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See a sample rate comparisonCPT 36406 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 36406 |
| Medicaid Fee Schedule | View Medicaid rates for 36406 |
National average reimbursement for CPT 36406 by major payers:
$23.40
$23.52
$25.00
$28.75
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CPT 36406
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateDaniel Henry
Deaconess Hospital Inc
$29.42Published rateRichard Uy
Deaconess Hospital Inc
$29.42Published rateJohn Buttari
Town Center Orthopaedic Associates, P.C.
$23.03Published rateChristopher Raio
St Francis Hospital
$9.32Published rate
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See a sample payer proposalCPT 36406 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36406 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 36406 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| 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 36406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36406 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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