CPT 36569
Global 000 ActiveInsj picc 5 yr+ w/o imaging
CPT 36569 Billing & Documentation Guide
CPT code 36569 (Insj picc 5 yr+ w/o imaging) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.85, a non-facility practice expense RVU of 0.4, and a malpractice RVU of 0.33, a total non-facility RVU of 2.58 and facility RVU of 2.58. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $86.43, though rates vary from $77.99 to $112.99 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36569, 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 36569 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 36569 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 36569
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.85 | 1.85 |
| Practice Expense RVU | 0.4 | 0.4 |
| Malpractice RVU | 0.33 | 0.33 |
| Total RVU | 2.58 | 2.58 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36569
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 | $85.79 | $85.79 | $83.39 - $93.76 | 29 |
| Florida | $96.65 | $96.65 | $91.13 - $103.58 | 3 |
| Georgia | $87.82 | $87.82 | $86.85 - $88.79 | 2 |
| Illinois | $95.98 | $95.98 | $91.22 - $100.95 | 4 |
| Michigan | $89.85 | $89.85 | $86.43 - $93.27 | 2 |
| North Carolina | $81.3 | $81.3 | $81.3 - $81.3 | 1 |
| New York | $94.61 | $94.61 | $82.23 - $102.1 | 5 |
| Ohio | $85.1 | $85.1 | $85.1 - $85.1 | 1 |
| Pennsylvania | $87.22 | $87.22 | $84.47 - $89.96 | 2 |
| Texas | $85.52 | $85.52 | $84.12 - $90.72 | 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 36569
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36569 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 |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36569
What does CPT code 36569 mean? +
CPT code 36569 represents: Insj picc 5 yr+ w/o imaging. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36569? +
The 2026 Medicare national average non-facility payment for CPT 36569 is $86.43. Rates range from $77.99 to $112.99 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36569? +
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 36569? +
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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