$424.61–$499.16
Both describe complete replacement of a tunneled central venous catheter without a port or pump through the existing access. 36581 includes imaging guidance; 36578 is used without it.
On this page
CMS RVU26D · Effective 2026-10-01
36581 Catheter replacement Medicare reimbursement rates in Virginia
Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance. Compare 36581 office and facility rates across CMS payment localities in Virginia.
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 36581 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$742.79–$878.79
2 of 2 localities have a supported rate.
Facility setting
$159.68–$180.00
2 of 2 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.
Vascular access
About 36581: Tunneled central venous catheter replacement with imaging
Reports complete replacement of a tunneled central venous catheter without an implanted port, using the existing venous access with imaging guidance.
This service replaces a tunneled, centrally inserted venous catheter in its entirety through the existing venous access, without a subcutaneous port or pump. Imaging guidance and its associated supervision and interpretation are included. It is commonly performed by an interventional radiologist or another physician experienced in vascular access, often for a patient whose long-term infusion or hemodialysis catheter is damaged, malfunctioning, or due for exchange. The code describes replacement, not repair of a catheter that remains in place or placement through a new venous access.
Report the code when documentation supports a complete exchange of the tunneled catheter through the same access and identifies the imaging-guided service. The procedure note should establish the catheter type, absence of a port or pump, the existing access used, and the replacement performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 36581
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.15 · 14%
- Practice expense (office) RVU19.11 · 84%
- Malpractice RVU0.43 · 2%
30.6K
Medicare services in 2024 · #971 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.
36581 compared with similar codes
Office rates for Virginia, from the same CMS release.
$188.84–$221.73
36580 is for a non-tunneled catheter replacement through the same access. 36581 is for a tunneled catheter and includes imaging guidance.
$838.24–$988.44
36582 applies when the tunneled central venous access device has a subcutaneous port or pump; 36581 is for a catheter without one.
$144.84–$171.07
36575 describes catheter repair, not complete exchange. Use 36581 when the tunneled catheter is replaced in its entirety through the existing access.
Compare 36581 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$878.79
Facility
$180.00
Virginia →
Office / nonfacility
$742.79
Facility
$159.68
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36581 billing questions
How is this different from 36578?
36581 includes imaging guidance with supervision and interpretation for the complete tunneled-catheter replacement. 36578 is the corresponding replacement without imaging guidance.
Can 36581 be reported for a catheter repair?
No. It represents complete catheter replacement. For repair of a catheter that remains in place, consider the applicable repair code, such as 36575 or 36576.
Is imaging guidance separately reported?
Imaging guidance and its associated supervision and interpretation are included in 36581. Do not report them separately for the same replacement service.
When is 36582 more appropriate?
Use 36582 for complete replacement of a tunneled central venous access device with a subcutaneous port or pump. Code 36581 is for a catheter without a port or pump.
What documentation supports the replacement?
Document that the catheter is tunneled and centrally inserted, that the entire catheter was replaced through the existing venous access, and that imaging guidance was used.
Can modifier 50 be used for bilateral replacement?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
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.
4,52036576,,Repair tunneled cv cath,A,,2.92,7.12,,1.62,,0.57,10.61,5.11,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52136578,,Replace tunneled cv cath,A,,3.21,9.20,,1.80,,0.65,13.06,5.66,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52236580,,Replace cvad cath,A,,1.28,4.32,,0.26,,0.18,5.78,1.72,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52336581,,Replace tunneled cv cath,A,,3.15,19.11,,1.35,,0.43,22.69,4.93,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52436582,,Replace tunneled cv cath,A,,4.87,19.98,,2.06,,0.83,25.68,7.76,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52536583,,Replace tunneled cv cath,A,,4.91,31.54,,3.22,,1.31,37.76,9.44,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,52636584,,Compl rplcmt picc rs&i,A,,1.17,7.91,,0.22,,0.13,9.21,1.52,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00