CPT 36474
Global ZZZ ActiveEndovenous mchnchem add-on
CPT 36474 Billing & Documentation Guide
CPT code 36474 (Endovenous mchnchem add-on) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.71, a non-facility practice expense RVU of 5.11, and a malpractice RVU of 0.38, a total non-facility RVU of 7.2 and facility RVU of 2.34. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $247.27, though rates vary from $210.27 to $316.32 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36474, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 36474 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 36474 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 36474
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.71 | 1.71 |
| Practice Expense RVU | 5.11 | 0.25 |
| Malpractice RVU | 0.38 | 0.38 |
| Total RVU | 7.2 | 2.34 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36474
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $268 | $75.93 | $251.95 - $316.32 | 29 |
| Florida | $253.07 | $90.2 | $239.36 - $266.89 | 3 |
| Georgia | $235.22 | $80.35 | $224.49 - $245.94 | 2 |
| Illinois | $246.49 | $89.64 | $232.78 - $258.18 | 4 |
| Michigan | $235.25 | $82.82 | $227.27 - $243.22 | 2 |
| North Carolina | $224.47 | $73.02 | $224.47 - $224.47 | 1 |
| New York | $267.49 | $86.39 | $228.18 - $287.28 | 5 |
| Ohio | $225.74 | $77.53 | $225.74 - $225.74 | 1 |
| Pennsylvania | $238.38 | $79.38 | $225.79 - $250.96 | 2 |
| Texas | $237.25 | $77.44 | $224.22 - $249.05 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 36474
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36474 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36474
What does CPT code 36474 mean? +
CPT code 36474 represents: Endovenous mchnchem add-on. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 36474? +
The 2026 Medicare national average non-facility payment for CPT 36474 is $247.27. Rates range from $210.27 to $316.32 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36474? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 36474? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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