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CPT 36640: Arterial Catheter Placement for Prolonged Infusion

CPT code 36640 denotes surgical placement of a catheter into an artery after incision and dissection to permit prolonged infusion therapy. Nationally, this code captures an important vascular access procedure used in cases that require sustained intra-arterial medication delivery, regional chemotherapy, or other prolonged infusion-based treatments. Accurate coding for this procedure affects both clinical documentation and payer adjudication across acute and ambulatory surgical settings.

Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent and care settings for the procedure, information on common modifiers and billing context where available, and guidance on what types of benchmarks and policy updates typically influence payment and utilization for arterial catheter placement procedures. The publication highlights clinical context for prolonged infusion therapy, expected sites of service, and the payer landscape relevant to national billing practices. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 36640 describes a surgical procedure in which a provider makes an incision to locate and dissect around an artery and then inserts a catheter for the purpose of prolonged infusion therapy. This procedure is performed to establish durable arterial access for continuous or repeated intra-arterial infusions.

Service type: Surgical vascular access procedure for prolonged arterial infusion
Typical site of service: Operating room or interventional suite, with possible placement in inpatient or outpatient surgical settings depending on clinical need and patient status.

Data not available in the input.

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CPT 36640: Arterial Catheter Placement for Prolonged Infusion

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Get alerted when payer policies referencing 36640 are released or updated.

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Billing Code Overview

Service type: Surgical vascular access procedure for prolonged arterial infusion
Typical site of service: Operating room or interventional suite, with possible placement in inpatient or outpatient surgical settings depending on clinical need and patient status.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 67-year-old patient with advanced peripheral arterial disease and chronic limb ischemia is admitted for initiation of long-term intra-arterial infusion therapy for limb-sparing thrombolysis. After preoperative assessment and informed consent, the patient is brought to the vascular operating suite. Under monitored anesthesia care, the vascular surgeon makes a small incision over the selected arterial site (commonly the common femoral artery), dissects through subcutaneous tissue and fascia to expose the artery, and places a retained arterial infusion catheter for prolonged medication delivery. The catheter is secured, the incision closed, and the patient is monitored in recovery with vascular access care protocols and serial neurovascular checks. This workflow typically involves vascular surgery or interventional radiology, perioperative nursing, sterile technique, and documentation of arterial access site, catheter type, laterality, medications to be infused, anticipated duration of infusion therapy, and any complications such as hematoma or arterial thrombosis.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default billing	Use as the primary claim code without a specific modifier when none of the specific circumstances apply
`11`	Office/Outpatient E/M — usually not a CPT modifier but listed	Not typically appended to procedure code; used in some payer systems to denote as-indexed service
`22`	Increased procedural services	Use when work required to perform the arterial catheter insertion is substantially greater than typical (document reason and additional work)
`52`	Reduced services	Use when the arterial catheter insertion is partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances or patient instability before completion
`62`	Two surgeons	Use when two surgeons collaborate with defined, documented distinct roles during the arterial catheter placement
`76`	Repeat procedure by same physician — Data not provided in raw list; not included per instructions	Data not available in the input.
`78`	Unplanned return to the operating/procedure room for a related procedure during the postoperative period	Use when the patient requires an unplanned return to the OR for management of access-related complications (e.g., bleeding, thrombosis)
`80`	Assistant surgeon	Use when an assistant surgeon professionally participates in the arterial catheter insertion
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service performed in part by a non-physician practitioner under appropriate state law	Use when an advanced practice provider performs or assists with the arterial access under appropriate supervision and payer rules
`QX`	CRNA service - when CRNA performs service with anesthesiologist absent	Use when a certified registered nurse anesthetist provides anesthesia services without medical direction by an anesthesiologist (payer-specific)
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Use when the anesthesiologist medically directs multiple concurrent anesthesia procedures during arterial catheter placement (payer-specific)
`TG`	Technologist service — diagnostic or therapeutic	Use when a registered technologist provides components of the procedure under supervision per payer guidance
`U1`	State-specific modifier — example used by some payers for location or contract	Use as required by specific state payer rules to identify place-of-service or contractual arrangements

Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Primary specialty performing arterial catheter placement for infusion therapy
`207YS0126X`	Interventional Radiology	Performs image-guided arterial access and catheter placement for prolonged infusion
`2080P0006X`	General Surgery	May perform arterial access in operative settings for infusion or bypass adjuncts
`363L00000X`	Critical Care Medicine	Manages critically ill patients requiring prolonged intra-arterial infusions and participates in access decisions
`208D00000X`	Diagnostic Radiology	Provides imaging guidance for catheter placement in some cases

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Peripheral arterial disease causing limb ischemia that may require intra-arterial thrombolytic infusion and arterial catheter placement
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Acute arterial occlusion where catheter-directed thrombolysis via an indwelling arterial catheter is indicated
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	While venous, may coexist and require vascular access planning; relevant for peri-procedural assessment
`G81.90`	Hemiplegia, unspecified affecting unspecified side	Patients with neurological deficits may require arterial access for targeted therapy; relevant to care planning and positioning
`A41.9`	Sepsis, unspecified organism	Critically ill septic patients may require arterial catheter placement for infusion of vasopressors or regional therapy; influences monitoring and site selection

