CPT 36475
Global 000 ActiveEndovenous rf 1st vein
CPT 36475 Billing & Documentation Guide
CPT code 36475 (Endovenous rf 1st vein) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.17, a non-facility practice expense RVU of 25.3, and a malpractice RVU of 1.15, a total non-facility RVU of 31.62 and facility RVU of 7.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1091, though rates vary from $918.36 to $1430.82 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36475, 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 36475 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 36475 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 36475
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.17 | 5.17 |
| Practice Expense RVU | 25.3 | 1.06 |
| Malpractice RVU | 1.15 | 1.15 |
| Total RVU | 31.62 | 7.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36475
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 | $1199.62 | $241.6 | $1122.37 - $1430.82 | 29 |
| Florida | $1095.32 | $282.98 | $1038.28 - $1149.51 | 3 |
| Georgia | $1025.08 | $252.68 | $972.25 - $1077.9 | 2 |
| Illinois | $1063.21 | $280.9 | $1004.24 - $1111.31 | 4 |
| Michigan | $1020.24 | $259.99 | $987.57 - $1052.91 | 2 |
| North Carolina | $985.65 | $230.26 | $985.65 - $985.65 | 1 |
| New York | $1175.82 | $272.59 | $1002.48 - $1259.82 | 5 |
| Ohio | $982.93 | $243.73 | $982.93 - $982.93 | 1 |
| Pennsylvania | $1043.01 | $249.98 | $984.73 - $1101.3 | 2 |
| Texas | $1041.26 | $244.17 | $977.36 - $1101.12 | 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 36475
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36475 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 | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0524T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36475
What does CPT code 36475 mean? +
CPT code 36475 represents: Endovenous rf 1st vein. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36475? +
The 2026 Medicare national average non-facility payment for CPT 36475 is $1091. Rates range from $918.36 to $1430.82 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36475? +
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 36475? +
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 May 31, 2026.
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