CPT 36573 Tunneled Arm PICC Reimbursement | OpenPayer

Summary & Overview

CPT 36573: Tunneled Central Venous Catheter Placement via Arm Vein

CPT code 36573 represents image-guided placement of a tunneled central venous catheter via the basilic or cephalic vein in the arm, advanced into a central vein or the right atrium, and excludes placement of a subcutaneous port or pump. This procedure is clinically important for long-term venous access for therapies such as infusion, hemodialysis adjuncts, or prolonged intravenous treatments and is commonly performed in interventional radiology or hospital outpatient settings.

Key national payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Coverage and coding interpretation can affect site-of-service decisions, billing accuracy, and payment parity across outpatient surgical centers and hospital settings.

Readers will find a concise overview of the procedure’s clinical context, the typical sites of service, and the primary payers addressed. The publication covers benchmarks relevant to utilization and reimbursement patterns, common billing considerations tied to imaging and radiology supervision, and any recent policy updates affecting coverage and claims processing. Data not available in the input is noted where applicable, and clinical and billing context is presented for national audiences to support operational and coding clarity.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare36573CPTcentral-venous-catheterimage-guided-procedureinterventional-radiologytunneled-cathetervascular-access

Billing Code Overview

CPT code 36573 describes the percutaneous placement of a tunneled central venous catheter through the basilic or cephalic vein in the arm with the catheter advanced into a major vein returning blood to the heart or directly into the right atrium. The procedure is performed under imaging guidance and includes image documentation and all required radiological supervision and interpretation.

Service type: Image-guided central venous catheter placement (tunneled, without subcutaneous port or pump)
Typical site of service: Interventional radiology suite, hospital-based procedural area, or ambulatory surgery center where imaging guidance and radiological interpretation are available.

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with advanced malignancy and poor peripheral venous access is scheduled for placement of a tunneled peripherally inserted central catheter (PICC) via the basilic vein for long-term infusion chemotherapy. The patient arrives to an interventional radiology (IR) suite or outpatient vascular access clinic. After informed consent and pre-procedure assessment, the patient is positioned and the selected arm is prepped and draped. Under ultrasound guidance, the basilic vein is cannulated and a guidewire advanced. Fluoroscopic imaging is used to direct the catheter tip into a central vein terminating in the superior vena cava or right atrium. The procedure includes sterile technique, local anesthesia, catheter advancement, verification of tip position with imaging, securement and dressing. Radiological supervision and interpretation are provided for imaging documentation. Post-procedure monitoring occurs in the IR PACU or recovery area before discharge with aftercare instructions for catheter maintenance.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s interpretation/supervisory component separated from technical services if the facility bills technical component separately.
`50`

CPT 36569: Upper-Extremity Central Venous Catheter Placement

CPT-36557-PEDIATRIC-CENTRAL-VENOUS-CATHETER-PLACEMENT

CPT 36557: Pediatric Central Venous Catheter Placement

CPT-36571-PERIPHERAL-CENTRAL-VENOUS-CATHETER-SUBCUTANEOUS-PORT

CPT 36571: Peripherally Inserted Central Venous Catheter with Subcutaneous Port

CPT-36556-CENTRAL-VENOUS-ACCESS-CATHETER-INSERTION-AGE-5-PLUS

CPT 36556: Central Venous Access Catheter Insertion, Age 5 and Older

CPT-36563-CENTRAL-VENOUS-ACCESS-DEVICE-TUNNELED-INSERTION

CPT 36563: Tunneled Central Venous Access Device Insertion

CPT-36568-PEDIATRIC-UPPER-EXTREMITY-CENTRAL-VENOUS-CATHETER-INSERTION

CPT 36568: Pediatric Upper-Extremity Central Venous Catheter Insertion

CPT-36565-TUNNELED-CENTRAL-VENOUS-CATHETER-PLACEMENT

CPT 36565: Tunneled Central Venous Catheter Placement

CPT-36558-CENTRAL-VENOUS-CATHETER-PLACEMENT-RIGHT-ATRIAL-OR-MAJOR-VEIN

CPT 36558: Central Venous Catheter Placement for Medication/Nutrition

CPT-36561-CENTRAL-VENOUS-ACCESS-CATHETER-TUNNELED

CPT 36561: Tunneled Central Venous Access Catheter Insertion

CPT-36566-TUNNELED-CENTRAL-VENOUS-CATHETER-INSERTION

CPT 36566: Tunneled Central Venous Catheter Insertion

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Taxonomy Code	Specialty	Notes
2084P0800X	Vascular Surgery	Commonly performs tunneled and nontunneled central venous access placement.
208D00000X	Diagnostic Radiology	Interventional radiologists frequently perform image-guided PICC and central line placement.
2086S0122X	Interventional Cardiology	May perform advanced central venous access in procedural suites.
363L00000X	Family Medicine	Outpatient clinicians may place PICCs or coordinate vascular access in clinic settings.
207K00000X	Emergency Medicine	Emergency physicians may place central venous catheters in urgent scenarios.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.409`	Acute embolism and thrombosis of unspecified deep veins of lower extremity, unspecified site	Central venous access may be indicated in patients with thrombotic disease needing long-term therapy or for access when peripheral veins are compromised.
`C80.1`	Malignant (primary) neoplasm, unspecified	Oncology patients frequently require PICC placement for chemotherapy, parenteral nutrition, or long-term antibiotics.
`B37.7`	Candidal infection of blood and disseminated candidiasis	Central venous access for antifungal therapy or removal/replacement of infected catheters.
`A41.9`	Sepsis, unspecified organism	Critically ill patients with sepsis often require central venous access for vasoactive infusions and monitoring.
`Z45.2`	Encounter for adjustment and management of vascular access device	Used for encounters related to management and troubleshooting of an existing vascular access device.
`T80.211A`	Acute venous thrombosis of central venous catheter, initial encounter	Catheter-related thrombosis necessitating evaluation, possible exchange, or new catheter placement.
`Z99.89`	Dependence on other enabling machines and devices, not elsewhere classified	Indicates dependence on devices such as long-term infusion catheters for ongoing therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36568`	Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump, with subcutaneous tunnel and cuff	Alternative method of central venous access when tunneling and cuff placement are required; may be performed when longer-term, tunneled catheter is indicated.
`36556`	Exchange of central venous catheter, over a guidewire, without subcutaneous port or pump	Performed when an existing PICC or central catheter requires exchange due to malfunction or infection.
`36561`	Insertion of central venous catheter, without subcutaneous port or pump, age 5 years or older; non-tunneled centrally inserted central venous catheter (e.g., internal jugular, subclavian, femoral)	Related central venous access technique used when upper arm approach is not feasible.
`36011`	Introduction of needle or intracatheter into peripheral vein for diagnostic sampling or injection, not otherwise classified (venous access)	Peripheral venous access or diagnostic venography performed before or during central line placement for site assessment.
`76937`	Ultrasound guidance for vascular access requiring ultrasound evaluation of vascular anatomy, real-time with permanent recording and reporting	Often reported when real-time ultrasound guidance is used for venous puncture during PICC placement.

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