Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated

CPT 36475 is the billing code for "Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated". Endovenous radiofrequency ablation of first incompetent vein in extremity

Medicare pays approximately $989.80 for CPT 36475 (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 36475 has a total RVU of 8.28, broken down as: Work RVU 3.50, Practice Expense RVU 4.50, and Malpractice RVU 0.28. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 36475 include: First vein treated documented; Radiofrequency method documented; Imaging guidance documented; Location of vein documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 36475: First vein only. Includes imaging guidance Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 36475 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 36475 is Typically 30-45 minutes. Time-based codes require documentation of the actual time spent providing the service.