Insertion of tunneled centrally inserted central venous catheter (CVC), without subcutaneous port or pump; age 5 years or older

CPT 36561 is the billing code for "Insertion of tunneled centrally inserted central venous catheter (CVC), without subcutaneous port or pump; age 5 years or older". Insertion of tunneled central venous catheter without port in patient age 5 years or older

Medicare pays approximately $899.88 for CPT 36561 (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 36561 has a total RVU of 7.78, broken down as: Work RVU 3.50, Practice Expense RVU 4.00, and Malpractice RVU 0.28. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 36561 include: Age of patient documented (5+); Tunneled catheter documented; No port documented; Insertion site documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 36561: Tunneled catheter. No port or pump Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 36561 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 36561 is Typically 45-60 minutes. Time-based codes require documentation of the actual time spent providing the service.