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CPT 36589: Tunneled Central Venous Catheter Removal, No Port

Headline: CPT code 36589: Removal of Tunneled Central Venous Access Device (No Port)

Lead: CPT code 36589 identifies the surgical removal of a tunneled central venous access device without a subcutaneous port or pump, a commonly encountered procedure in vascular access management. The code captures a targeted explantation service that has implications for facility and professional billing, perioperative planning, and complication management.

What it represents and why it matters: CPT code 36589 denotes removal of tunneled catheters used for long-term central venous access. Accurate coding informs reimbursement, quality tracking, and resource allocation across hospitals and ambulatory surgical centers. The procedure is relevant for episodes of care involving device malfunction, infection, or discontinuation of long-term vascular access.

Key payers covered: Analysis and guidance reference national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

What readers will learn: The publication outlines clinical context for catheter removal, common diagnostic scenarios that justify the service, and coding relationships to adjacent services. Readers will find benchmarking context and payer coverage patterns, coding linkage to related removal codes, and operational considerations for site-of-service selection. Policy notes and updates affecting coding and claims adjudication at a national level are summarized to inform billing and clinical documentation practices.

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Billing Code Overview

CPT code 36589 describes the surgical removal of a tunneled central venous access device without a subcutaneous port or pump. This procedure involves explantation of a tunneled catheter that traverses subcutaneous tissue into a central vein and is removed without addressing any port or pump component.

Service Type: Surgical procedure — central venous catheter removal

Typical Site of Service: Operating room, procedure suite, or ambulatory surgical center

National Reimbursement Benchmarks

Across national payers, Medicare’s mean rate of $170.6 sits well below BUCA’s average commercial mean of $508.4, indicating a substantial gap between public and average commercial reimbursement for CPT 36589. The difference of $337.8 underscores how commercial networks commonly pay multiples of Medicare for this service, with BUCA’s mean more than two and a half times Medicare’s mean.

Examining dispersion using the interquartile range (P75 minus P25) highlights variability: Blue Cross Blue Shield has the widest IQR at $561.3 (P75 $960.2 minus P25 $398.9), followed by BUCA at $389.2 (P75 $670.3 minus P25 $288.1). Aetna and Cigna show tighter IQRs of $123.0 and $140.6 respectively, while UnitedHealth Group’s IQR is $166.1. These differences reflect markedly varying consistency in commercial contracting across payers.

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CPT 36589: Tunneled Central Venous Catheter Removal, No Port

Headline: CPT code 36589: Removal of Tunneled Central Venous Access Device (No Port)

Key payers covered: Analysis and guidance reference national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

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Billing Code Overview

Service Type: Surgical procedure — central venous catheter removal

Typical Site of Service: Operating room, procedure suite, or ambulatory surgical center

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a tunneled externalized central venous access catheter (e.g., Hickman or Broviac) presents to the ambulatory infusion clinic after completion of long-term chemotherapy. The catheter site shows no signs of ongoing infection and the device is no longer required for venous access. The vascular access team schedules a routine removal. On arrival, the nurse reviews consent and anticoagulation status, verifies the device and laterality, and confirms no active infection or bacteremia. The procedure is performed in a procedure room or minor operating suite: the skin over the catheter exit site and tunnel is prepped and draped, local anesthetic is administered, a cotton suture (if present) is removed, the tunneled catheter cuff is freed, and the catheter is steadily withdrawn from the subcutaneous tunnel and central vein. Hemostasis is obtained, the exit site is irrigated, and a sterile dressing is applied. Post-procedure vital signs and site checks are performed; instructions for wound care and signs of infection are provided. If removal is indicated because of infection, mechanical complication, or device malfunction, documentation includes the indication (for example, T82.590A or T82.7XXA), procedure details, device description, estimated blood loss, and any specimens sent for culture.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	Use when the removal was partially performed or substantially reduced in scope compared with the full procedure.
`53`	Discontinued procedure	Use if the procedure was started but terminated due to patient condition or unexpected findings.
`59`	Distinct procedural service	Use when billing for another separate, unrelated procedure on the same date that is not normally reported with `36589`.
`76`	Repeat procedure by same physician	Use when the same physician repeats the removal procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use if the patient returns to the procedure room shortly after removal for management of a complication.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`24`	Unrelated E/M service during postoperative period	Use when an evaluation unrelated to the removal is performed during the global period.
`26`	Professional component	Rare for this code, use if reporting a separately identifiable professional component when applicable.
`TC`	Technical component	Use if an entity bills only the technical component of the service (facility supplies/equipment) separately.
`LT`	Left side	Use to indicate the left-sided device removal when laterality reporting is required.
`RT`	Right side	Use to indicate the right-sided device removal when laterality reporting is required.
`22`	Increased procedural services	Use when the procedure requires substantially greater work than usual and documentation supports the increase.
`52`	Reduced services	(Included above — do not duplicate)

