CPT 36516
Global 000 ActiveApheresis immunoads slctv
CPT 36516 Billing & Documentation Guide
CPT code 36516 (Apheresis immunoads slctv) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.52, a non-facility practice expense RVU of 64.83, and a malpractice RVU of 0.35, a total non-facility RVU of 66.7 and facility RVU of 2.23. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2321.68, though rates vary from $1916.85 to $3185.1 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36516, 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 36516 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 36516 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 36516
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.52 | 1.52 |
| Practice Expense RVU | 64.83 | 0.36 |
| Malpractice RVU | 0.35 | 0.35 |
| Total RVU | 66.7 | 2.23 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36516
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 | $2621.17 | $73.16 | $2431.16 - $3185.1 | 29 |
| Florida | $2246.13 | $85.59 | $2138.44 - $2334.5 | 3 |
| Georgia | $2130.61 | $76.31 | $1996.22 - $2264.99 | 2 |
| Illinois | $2165.59 | $84.91 | $2046.03 - $2295.69 | 4 |
| Michigan | $2100.52 | $78.52 | $2040.96 - $2160.07 | 2 |
| North Carolina | $2078.54 | $69.46 | $2078.54 - $2078.54 | 1 |
| New York | $2484.77 | $82.48 | $2116.1 - $2650.36 | 5 |
| Ohio | $2039.55 | $73.53 | $2039.55 - $2039.55 | 1 |
| Pennsylvania | $2184.72 | $75.51 | $2049.64 - $2319.79 | 2 |
| Texas | $2193.73 | $73.75 | $2032.13 - $2352.2 | 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 36516
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36516 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 |
| 0537T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 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 | 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 |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36516
What does CPT code 36516 mean? +
CPT code 36516 represents: Apheresis immunoads slctv. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36516? +
The 2026 Medicare national average non-facility payment for CPT 36516 is $2321.68. Rates range from $1916.85 to $3185.1 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36516? +
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 36516? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team