Billing code 36593: Device declotMedicare rate & RVUs in Texas
Reports thrombolytic treatment used to restore patency in an occluded vascular access device, such as a dialysis catheter or implanted infusion port.
Medicare pays $34.66–$40.17 for 36593 in the office in Texas, from Beaumont to Austin. 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 36593 covers
This service treats an obstructed vascular access device by instilling a thrombolytic agent into the device to dissolve the material blocking flow. Examples include a central venous catheter used for dialysis or an implanted infusion port that will not flush or provide adequate blood return. The service is performed by a clinician managing the access device in settings such as an office, infusion center, dialysis unit, or hospital. It describes thrombolytic treatment rather than mechanical extraction of an obstruction or replacement of the catheter.
Report 36593 when the documented service is thrombolytic declotting of the vascular device. Documentation should identify the affected device, the patency problem, the treatment performed, and the response or outcome. If the drug is separately supplied and reportable, its drug code may also be reported. CMS classifies 36593 as a technical-component-only service; a separate code covers interpretation. The reported service therefore represents the technical work, not an interpretation component.
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 36593 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$34.66 to $40.17
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $40.17 | Unavailable |
| Beaumont | $34.66 | Unavailable |
| Brazoria | $37.59 | Unavailable |
| Dallas | $37.83 | Unavailable |
| Fort Worth | $37.47 | Unavailable |
| Galveston | $37.70 | Unavailable |
| Houston | $38.07 | Unavailable |
| Rest Of Texas | $36.10 | Unavailable |
How the 36593 rate is calculated
Each of 36593’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 · 36593
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 1.12Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36593
The CMS indicators that decide how 36593 is paid alongside other services.
CMS payment indicators · 36593
Device declot
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
36593 compared with similar codes
Compare codes
36593 vs 36595 vs 36596 vs 36598: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36595Catheter removal
- 36593 describes thrombolytic treatment. Use 36595 when the obstruction is mechanically removed through a transcatheter approach.
- 36596Catheter declotting
- 36593 describes thrombolytic treatment. Code 36596 is for mechanical removal by a non-transcatheter approach.
- 36598Inj w/fluor eval cv device
- 36593 treats an obstruction with a thrombolytic agent. Code 36598 describes radiologic evaluation of an existing central venous access device using contrast and fluoroscopy.
36593 billing questions
When should 36593 be used instead of 36595 or 36596?
Use 36593 for thrombolytic treatment of an obstructed vascular device. Codes 36595 and 36596 describe mechanical removal of an intraluminal obstruction, using different approaches.
Does 36593 include the thrombolytic drug?
The service is the thrombolytic treatment of the device. When the drug is separately supplied and reportable, report the applicable drug code as well, supported by the medication record.
Does 36593 include interpretation?
No. CMS identifies 36593 as technical-component-only; a separate code covers interpretation.
What documentation supports reporting 36593?
Document which vascular device was obstructed, the clinical patency problem, the thrombolytic treatment performed, and the treatment response.
Is 36593 appropriate for a catheter exchange?
No. It represents thrombolytic declotting, not catheter replacement. Report the applicable replacement service when the catheter is exchanged.
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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