$1,305.30
36473 reports mechanochemical treatment of the first vein. Use 36474 for an additional vein in the same extremity through a separate access site.
On this page
CMS RVU26D · Effective 2026-10-01
36474 Vein ablation Medicare reimbursement rates in Hawaii
Reports mechanochemical catheter ablation of an additional incompetent vein in the same extremity, following treatment of the first vein. Compare 36474 office and facility rates across CMS payment localities in Hawaii.
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 36474 in Hawaii?
Hawaii 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
$258.53
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$73.96
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 procedure
About 36474: Mechanochemical ablation, additional vein
Reports mechanochemical catheter ablation of an additional incompetent vein in the same extremity, following treatment of the first vein.
This add-on represents catheter-based mechanochemical ablation of an additional incompetent vein, using mechanical action together with a sclerosant to close the treated vein. It is used for venous reflux treatment, including treatment of superficial truncal veins, and is typically performed by a vascular surgeon, interventional radiologist, or vein specialist in an office or outpatient procedural setting. The additional vein is treated through a separate access site in the same extremity as the first vein.
Report 36474 only with the primary mechanochemical ablation code 36473; it is not a stand-alone service. Documentation should identify the treated veins, extremity, separate access sites, and the mechanochemical technique. CMS treats this add-on as paid within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays at 150%.
CMS billing rules for 36474
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
Where the value comes from
- Work RVU1.71 · 24%
- Practice expense (office) RVU5.11 · 71%
- Malpractice RVU0.38 · 5%
100
Medicare services in 2024 · #4883 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.
36474 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$294.68
Both are additional-vein codes, but 36476 describes radiofrequency ablation; 36474 describes mechanochemical ablation.
$330.93
36479 reports laser ablation of an additional vein. Choose 36474 when the additional vein is treated with the mechanochemical method.
$145.36
36483 is for an additional vein treated with chemical adhesive. Code 36474 is for mechanochemical treatment.
Compare 36474 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
Hawaii, Guam →
Office / nonfacility
$258.53
Facility
$73.96
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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 36474 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,487
- Code
- 36474
- Physician work
- 1.71
- Practice expense
- 5.11
- Malpractice
- 0.38
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.000 | 1.7100 |
| Practice expense | 5.11 | × 1.137 | 5.8101 |
| Malpractice | 0.38 | × 0.579 | 0.2200 |
| Total RVUs | 7.7401 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$258.53
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1 |
| Practice expense | 5.11 | 1.137 |
| Malpractice | 0.38 | 0.579 |
(1.71 × 1 + 5.11 × 1.137 + 0.38 × 0.579) × $33.4009 = $258.53
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1 |
| Practice expense | 0.25 | 1.137 |
| Malpractice | 0.38 | 0.579 |
(1.71 × 1 + 0.25 × 1.137 + 0.38 × 0.579) × $33.4009 = $73.96
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.
36474 billing questions
When should 36474 be reported instead of 36473?
Use 36473 for the first vein treated with mechanochemical ablation. Report 36474 for each qualifying additional vein in the same extremity, treated through a separate access site.
Can 36474 be billed by itself?
No. It is an add-on code and must be reported with 36473 for the primary vein treatment.
What documentation supports the additional-vein service?
Document the mechanochemical method, the first and additional veins treated, the extremity, and the separate access site for the additional vein.
How is bilateral treatment handled?
CMS pays a bilateral procedure reported with modifier 50 at 150%. The add-on remains linked to the primary mechanochemical ablation service.
How does this differ from 36476?
36474 is for an additional vein treated by mechanochemical ablation. Code 36476 is the additional-vein code for radiofrequency ablation.
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.
4,48436470,,Njx sclrsnt 1 incmptnt vein,A,,0.73,2.74,,0.13,,0.15,3.62,1.01,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48536471,,Njx sclrsnt mlt incmptnt vn,A,,1.46,4.39,,0.25,,0.29,6.14,2.00,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48636473,,Endovenous mchnchem 1st vein,A,,3.41,30.99,,0.58,,0.75,35.15,4.74,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48736474,,Endovenous mchnchem add-on,A,,1.71,5.11,,0.25,,0.38,7.20,2.34,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48836475,,Endovenous rf 1st vein,A,,5.17,25.30,,1.06,,1.15,31.62,7.38,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48936476,,Endovenous rf vein add-on,A,,2.58,5.20,,0.37,,0.57,8.35,3.52,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,49036478,,Endovenous laser 1st vein,A,,5.17,23.09,,1.13,,1.09,29.35,7.39,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014