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See a sample rate comparisonCPT 36425 Fee Schedule
Last Verified: October 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.
Surgical Blood Draw From Vein, A Procedure To Obtain A Blood Sample Or Gain Access To A Vein To Give Medication To A Child. A Cut Is Made In The Skin Directly Over The Vein.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $33.07 national non-facility rate (2026) · View Medicare rates for 36425 |
| Medicaid Fee Schedule | $26.785 median of the 8 states in the free preview · View Medicaid rates for 36425 |
National average reimbursement for CPT 36425 by major payers:
$52.74
$55.25
$57.48
$69.28
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CPT 36425
5 of 25 sample ratesHigher to lower in this preview
Ambulatory Surgical Center Of Somerville LLC, Somerset Ambulatory Surgical Center
$1,251.00Published rateBaptist Surgery Center Lp, Baptist Ambulatory Surgery Center
Baptist Surgery Center Lp
$632.00Published rateGrand Rapids Surgical Suites LLC
Grand Rapids Surgical Suites, PLLC
$531.00Published rateChildren'S West Surgery Center
Childrens West Surgery Center
$208.00Published rateApollo Surgery Center LLC
$45.00Published rate
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See a sample payer proposalCPT 36425 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36425 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 36425 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 |
| 36420-CPT | Low | Surgical Blood Draw From Vein, A Procedure To Obtain A Blood Sample Or Gain Access To A Vein To Give Medication To A Child. A Cut Is Made In The Skin Directly Over The Vein. |
| 36425-CPT | Low | Surgical Blood Draw From Vein, A Procedure To Obtain A Blood Sample Or Gain Access To A Vein To Give Medication To A Child. A Cut Is Made In The Skin Directly Over The Vein. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36425 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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