Billing code 36470: Vein sclerotherapyMedicare rate & RVUs in Illinois
Reports injection of sclerosant into one incompetent vein, commonly to treat a varicose vein associated with venous insufficiency.
Medicare pays $115.77–$128.03 for 36470 in the office in Illinois, from Rest Of Illinois to Chicago. 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 36470 covers
A clinician injects a sclerosing agent into one incompetent vein, commonly a varicose vein in a patient with chronic venous insufficiency. Vascular surgeons, vein specialists, and other clinicians who perform venous procedures may provide the service in an office or facility. Imaging guidance and monitoring integral to the injection are included in the service.
Choose this code when treatment is directed to one incompetent vein; treatment of multiple incompetent veins is reported with 36471. The record should identify the treated vein, the venous condition, and the injection performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and 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.
Where 36470 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$115.77 to $128.03
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $128.03 | $40.42 |
| East St. Louis | $118.67 | $38.47 |
| Rest Of Illinois | $115.77 | $36.18 |
| Suburban Chicago | $127.42 | $37.89 |
How the 36470 rate is calculated
Each of 36470’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 · 36470
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense2.74
2.74 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
3.6200
Conversion factor
$33.4009
Medicare rate
$120.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36470
The CMS indicators that decide how 36470 is paid alongside other services.
CMS payment indicators · 36470
Vein sclerotherapy
| 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
36470 without 50 · national office
$120.91
Vein sclerotherapy
36470-50 · Bilateral: 150%
$181.37
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).
36470 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36471Sclerotherapy
- 36470 is for one incompetent vein; 36471 is for multiple incompetent veins.
- 36468Njx sclrsnt spider veins
- 36468 treats spider veins. Use 36470 for injection treatment of one incompetent vein.
- 36465Foam sclerotherapy
- 36465 is specific to non-compounded foam treatment of one truncal vein; 36470 describes treatment of one incompetent vein with sclerosant.
- 36473Vein ablation
- 36473 describes mechanochemical endovenous treatment, not injection sclerotherapy.
36470 billing questions
When should 36470 be chosen instead of 36471?
Use 36470 when one incompetent vein is treated. When multiple incompetent veins are treated, consider 36471.
Can imaging guidance be billed separately?
Imaging guidance and monitoring integral to the sclerotherapy service are included; do not unbundle them as separate services.
How should bilateral treatment be reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Does 36470 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted under the CMS rules 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 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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