Summary & Overview

CPT 36482: Endovenous Chemical Adhesive Ablation of First Extremity Vein

CPT code 36482 denotes endovenous chemical adhesive ablation of an incompetent extremity vein and is reported for the first vein treated. The code captures a minimally invasive, catheter-based procedure that delivers a chemical adhesive to close refluxing superficial veins and is an increasingly utilized alternative to thermal ablation and surgical stripping. Nationally, this code matters because it maps to outpatient vascular care, impacts ambulatory surgical workflows, and informs payer coverage and coding guidance for varicose vein management.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for chemical adhesive ablation, typical sites of service, and common modifiers associated with procedural reporting (modifier list provided in the input). The publication summarizes benchmarks and payment considerations where available, highlights coding nuances specific to reporting the first vein treated, and outlines areas where billing practitioners and revenue cycle teams should confirm payer-specific coverage rules.

This national summary provides the clinical framing and coding definition needed by clinicians, billing staff, and policy analysts to understand where CPT code 36482 fits within venous intervention services and how it may influence outpatient procedural coding and reimbursement workflows.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare36482CPTendovenous ablationchemical adhesivevenous interventionoutpatient surgeryvascular procedureprocedure coding

Billing Code Overview

CPT code 36482 describes a procedure in which a provider inserts a chemical adhesive through a catheter into an incompetent vein in an extremity to ablate the vein. This code is reported for treatment of the first vein treated during the session.

Service Type: Endovenous chemical ablation of an extremity vein

Typical Site of Service: Outpatient vascular clinic, ambulatory surgery center, or hospital outpatient department

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 52-year-old ambulatory patient with symptomatic varicose veins presents to an outpatient vascular clinic. After duplex ultrasound confirms an incompetent saphenous vein with reflux and correlated symptoms (pain, swelling, cosmetic concern, or recurrent superficial thrombophlebitis), the patient is scheduled for endovenous closure using a proprietary cyanoacrylate chemical adhesive delivered via catheter. The procedure is performed under local anesthesia with ultrasound guidance in an ambulatory surgery center or office-based procedure room. The provider accesses the incompetent vein percutaneously, advances the catheter to the target segment, injects the adhesive to ablate the first treated vein, and performs post-procedure ultrasound to confirm closure. Typical workflow includes pre-procedure verification, informed consent, sterile preparation, ultrasound-guided catheter insertion, adhesive delivery to the first vein (report 36482), hemostasis, brief recovery, and discharge with post-procedure instructions and follow-up duplex imaging.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier; standard reporting	Use when no additional modifier applies to the service.

| 11 | Normally expected physician or practitioner service | Use to report the professional component when applicable (rare for this full procedure code but used by some payors to denote routine service).

Taxonomy Code	Specialty	Notes
`2080P0207X`	Vascular Surgery	Common specialty performing venous ablation procedures.

ICD-10 Code	Description	Clinical Relevance
`I83.90`	Varicose veins of lower extremities with unspecified complications, unspecified lower extremity	Common indication for endovenous adhesive ablation when varicose veins cause symptoms.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36482`	Cyanoacrylate adhesive ablation, first vein treated	Primary code for chemical adhesive endovenous ablation of the first incompetent vein in an extremity.

| 36483 | Cyanoacrylate adhesive ablation, each additional vein (List separately in addition to code for primary vein) | Reported for each additional vein treated during the same session after 36482.

| 76937 | Ultrasound guidance for vascular access requiring imaging documentation | Used when ultrasound guidance is reported separately for vascular access placement during the procedure if payer allows separate reporting.

| 93970 | Duplex scan of extremity veins, noninvasive, complete bilateral study | Pre- or post-procedure diagnostic duplex ultrasound to evaluate venous reflux and confirm closure; typically performed before and/or after the ablation.

| 36465 | Endovenous laser ablation of incompetent vein, extremity; using thermal energy (e.g., laser) | Alternative endovenous ablation technique; listed for clinical context when thermal ablation is used instead of adhesive ablation.

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