,2.37,0.58,NA,0.58,,0.27,3.22,3.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54436810,,Insertion of cannula,A,,3.86,1.11,NA,1.11,,0.34,5.31,5.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54536815,,Insertion of cannula,A,,2.55,0.50,NA,0.50,,0.64,3.69,3.69,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,