Billing code 36473: Vein ablationMedicare rate & RVUs in Guam
Reports catheter-based mechanochemical treatment of the first incompetent lower-extremity vein, combining mechanical endothelial disruption with delivery of a sclerosant.
Medicare pays $1,305.30 for 36473 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 36473 covers
This code covers percutaneous treatment of an incompetent lower-extremity vein using a catheter that mechanically disrupts the vein lining while delivering a sclerosant. It is used for superficial venous reflux, such as in a saphenous vein, and is typically performed by a vascular surgeon or another clinician trained in endovenous vein procedures in an office vein center or facility. Imaging guidance and monitoring during the treatment are included in the service.
Report 36473 for the first vein treated by this method; report 36474 for each additional vein treated in the same extremity. Documentation should identify the treated vein, the venous incompetence, the mechanochemical method, and any additional vein treated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery services are restricted; co-surgeons and team surgery are not permitted.
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.
36473 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $1,305.30 | $150.43 |
How the 36473 rate is calculated
Each of 36473’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 · 36473
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.41Practice expense 30.99Malpractice 0.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36473
The CMS indicators that decide how 36473 is paid alongside other services.
CMS payment indicators · 36473
Vein ablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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
36473 without 50 · national office
$1,174.04
Vein ablation
36473-50 · Bilateral: 150%
$1,761.06
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).
36473 compared with similar codes
Compare codes
36473 vs 36474 vs 36475 vs 36478 vs 36482: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36474Vein ablation
- 36473 is for the first vein treated by mechanochemical ablation; 36474 is the add-on for each additional vein in the same extremity.
- 36475Venous ablation
- Use 36475 for radiofrequency ablation of the first vein. Use 36473 when treatment combines mechanical disruption with sclerosant delivery.
- 36478Laser vein ablation
- Use 36478 for laser ablation of the first vein; 36473 describes the mechanochemical method instead.
- 36482Vein ablation
- 36482 uses transcatheter chemical adhesive to close the vein. Code 36473 describes mechanochemical treatment with a sclerosant.
36473 billing questions
When should 36473 be selected instead of 36475 or 36478?
Use 36473 when the vein is treated with mechanochemical catheter treatment. Codes 36475 and 36478 describe radiofrequency and laser ablation, respectively.
How is treatment of another vein reported?
Report 36473 for the first vein and 36474 for each additional vein treated in the same extremity. The record should distinguish the veins treated.
Can imaging guidance be billed separately?
Imaging guidance and monitoring for the mechanochemical treatment are included in 36473.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure: report modifier 50 for bilateral treatment, which is paid at 150%.
Does the procedure have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant or co-surgeon be reported?
CMS restricts payment for an assistant at surgery. 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 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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