Injection of sclerosant; single incompetent vein (other than telangiectasia), including all necessary injection procedures on same day

CPT 36471 is the billing code for "Injection of sclerosant; single incompetent vein (other than telangiectasia), including all necessary injection procedures on same day". Injection of sclerosant for single incompetent vein treatment

Medicare pays approximately $191.81 for CPT 36471 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 36471 has a total RVU of 2.28, broken down as: Work RVU 1.00, Practice Expense RVU 1.20, and Malpractice RVU 0.08. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 36471 include: Single vein treated documented; Sclerosant used documented; Location of vein documented; Patient response to treatment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 36471: Single vein only. Includes all injections on same day Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 36471 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure), LT (Left side). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 36471 is Typically 15-20 minutes. Time-based codes require documentation of the actual time spent providing the service.