Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older

CPT 36556 is the billing code for "Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older". Insertion of non-tunneled central venous catheter in patient age 5 years or older

Medicare pays approximately $201.20 for CPT 36556 (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 36556 has a total RVU of 5.70, broken down as: Work RVU 2.50, Practice Expense RVU 3.00, and Malpractice RVU 0.20. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 36556 include: Age of patient documented (5+); Type of catheter documented; Insertion site documented; Confirmation of placement documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 36556: Non-tunneled catheter. Age 5+ only Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 36556 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 36556 is Typically 30-45 minutes. Time-based codes require documentation of the actual time spent providing the service.