CPT 36555
Global 000 ActiveInsert non-tunnel cv cath
CPT 36555 Billing & Documentation Guide
CPT code 36555 (Insert non-tunnel cv cath) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.88, a non-facility practice expense RVU of 4.35, and a malpractice RVU of 0.16, a total non-facility RVU of 6.39 and facility RVU of 2.37. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $220.29, though rates vary from $190.35 to $282.08 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36555, 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 36555 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 2 units of 36555 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 36555
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.88 | 1.88 |
| Practice Expense RVU | 4.35 | 0.33 |
| Malpractice RVU | 0.16 | 0.16 |
| Total RVU | 6.39 | 2.37 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36555
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 | $239.87 | $80.99 | $225.97 - $282.08 | 29 |
| Florida | $218.98 | $84.25 | $209.73 - $227.56 | 3 |
| Georgia | $207.9 | $79.8 | $198.77 - $217.02 | 2 |
| Illinois | $213.62 | $83.88 | $203.8 - $221.92 | 4 |
| Michigan | $206.75 | $80.66 | $201.48 - $212.01 | 2 |
| North Carolina | $201.77 | $76.49 | $201.77 - $201.77 | 1 |
| New York | $235.13 | $85.33 | $204.58 - $249.49 | 5 |
| Ohio | $200.83 | $78.24 | $200.83 - $200.83 | 1 |
| Pennsylvania | $211.39 | $79.87 | $201.22 - $221.55 | 2 |
| Texas | $211.15 | $78.96 | $199.98 - $221.38 | 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 36555
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36555 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0921T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0922T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36555
What does CPT code 36555 mean? +
CPT code 36555 represents: Insert non-tunnel cv cath. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36555? +
The 2026 Medicare national average non-facility payment for CPT 36555 is $220.29. Rates range from $190.35 to $282.08 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36555? +
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 36555? +
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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