CPT 36478
Global 000 ActiveEndovenous laser 1st vein
CPT 36478 Billing & Documentation Guide
CPT code 36478 (Endovenous laser 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 23.09, and a malpractice RVU of 1.09, a total non-facility RVU of 29.35 and facility RVU of 7.39. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1012.25, though rates vary from $853.92 to $1323.3 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36478, 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 36478 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 36478 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 36478
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.17 | 5.17 |
| Practice Expense RVU | 23.09 | 1.13 |
| Malpractice RVU | 1.09 | 1.09 |
| Total RVU | 29.35 | 7.39 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36478
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 | $1111.19 | $243.28 | $1040.4 - $1323.3 | 29 |
| Florida | $1017.35 | $281.42 | $964.7 - $1067.6 | 3 |
| Georgia | $952.25 | $252.51 | $904.01 - $1000.49 | 2 |
| Illinois | $988.06 | $279.33 | $933.72 - $1032.53 | 4 |
| Michigan | $948.11 | $259.37 | $917.92 - $978.3 | 2 |
| North Carolina | $915.5 | $231.16 | $915.5 - $915.5 | 1 |
| New York | $1090.75 | $272.47 | $930.94 - $1168.33 | 5 |
| Ohio | $913.51 | $243.84 | $913.51 - $913.51 | 1 |
| Pennsylvania | $968.57 | $250.13 | $915.07 - $1022.07 | 2 |
| Texas | $966.72 | $244.61 | $908.32 - $1021.24 | 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 36478
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36478 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 36478
What does CPT code 36478 mean? +
CPT code 36478 represents: Endovenous laser 1st vein. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36478? +
The 2026 Medicare national average non-facility payment for CPT 36478 is $1012.25. Rates range from $853.92 to $1323.3 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36478? +
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 36478? +
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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