Billing code 36476: Vein ablationMedicare rate & RVUs in Nevada

Reports radiofrequency catheter ablation of each additional incompetent vein treated in the same extremity after the primary vein procedure.

CMS RVU26DEffective Oct 1, 20261 payment locality3.9K Medicare services in 2024

Medicare pays $275.89 for 36476 in the office in Nevada (Nevada**). Which amount applies depends on the service address.

$275.89Office (non-facility)
$114.40Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 36476 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nevada
  2. What 36476 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 36476 covers

This add-on reports percutaneous radiofrequency ablation of an additional incompetent vein in the same extremity after the first vein is treated. A vascular surgeon, interventional radiologist, or other qualified physician typically uses a catheter and imaging guidance to close refluxing superficial veins in patients with chronic venous insufficiency or varicose veins. Imaging guidance and monitoring are included in the endovenous ablation service.

Report 36476 for each additional vein treated, alongside 36475 for the first vein treated with radiofrequency in that extremity. Document the treated vein, side, ablation method, and number of additional veins so the unit count is supported. CMS identifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period. For a bilateral procedure reported with modifier 50, CMS pays 150%.

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.

36476 in Nevada**

36476 office and facility rates by payment locality
Payment localityOfficeFacility
Nevada**$275.89$114.40

How the 36476 rate is calculated

Each of 36476’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 · 36476

RVUs × geographic indexes × conversion factor

Work2.58

2.58 RVUs× 1.000 GPCI

Practice expense5.20

5.20 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

8.3500

Conversion factor

$33.4009

Medicare rate

$278.90

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 36476

The CMS indicators that decide how 36476 is paid alongside other services.

CMS payment indicators · 36476

Vein ablation

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

36476 without 50 · national office

$278.90

Vein ablation

36476-50 · Bilateral: 150%

$418.35

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).

When to use modifier 50

36476 compared with similar codes

Compare codes · National

5 codes, side by side

  • 36476

    Vein ablation2.58 wRVU

    $278.90

  • 36475

    Venous ablation5.17 wRVU

    $1,056.14+$777.24

  • 36474

    Vein ablation1.71 wRVU

    $240.49−$38.41

  • 36479

    Laser vein ablation2.58 wRVU

    $310.29+$31.39

  • 36483

    Vein ablation1.71 wRVU

    $141.29−$137.61

How to choose

36475Venous ablation
36475 covers the first vein treated with radiofrequency in an extremity. Use 36476 only for additional veins treated in that same extremity.
36474Vein ablation
Both are add-on services for additional vein treatment, but 36474 uses mechanochemical ablation; 36476 uses radiofrequency.
36479Laser vein ablation
Both report additional vein treatment, but 36479 uses laser ablation while 36476 uses radiofrequency.
36483Vein ablation
36483 reports a subsequent vein treated with chemical adhesive. Choose 36476 when the additional vein is treated with radiofrequency.

36476 billing questions

When is 36476 reported instead of 36475?

Use 36475 for the first vein treated with radiofrequency in an extremity. Report 36476 for each additional vein treated in that same extremity.

Can 36476 be billed by itself?

No. It is an add-on code and must be reported with the appropriate primary procedure, such as 36475 for radiofrequency treatment of the first vein.

What supports the units reported?

Document each additional vein treated, the extremity and side, and the radiofrequency method. The number of units should match the additional veins treated.

Is imaging guidance separately reported with 36476?

Imaging guidance and monitoring are included in the endovenous ablation service; they are not separate components of 36476.

How does CMS handle bilateral reporting?

For a bilateral procedure reported with modifier 50, the CMS payment rule is 150%.

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
RVUs for 36476PPRRVU2026_Oct_nonQPP.csv, line 4,489 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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