Billing code 36420: Venous cutdownMedicare rate & RVUs in Florida
Surgical venous access by cutdown in an infant younger than one year, reported when incision and vein exposure are needed for venipuncture.
CMS doesn’t publish an office rate for 36420 in Florida.
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 9 sections
What 36420 covers
This service provides venous access in an infant younger than one year by making an incision and exposing a vein for needle or catheter entry. It is used when access is needed but a percutaneous puncture is not the approach performed. Physicians or other qualified practitioners may perform the procedure in settings such as a hospital or emergency department, including for infants who need urgent vascular access.
Report the code only when the patient is under one year old and the documented technique involves surgical exposure of a vein, rather than needle puncture through intact skin. The record should support the infant’s age, the clinical need for access, and the cutdown technique performed. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple procedure reduction.
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 36420 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $52.64 |
| Miami | Unavailable | $58.57 |
| Rest Of Florida | Unavailable | $49.89 |
How the 36420 rate is calculated
Each of 36420’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 · 36420
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.24
0.24 RVUs× 1.000 GPCI
Adjusted RVUs
1.3800
Conversion factor
$33.4009
Medicare rate
$46.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36420
The CMS indicators that decide how 36420 is paid alongside other services.
CMS payment indicators · 36420
Venous cutdown
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 51 · payment effect
With and without the modifier
36420 without 51 · national facility
$46.09
Venous cutdown
36420-51 · Second procedure: 50%
$23.05
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
36420 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36425Venous cutdown
- Both describe venous access by cutdown; choose based on age. Code 36420 is for patients under one year, while 36425 is for patients one year or older.
- 36405Scalp venipuncture
- Code 36405 is percutaneous venipuncture at a scalp vein in a child under three. Code 36420 requires an incision to expose a vein and is limited to infants under one year.
- 36415Coll venous bld venipuncture
- Code 36415 is for routine venous blood collection. Code 36420 describes surgical venous access in an infant, not an ordinary blood draw.
36420 billing questions
How does this code differ from percutaneous venipuncture codes?
This code describes access using an incision to expose a vein in an infant under one year. Codes such as 36400, 36405, and 36406 describe needle venipuncture without a cutdown.
Does the patient’s age determine whether to use this code or 36425?
Yes. Use 36420 for a patient younger than one year and 36425 for a patient who is one year or older, when a venous cutdown is performed.
What documentation supports reporting a cutdown?
Document the patient’s age, the need for venous access, and that an incision was made to expose the vein for access. A record of needle puncture alone does not support this code.
How does the multiple procedure reduction affect this service?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can this code be used for routine blood collection?
No. This code represents surgical venous access by cutdown in an infant, not routine venous blood collection such as a standard blood draw.
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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