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See a sample rate comparisonCPT 36405 Fee Schedule
Medicare rates as of October 2026
CPT 36405 is classified under Surgery, in the Surgical Procedures on the Cardiovascular System subgroup.
Vnpnxr<3yrs Phy/Qhp Scalp Vn, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture; Scalp Vein
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | 59 - Distinct Procedural Service 53 - Discontinued procedure XP - Separate Practitioner |
| Complexity Level | Low |
| Medicare Fee Schedule | $24.05 national non-facility rate (2026) · View Medicare rates for 36405 |
| Medicaid Fee Schedule | $19.465 median of the 8 states in the free preview · View Medicaid rates for 36405 |
National average reimbursement for CPT 36405 by major payers:
$30.49
BCBS / Anthem
$32.46
UnitedHealthcare
$34.01
Aetna
$38.60
Cigna
Compare published rates across providers.
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CPT 36405
5 of 25 sample ratesHigher to lower in this preview
Chong Nicholls
Deaconess Hospital Inc
$41.38Published rateJudith Canlas
Deaconess Hospital Inc
$41.38Published rateChristopher Raio
St Joseph Hospital
$31.63Published rateSteven Cook
Deaconess Hospital Inc
$19.01Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$15.92Published rate
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See a sample payer proposalCPT 36405 vs. Other Surgical Procedures on the Cardiovascular System Codes
The table lists codes related to 36405. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 36400-CPT | Low | Bl Draw 3 Yrs Fem Jugular, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture Femoral Or Jugular Vein |
| 36405-CPT | Low | Vnpnxr<3yrs Phy/Qhp Scalp Vn, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture; Scalp Vein |
| 36406-CPT | Low | Vnpnxr<3yrs Phy/Qhp Other Vn, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture; Other Vein |
| 36410-CPT | Low | Non Routine Bl Draw 3 Yrs, Venipuncture Age 3 Years Or Older Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Separate Procedure For Diagnostic Or Therapeutic Purposes Not To Be Used For Routine Venipuncture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36405 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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