Summary & Overview
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.
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.
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Service type: Surgical vascular access procedure for prolonged arterial infusion
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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.
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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 |