$1,169.97–$1,280.45
Use 36465 for foam treatment of one incompetent truncal vein; 36466 is for treatment of multiple incompetent truncal veins.
On this page
CMS RVU26D · Effective 2026-10-01
36465 Foam sclerotherapy Medicare reimbursement rates in Missouri
Reports ultrasound-guided treatment of one incompetent truncal vein using noncompounded foam sclerosant for symptomatic venous reflux. Compare 36465 office and facility rates across CMS payment localities in Missouri.
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 36465 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$1121.40–$1229.32
3 of 3 localities have a supported rate.
Facility setting
$103.33–$104.95
3 of 3 localities have a supported rate.
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.
Where 36465 pays more and less in Missouri
3 payment localities
$1121.40 to $1229.32
Vascular surgery
About 36465: Noncompounded foam sclerotherapy, one truncal vein
Reports ultrasound-guided treatment of one incompetent truncal vein using noncompounded foam sclerosant for symptomatic venous reflux.
This service treats venous reflux in one incompetent truncal vein, such as the great saphenous or an accessory saphenous vein. The clinician injects noncompounded foam sclerosant percutaneously and uses ultrasound and compression maneuvers to guide its spread and monitor treatment. Vascular specialists commonly perform it in an office or outpatient setting for patients with symptomatic varicose veins related to truncal reflux.
Report one unit for treatment of one qualifying truncal vein. Documentation should identify the treated vein and extremity, the reflux problem, and the foam treatment performed. Ultrasound guidance and monitoring for this treatment are included. The service has 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%. Modifier 50 results in payment at 150% for bilateral treatment. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 36465
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- 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 RVU2.29 · 6%
- Practice expense (office) RVU35.75 · 93%
- Malpractice RVU0.48 · 1%
101.8K
Medicare services in 2024 · #551 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.
36465 compared with similar codes
Office rates for Missouri, from the same CMS release.
$108.15–$116.53
36470 covers sclerosant injection into one incompetent vein other than a telangiectasia. 36465 is specifically for noncompounded foam treatment of an incompetent truncal vein.
$184.59–$198.06
36471 covers sclerosant injection into multiple incompetent veins other than telangiectasias. It is not the multiple-truncal-vein foam code; that is 36466.
36468
No office rateNjx sclrsnt spider veins
36468 is for spider-vein sclerotherapy. Use 36465 for foam treatment of one incompetent truncal vein.
Compare 36465 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$1213.39
Facility
$104.38
Metropolitan St. Louis →
Office / nonfacility
$1229.32
Facility
$104.95
Rest Of Missouri →
Office / nonfacility
$1121.40
Facility
$103.33
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36465 billing questions
When should 36465 be used instead of 36466?
Use 36465 when one incompetent truncal vein is treated with noncompounded foam. Use 36466 when multiple incompetent truncal veins are treated.
Is ultrasound guidance separately reported with 36465?
No. Ultrasound guidance and monitoring used to direct and observe the foam treatment are included in 36465.
How many units are reported for one treated vein?
Report one unit for treatment of one qualifying truncal vein. The documentation should identify the treated vein and extremity.
How does 36465 differ from 36470 or 36471?
36465 is for noncompounded foam treatment of an incompetent truncal vein. Codes 36470 and 36471 describe sclerosant treatment of one or multiple other incompetent veins, rather than truncal-vein foam treatment.
How is bilateral treatment handled?
When bilateral treatment is reported with modifier 50, CMS payment is 150% of the single-procedure rate. Multiple procedures in the same session are subject to the standard reduction, with the highest-valued procedure paid in full and others at 50%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay 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.
4,47836455,,Bld exchange truj oth thn nb,A,,2.37,0.46,NA,0.46,,0.59,3.42,3.42,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47936456,,Prtl exchange transfuse nb,A,,1.95,0.39,NA,0.39,,0.12,2.46,2.46,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48036460,,Intrauterine transfusion ftl,A,,6.42,1.36,NA,1.36,,1.13,8.91,8.91,0,XXX,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48136465,,Njx noncmpnd sclrsnt 1 vein,A,,2.29,35.75,,0.39,,0.48,38.52,3.16,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48236466,,Njx noncmpnd sclrsnt mlt vn,A,,2.93,36.57,,0.47,,0.59,40.09,3.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,48336468,,Njx sclrsnt spider veins,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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