Use 36450 for exchange transfusion in a newborn; 36455 is the exchange transfusion code for patients other than newborns.
On this page
CMS RVU26D · Effective 2026-10-01
36455 Exchange transfusion Medicare reimbursement rates in Wisconsin
Reports an exchange transfusion for a patient who is not a newborn, in which the patient’s blood is removed and replaced with donor blood. Compare 36455 office and facility rates across CMS payment localities in Wisconsin.
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 36455 in Wisconsin?
Wisconsin 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
$99.95
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 36455: Non-newborn exchange transfusion
Reports an exchange transfusion for a patient who is not a newborn, in which the patient’s blood is removed and replaced with donor blood.
This service involves removing a patient’s blood while replacing it with donor blood as part of an exchange transfusion. It is distinct from a routine transfusion, which administers blood or blood components without exchanging the patient’s blood. Hematology, critical care, or other clinicians may perform the procedure in a hospital or another setting equipped to manage transfusion procedures. A common clinical context is exchange transfusion for a patient with sickle cell disease.
Report 36455 for an exchange transfusion in a patient who is not a newborn; use the newborn-specific codes when the patient and procedure meet those code descriptions. Documentation should identify the indication, the exchange performed, and the patient’s status as non-newborn. The code represents the exchange service, not a separate service for each portion of blood removed or infused. When other procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces the other procedures to 50% under the standard multiple procedure rule.
CMS billing rules for 36455
- 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 RVU2.37 · 69%
- Practice expense (office) RVU0.46 · 13%
- Malpractice RVU0.59 · 17%
15
Medicare services in 2024 · #6070 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.
36455 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
36456 describes partial exchange transfusion for a newborn. 36455 is for an exchange transfusion in a non-newborn patient.
36430 is for a transfusion of blood or blood components, not an exchange of the patient’s blood.
36512 describes therapeutic apheresis involving cell exchange. Select the code that matches the service and method performed, rather than using 36455 solely because blood is exchanged.
Compare 36455 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$99.95
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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 36455 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,478
- Code
- 36455
- Physician work
- 2.37
- Practice expense
- 0.46
- Malpractice
- 0.59
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.37 | × 1.000 | 2.3700 |
| Practice expense | 0.46 | × 0.958 | 0.4407 |
| Malpractice | 0.59 | × 0.308 | 0.1817 |
| Total RVUs | 2.9924 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$99.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.37 | 1 |
| Practice expense | 0.46 | 0.958 |
| Malpractice | 0.59 | 0.308 |
(2.37 × 1 + 0.46 × 0.958 + 0.59 × 0.308) × $33.4009 = $99.95
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.
36455 billing questions
How is 36455 distinguished from 36450?
36455 is for exchange transfusion in a patient other than a newborn. Code 36450 is the newborn exchange transfusion code.
When is 36456 used instead?
36456 describes partial exchange transfusion for a newborn. It is not the code for a non-newborn exchange transfusion.
Is a routine blood transfusion reported with 36455?
A routine transfusion administers blood or components without exchanging the patient’s blood and is described by a different service. Report the procedure actually performed rather than treating an exchange as a routine transfusion.
How does CMS handle other procedures performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and reduces the other procedures to 50%.
What documentation supports reporting 36455?
Document the clinical indication, that an exchange transfusion was performed, and that the patient was not a newborn. The record should distinguish the exchange from a routine transfusion.
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.