Taxonomy Code	Specialty	Notes
`208600000X`	Surgery Physician	General surgeons frequently perform tunneled catheter removals in outpatient or OR settings.
`207XS0117X`	Surgical Oncology Physician	Oncology surgeons remove tunneled access devices placed for cancer therapy.
`208800000X`	Urology Physician	Urologists may be listed in associated taxonomies but are less commonly the primary operator for tunneled central venous catheter removal.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T82.590A`	Other mechanical complication of other vascular devices, implants and grafts, initial encounter	Indicates mechanical problems (e.g., catheter fracture, occlusion, dislodgement) prompting removal of a tunneled device.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Supports removal when device-associated infection is present; may necessitate specimen cultures and targeted therapy.
`Z45.2`	Encounter for adjustment and management of vascular access device	Reflects visits related to managing an existing vascular access device; may precede decision to remove the device.
`Z46.82`	Encounter for fitting and adjustment of vascular access device	Used for peri-procedural encounters addressing device fit or adjustment, relevant to pre- or post-removal care.
`Z95.828`	Presence of other vascular implants and grafts	Documents the presence of vascular implants or grafts in the patient history, relevant to planning device removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36590`	Removal of central venous access device, including subcutaneous port and pump (when performed)	Alternative code used when the device includes a subcutaneous port or pump; distinguishes scope of removal from `36589`.

CPT 36590: Removal of Tunneled Central Venous Device and Port

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	Use when the removal was partially performed or substantially reduced in scope compared with the full procedure.
`53`	Discontinued procedure	Use if the procedure was started but terminated due to patient condition or unexpected findings.
`59`	Distinct procedural service	Use when billing for another separate, unrelated procedure on the same date that is not normally reported with `36589`.
`76`	Repeat procedure by same physician	Use when the same physician repeats the removal procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use if the patient returns to the procedure room shortly after removal for management of a complication.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`24`	Unrelated E/M service during postoperative period	Use when an evaluation unrelated to the removal is performed during the global period.
`26`	Professional component	Rare for this code, use if reporting a separately identifiable professional component when applicable.
`TC`	Technical component	Use if an entity bills only the technical component of the service (facility supplies/equipment) separately.
`LT`	Left side	Use to indicate the left-sided device removal when laterality reporting is required.
`RT`	Right side	Use to indicate the right-sided device removal when laterality reporting is required.
`22`	Increased procedural services	Use when the procedure requires substantially greater work than usual and documentation supports the increase.
`52`	Reduced services	(Included above — do not duplicate)

Taxonomy Code	Specialty	Notes
`208600000X`	Surgery Physician	General surgeons frequently perform tunneled catheter removals in outpatient or OR settings.
`207XS0117X`	Surgical Oncology Physician	Oncology surgeons remove tunneled access devices placed for cancer therapy.
`208800000X`	Urology Physician	Urologists may be listed in associated taxonomies but are less commonly the primary operator for tunneled central venous catheter removal.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T82.590A`	Other mechanical complication of other vascular devices, implants and grafts, initial encounter	Indicates mechanical problems (e.g., catheter fracture, occlusion, dislodgement) prompting removal of a tunneled device.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Supports removal when device-associated infection is present; may necessitate specimen cultures and targeted therapy.
`Z45.2`	Encounter for adjustment and management of vascular access device	Reflects visits related to managing an existing vascular access device; may precede decision to remove the device.
`Z46.82`	Encounter for fitting and adjustment of vascular access device	Used for peri-procedural encounters addressing device fit or adjustment, relevant to pre- or post-removal care.
`Z95.828`	Presence of other vascular implants and grafts	Documents the presence of vascular implants or grafts in the patient history, relevant to planning device removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36590`	Removal of central venous access device, including subcutaneous port and pump (when performed)	Alternative code used when the device includes a subcutaneous port or pump; distinguishes scope of removal from `36589`.

CPT 36590: Removal of Tunneled Central Venous Device and Port

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 36589: Tunneled Central Venous Catheter Removal, No Port

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Billing Code Overview

National Reimbursement Benchmarks

OpenPayer

CPT 36589: Tunneled Central Venous Catheter Removal, No Port

Sign up for cpt 36589 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References