Wiki 36558 - Insertion of tunneled centrally inserted central venous catheter

[LeaHarris]

Any idea how to figure a price for this CPT code? Our RVU book doesn't provide a price on this. My provider was working as a hospitalist when this procedure was performed. Thank you!

 

[SharonCollachi]

Well, if you go to the Medicare Fee Schedule Lookup Tool, available on cms.gov (click for link), then you'll find all the info. My locality is 0111256, and here is the result for me:

HCPCS CODE

MODIFIER

SHORT DESCRIPTION

PROC STAT

MAC LOCALITY

NON-FACILITY PRICE

FACILITY PRICE

NON-FACILITY LIMITING CHARGE

FACILITY LIMITING CHARGE

CONV FACT

GPCI WORK

GPCI PE

GPCI MP

36558​

Insert tunneled cv cath

A

111256​

$876.50​

$273.32​

$957.58​

$298.60​

36.0896​

1.024​

1.07​

0.58​

PROC STAT	PCTC	NOT USED FOR MEDICARE	WORK RVU	NA FLAG FOR NON-FAC PE RVU	NON-FACILITY PE RVU	NA FLAG FOR TRANS NON-FAC PE RVU	TRANSITIONED NON-FAC PE RVU	NA FLG FOR FULLY IMP NON-FAC PE RVU
A	0​		4.59​				17.98​

FULLY IMPLEMENTED NON-FAC PE RVU	NA FLAG FOR TRANS FACILITY PE RVU	NA FLAG FOR FACILITY PE RVU	FACILITY PE RVU	TRANSITIONED FACILITY PE RVU	NA FLAG FOR FULLY IMP FAC PE RVU	FULLY IMPLEMENTED FACILITY PE RVU
17.98​				2.36​		2.36​

MP RVU	NON-FACILITY TOTAL	TRANSITIONED NON-FAC TOTAL	FACILITY TOTAL	TRANSITIONED FACILITY TOTAL	FULLY IMPLEMENTED NON-FAC TOTAL	FULLY IMPLEMENTED FACILITY TOTAL	PCTC	GLOBAL	PRE OP	INTRA OP
0.6​		23.17​		7.55​	23.17​	7.55​	0​	10​	0.1​	0.8​

POST OP	MULT SURG	BILT SURG	ASST SURG	CO SURG	TEAM SURG	PHYS SUPV	ENDOBASE	CONV FACT	NOT USED FOR MEDICARE	DIAG IMAGING FAMILY IND	OPPS NON-FACILITY PAYMENT AMOUNT<sup>1</sup>
0.1​	2​	1​	0​	0​	0​	9​		36.0896​		99​	NA

OPPS FACILITY PAYMENT AMOUNT<sup>1</sup>	NON-FAC PE USED FOR OPPS PMT AMT	FACILITY PE USED FOR OPPS PMT AMT	MALPRACTICE USED FOR OPPS PMT AMT
NA	0​	0​	0​