No office rate
Both concern exchange transfusion in a newborn. Choose 36456 for a partial exchange and 36450 for a full exchange.
On this page
CMS RVU26D · Effective 2026-10-01
36456 Blood exchange Medicare reimbursement rates in Nevada
Reports a partial blood-exchange procedure in a newborn, typically to lower excessive hematocrit while maintaining circulating volume. Compare 36456 office and facility rates across CMS payment localities in Nevada.
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 36456 in Nevada?
Nevada 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
No supported rate
Facility setting
$81.51
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
Transfusion medicine
About 36456: Partial neonatal exchange transfusion
Reports a partial blood-exchange procedure in a newborn, typically to lower excessive hematocrit while maintaining circulating volume.
Code 36456 represents a partial exchange transfusion in a newborn: measured portions of the infant’s blood are withdrawn and replaced, commonly with isotonic fluid, to reduce an elevated hematocrit without performing a full-volume exchange. A classic setting is neonatal polycythemia with concern for hyperviscosity. A neonatologist or other qualified physician typically performs the procedure in a hospital nursery or neonatal intensive care unit, often using umbilical venous access and clinical monitoring.
Report this code when the procedure is partial and the patient meets the code’s newborn description; a full exchange in a newborn is reported with the newborn exchange code. Documentation should support the indication, partial-exchange plan, amounts removed and infused, access used, and the patient’s response. CMS applies the standard multiple-procedure reduction when this service and other procedures subject to that rule occur in the same session: the highest-valued procedure is paid in full, and the others are paid at 50%.
CMS billing rules for 36456
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU1.95 · 79%
- Practice expense (office) RVU0.39 · 16%
- Malpractice RVU0.12 · 5%
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.
36456 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
This exchange-transfusion code is for a patient other than a newborn; 36456 is the partial-exchange code for a newborn.
$47.31
Code 36430 covers transfusion of blood or blood components; 36456 describes a partial exchange that removes and replaces portions of the newborn’s blood.
No office rate
Code 36440 describes blood transfusion by push technique in a young child. It is not the partial exchange-transfusion service reported with 36456.
Compare 36456 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$81.51
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 36456 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
4,479
- Code
- 36456
- Physician work
- 1.95
- Practice expense
- 0.39
- Malpractice
- 0.12
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.95 | × 1.000 | 1.9500 |
| Practice expense | 0.39 | × 1.001 | 0.3904 |
| Malpractice | 0.12 | × 0.833 | 0.1000 |
| Total RVUs | 2.4403 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$81.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.95 | 1 |
| Practice expense | 0.39 | 1.001 |
| Malpractice | 0.12 | 0.833 |
(1.95 × 1 + 0.39 × 1.001 + 0.12 × 0.833) × $33.4009 = $81.51
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.
36456 billing questions
How do I choose between 36456 and 36450?
Use 36456 for a partial exchange in a newborn. Code 36450 is for an exchange transfusion in a newborn when the procedure is not partial.
How does 36456 differ from 36430?
Code 36456 describes a partial exchange, involving removal and replacement of portions of the newborn’s blood. Code 36430 is for transfusion of blood or blood components, rather than this partial-exchange procedure.
What should the procedure note support?
Document the newborn’s indication, the partial-exchange approach, amounts removed and infused, vascular access, and the patient’s response.
When does the multiple-procedure reduction affect payment?
When 36456 and other procedures subject to the CMS multiple-procedure rule are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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.
4,47636440,,Bld push tfuj 2 yr/<,A,,1.00,0.20,NA,0.20,,0.06,1.26,1.26,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47736450,,Bld exchange truj newborn,A,,3.41,0.69,NA,0.69,,0.21,4.31,4.31,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47836455,,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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097