No office rate
Both describe PICC insertion without imaging guidance. Choose 36568 for a patient younger than five and 36569 for a patient age five or older.
On this page
CMS RVU26D · Effective 2026-10-01
36569 PICC insertion Medicare reimbursement rates in Colorado
Insertion of a peripherally inserted central catheter in a patient age five or older when imaging guidance is not used. Compare 36569 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 36569 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$85.36
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular access
About 36569: PICC insertion without imaging, age five or older
Insertion of a peripherally inserted central catheter in a patient age five or older when imaging guidance is not used.
A clinician advances a peripherally inserted catheter through an arm vein, commonly the basilic, brachial, or cephalic vein, with the catheter tip positioned in central venous circulation. This service is for patients age five or older when placement is performed without imaging guidance. Common clinical uses include prolonged intravenous antibiotic treatment, chemotherapy, parenteral nutrition, or repeated infusions. Placement may occur in a hospital, outpatient setting, or at the bedside by a qualified clinician.
Report this code for the insertion episode when the patient is at least five years old and imaging guidance is not used. The record should support the patient’s age, catheter placement, access site, and absence of imaging guidance. Use 36573 for an age-five-or-older patient when imaging guidance is used; 36568 is the no-imaging code for a patient younger than five. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 36569
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.85 · 72%
- Practice expense (office) RVU0.40 · 16%
- Malpractice RVU0.33 · 13%
6.5K
Medicare services in 2024 · #1711 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.
36569 compared with similar codes
Office rates for Colorado, from the same CMS release.
$384.56
Both are for PICC insertion in patients age five or older. The distinguishing factor is imaging guidance: 36573 is used when it is used; 36569 is used when it is not.
$382.93
This is the imaging-guided PICC insertion code for patients younger than five. Code 36569 is for patients age five or older and placement without imaging guidance.
Compare 36569 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$85.36
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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 36569 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
4,514
- Code
- 36569
- Physician work
- 1.85
- Practice expense
- 0.40
- Malpractice
- 0.33
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.85 | × 1.012 | 1.8722 |
| Practice expense | 0.40 | × 1.064 | 0.4256 |
| Malpractice | 0.33 | × 0.781 | 0.2577 |
| Total RVUs | 2.5555 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$85.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.85 | 1.012 |
| Practice expense | 0.4 | 1.064 |
| Malpractice | 0.33 | 0.781 |
(1.85 × 1.012 + 0.4 × 1.064 + 0.33 × 0.781) × $33.4009 = $85.36
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.
36569 billing questions
When should 36569 be reported instead of 36573?
For a patient age five or older, report 36569 when PICC insertion is performed without imaging guidance. Use 36573 when imaging guidance is used.
How does age affect code selection?
For PICC insertion without imaging guidance, 36569 is for patients age five or older; 36568 is for patients younger than five.
What documentation supports 36569?
Document the patient’s age, the PICC insertion and access site, and that imaging guidance was not used.
Can modifier 50 be appended for bilateral placement?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant-at-surgery or co-surgeon be reported?
CMS does not pay for an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
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.
4,51136565,,Insert tunneled cv cath,A,,5.65,18.89,,2.50,,1.22,25.76,9.37,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51236566,,Insert tunneled cv cath,A,,6.13,124.58,,2.68,,1.19,131.90,10.00,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51336568,,Insj picc <5 yr w/o imaging,A,,2.06,0.19,NA,0.19,,0.26,2.51,2.51,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51436569,,Insj picc 5 yr+ w/o imaging,A,,1.85,0.40,NA,0.40,,0.33,2.58,2.58,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51536570,,Insert picvad cath,A,,4.98,41.19,,3.23,,1.33,47.50,9.54,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51636571,,Insert picvad cath,A,,4.96,34.12,,2.77,,1.07,40.15,8.80,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,51736572,,Insj picc rs&i <5 yr,A,,1.77,8.93,,0.21,,0.22,10.92,2.20,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899