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36010`	Introduction of catheter, superior or inferior vena cava, central venous access	Central venous access may be obtained in the same episode for systemic medication or monitoring separate from arterial infusion
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal visceral, or lower extremity artery, open or percutaneous	May be performed in the same session when selective arterial catheterization beyond the access site is required for infusion or angiography
`36620`	Arterial catheterization, other than brachial or radial, with insertion of indwelling catheter, percutaneous; initial	Similar arterial access codes often used for percutaneous arterial catheter placements; relates by site and technique differences
`76937`	Ultrasound guidance for vascular access	Commonly used adjunct when ultrasound guidance is used for arterial puncture or catheter placement
`36415`	Collection of venous blood by venipuncture	Routine adjunct services for monitoring labs during prolonged infusion therapy

CPT 36600: Arterial Blood Sampling for Diagnostic Testing

CPT-36620-ARTERIAL-CATHETER-INSERTION-FOR-MONITORING-AND-SAMPLING

CPT 36620: Arterial Catheter Insertion for Monitoring and Sampling

CPT-36625-ARTERIAL-CATHETERIZATION-FOR-MONITORING-AND-SAMPLING

CPT 36625: Arterial Catheterization for Sampling and Monitoring

CPT-36660-UMBILICAL-ARTERY-CATHETER-INSERTION-NEWBORN

CPT 36660: Umbilical Artery Catheter Insertion in Newborn

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default billing	Use as the primary claim code without a specific modifier when none of the specific circumstances apply
`11`	Office/Outpatient E/M — usually not a CPT modifier but listed	Not typically appended to procedure code; used in some payer systems to denote as-indexed service
`22`	Increased procedural services	Use when work required to perform the arterial catheter insertion is substantially greater than typical (document reason and additional work)
`52`	Reduced services	Use when the arterial catheter insertion is partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances or patient instability before completion
`62`	Two surgeons	Use when two surgeons collaborate with defined, documented distinct roles during the arterial catheter placement
`76`	Repeat procedure by same physician — Data not provided in raw list; not included per instructions	Data not available in the input.
`78`	Unplanned return to the operating/procedure room for a related procedure during the postoperative period	Use when the patient requires an unplanned return to the OR for management of access-related complications (e.g., bleeding, thrombosis)
`80`	Assistant surgeon	Use when an assistant surgeon professionally participates in the arterial catheter insertion
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service performed in part by a non-physician practitioner under appropriate state law	Use when an advanced practice provider performs or assists with the arterial access under appropriate supervision and payer rules
`QX`	CRNA service - when CRNA performs service with anesthesiologist absent	Use when a certified registered nurse anesthetist provides anesthesia services without medical direction by an anesthesiologist (payer-specific)
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Use when the anesthesiologist medically directs multiple concurrent anesthesia procedures during arterial catheter placement (payer-specific)
`TG`	Technologist service — diagnostic or therapeutic	Use when a registered technologist provides components of the procedure under supervision per payer guidance
`U1`	State-specific modifier — example used by some payers for location or contract	Use as required by specific state payer rules to identify place-of-service or contractual arrangements

Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Primary specialty performing arterial catheter placement for infusion therapy
`207YS0126X`	Interventional Radiology	Performs image-guided arterial access and catheter placement for prolonged infusion
`2080P0006X`	General Surgery	May perform arterial access in operative settings for infusion or bypass adjuncts
`363L00000X`	Critical Care Medicine	Manages critically ill patients requiring prolonged intra-arterial infusions and participates in access decisions
`208D00000X`	Diagnostic Radiology	Provides imaging guidance for catheter placement in some cases

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Peripheral arterial disease causing limb ischemia that may require intra-arterial thrombolytic infusion and arterial catheter placement
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Acute arterial occlusion where catheter-directed thrombolysis via an indwelling arterial catheter is indicated
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	While venous, may coexist and require vascular access planning; relevant for peri-procedural assessment
`G81.90`	Hemiplegia, unspecified affecting unspecified side	Patients with neurological deficits may require arterial access for targeted therapy; relevant to care planning and positioning
`A41.9`	Sepsis, unspecified organism	Critically ill septic patients may require arterial catheter placement for infusion of vasopressors or regional therapy; influences monitoring and site selection

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36010`	Introduction of catheter, superior or inferior vena cava, central venous access	Central venous access may be obtained in the same episode for systemic medication or monitoring separate from arterial infusion
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal visceral, or lower extremity artery, open or percutaneous	May be performed in the same session when selective arterial catheterization beyond the access site is required for infusion or angiography
`36620`	Arterial catheterization, other than brachial or radial, with insertion of indwelling catheter, percutaneous; initial	Similar arterial access codes often used for percutaneous arterial catheter placements; relates by site and technique differences
`76937`	Ultrasound guidance for vascular access	Commonly used adjunct when ultrasound guidance is used for arterial puncture or catheter placement
`36415`	Collection of venous blood by venipuncture	Routine adjunct services for monitoring labs during prolonged infusion therapy

CPT 36600: Arterial Blood Sampling for Diagnostic Testing

CPT-36620-ARTERIAL-CATHETER-INSERTION-FOR-MONITORING-AND-SAMPLING

CPT 36620: Arterial Catheter Insertion for Monitoring and Sampling

CPT-36625-ARTERIAL-CATHETERIZATION-FOR-MONITORING-AND-SAMPLING

CPT 36625: Arterial Catheterization for Sampling and Monitoring

CPT-36660-UMBILICAL-ARTERY-CATHETER-INSERTION-NEWBORN

CPT 36660: Umbilical Artery Catheter Insertion in Newborn

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

OpenPayer

CPT 36640: Arterial Catheter Placement for Prolonged Infusion

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Billing Code Overview

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CPT 36640: Arterial Catheter Placement for Prolonged Infusion

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Billing Code Overview

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