No office rate
Both codes describe cutdown access; 36420 is for patients younger than one year, while 36425 is for patients age one year or older.
On this page
CMS RVU26D · Effective 2026-10-01
36425 Venous cutdown Medicare reimbursement rates in Washington
Reports venous access obtained by surgically exposing a vein through a cutdown in a patient who is at least one year old. Compare 36425 office and facility rates across CMS payment localities in Washington.
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 36425 in Washington?
Washington 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
No supported rate
Facility setting
$32.95–$34.97
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 36425: Venous access by cutdown, age one or older
Reports venous access obtained by surgically exposing a vein through a cutdown in a patient who is at least one year old.
This service involves making an incision to expose a vein and obtain venous access in a patient age one year or older. It may be used when access is needed but a vein cannot be reached by ordinary percutaneous venipuncture. Physicians or other qualified clinicians perform it in settings equipped for procedural vascular access, including hospitals and offices.
Report 36425 when the documented method is a cutdown, not simply a difficult needle puncture. The record should support the patient’s age and describe the incision, vein exposure, and access performed. A routine blood draw or specimen collection alone does not describe this service. Under the CMS multiple-procedure rule, when this and other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction.
CMS billing rules for 36425
- 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 RVU0.74 · 75%
- Practice expense (office) RVU0.16 · 16%
- Malpractice RVU0.09 · 9%
370
Medicare services in 2024 · #3799 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.
36425 compared with similar codes
Office rates for Washington, from the same CMS release.
$19.61–$22.02
Use 36410 for difficult venipuncture in a patient age three or older when access is obtained without a cutdown. Use 36425 when the vein is surgically exposed.
36415
No office rateColl venous bld venipuncture
Use 36415 for routine venous blood collection. It does not describe the incision and vein exposure involved in a cutdown.
Compare 36425 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$32.95
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$34.97
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36425 billing questions
How does 36425 differ from difficult venipuncture code 36410?
36425 describes access obtained by surgically exposing a vein through a cutdown. Code 36410 is for difficult venipuncture in patients age three or older without a cutdown.
Can a routine blood collection code also be reported?
A routine collection alone is not a cutdown. Do not report a separate routine collection code for the same access merely because blood was drawn through it.
What documentation supports 36425?
Document the patient's age and that an incision was used to expose a vein and obtain access. A note describing only a difficult or unsuccessful needle attempt does not establish a cutdown.
How does CMS apply the multiple-procedure reduction?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and reduces the others by 50%.
Is 36425 selected by the vein used?
The defining distinction is the cutdown method in a patient age one year or older. Do not select it solely because access was obtained from a particular vein.
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.
4,47136415,,Coll venous bld venipuncture,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47236416,,Collj capillary blood spec,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47336420,,Venipuncture cutdown < 1 yr,A,,0.98,0.16,NA,0.16,,0.24,1.38,1.38,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47436425,,Venipuncture cutdown 1 yr/>,A,,0.74,0.16,NA,0.16,,0.09,0.99,0.99,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,47536430,,Transfusion bld/bld compnt,A,,0.00,1.39,,1.39,NA,0.03,1.42,1.42,5,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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