No office rate
Choose 36620 for percutaneous arterial catheterization for sampling, monitoring, or transfusion. Choose 36640 when arterial access is for extracorporeal circulation or standby.
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CMS RVU26D · Effective 2026-10-01
36640 Arterial cannulation Medicare reimbursement rates in Wyoming
Reports arterial catheter placement or cannulation for extracorporeal circulation or standby access, such as arterial access established for cardiopulmonary bypass. Compare 36640 office and facility rates across CMS payment localities in Wyoming.
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 36640 in Wyoming?
Wyoming 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
$99.65
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Vascular access
About 36640: Arterial cannulation for extracorporeal circulation
Reports arterial catheter placement or cannulation for extracorporeal circulation or standby access, such as arterial access established for cardiopulmonary bypass.
This code covers arterial catheter placement or cannulation when the access is for extracorporeal circulation or standby use. A surgeon or other physician may establish the arterial access in an operating room for a procedure such as cardiopulmonary bypass. It is distinct from placing a routine arterial line solely for blood sampling or hemodynamic monitoring.
Report the code when the documented purpose of the arterial access supports extracorporeal circulation or standby use; record the indication and catheterization performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 36640
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.05 · 68%
- Practice expense (office) RVU0.83 · 27%
- Malpractice RVU0.14 · 5%
139
Medicare services in 2024 · #4613 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.
36640 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Code 36625 describes arterial catheterization by cutdown for sampling, monitoring, or transfusion. The purpose of access, not simply the presence of an arterial catheter, distinguishes it from 36640.
$27.22
Code 36600 is for arterial puncture to obtain a blood sample. It does not describe placement or cannulation of an arterial catheter for extracorporeal circulation or standby.
Compare 36640 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$99.65
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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 36640 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,540
- Code
- 36640
- Physician work
- 2.05
- Practice expense
- 0.83
- Malpractice
- 0.14
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.05 | × 1.000 | 2.0500 |
| Practice expense | 0.83 | × 1.000 | 0.8300 |
| Malpractice | 0.14 | × 0.740 | 0.1036 |
| Total RVUs | 2.9836 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$99.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.05 | 1 |
| Practice expense | 0.83 | 1 |
| Malpractice | 0.14 | 0.74 |
(2.05 × 1 + 0.83 × 1 + 0.14 × 0.74) × $33.4009 = $99.65
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.
36640 billing questions
How is this different from 36620?
Use 36640 for arterial access intended for extracorporeal circulation or standby use. Code 36620 describes percutaneous arterial catheterization for sampling, monitoring, or transfusion.
Can a one-time arterial blood draw be reported with this code?
No. A single arterial puncture to withdraw blood is represented by 36600; 36640 concerns arterial catheter placement or cannulation for extracorporeal circulation or standby.
What documentation supports reporting 36640?
Document the reason for arterial access and the catheterization or cannulation performed. The record should show its role in extracorporeal circulation or standby use, rather than routine arterial-line monitoring alone.
Can modifier 50 be used if access is placed on both sides?
No. CMS identifies bilateral adjustment as inapplicable for this code; the descriptor or anatomy makes modifier 50 inappropriate.
How does Medicare handle this code with other procedures in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team also be paid for this service?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
4,53736600,,Withdrawal of arterial blood,A,,0.31,0.49,,0.06,,0.02,0.82,0.39,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,53836620,,Insertion catheter artery,A,,0.98,0.16,NA,0.16,,0.08,1.22,1.22,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,53936625,,Insertion catheter artery,A,,2.06,0.47,NA,0.47,,0.33,2.86,2.86,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54036640,,Insertion catheter artery,A,,2.05,0.83,NA,0.83,,0.14,3.02,3.02,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54136660,,Insertion catheter artery,A,,1.37,0.28,NA,0.28,,0.07,1.72,1.72,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54236680,,Insert needle bone cavity,A,,1.17,0.33,NA,0.33,,0.23,1.73,1.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54336800,,Insertion of cannula,A,,2.37,0.58,NA,0.58,,0.27,3.22,3.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,