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2025 CPT code 36483

Endovenous ablation of subsequent vein(s) in a single extremity using a chemical adhesive delivered via catheter, following an initial vein treatment (36482).

This is an add-on code. Report only once per extremity, regardless of the number of veins treated. Must be reported with 36482.

Modifiers 50 (bilateral procedure), 59 (distinct procedural service), and others as clinically indicated.

Medical necessity is established by the presence of symptomatic venous insufficiency.Documentation should clearly demonstrate the impact of the venous disease on the patient's quality of life, the need for treatment, and the appropriateness of this method given patient-specific factors.

The physician's responsibility includes prepping the patient, inserting a guidewire and catheter into the vein under ultrasound guidance, injecting a chemical adhesive (e.g., cyanoacrylate) to ablate the vein, and post-procedure care.

IMPORTANT:36474 (mechanochemical ablation, subsequent vein), 36476 (radiofrequency ablation, subsequent vein), 36479 (laser ablation, subsequent vein)

In simple words: This code is for a follow-up treatment to close off unhealthy veins in one leg or arm.It's only used if a doctor already used a special glue to close off a vein in that same limb (coded as 36482).This additional procedure closes off other unhealthy veins in the same limb.

This CPT code, 36483, reports endovenous ablation therapy of incompetent veins in an extremity using transcatheter delivery of a chemical adhesive (e.g., cyanoacrylate).This is an add-on code and should only be reported in addition to 36482 (initial vein treatment) for subsequent veins treated in the same extremity, each accessed through a separate site.The procedure includes all imaging guidance and monitoring.Do not report this code more than once per extremity.It is not reported with certain other codes for the same extremity (29520, 29530, 29540, 29550, 29580, 29581, 29584, 36000, 36002, 36005, 36410, 36425, 36475, 36476, 36478, 36479, 37241, 75894, 76000, 76937, 76942, 76998, 77022, 93970, 93971).

Example 1: A patient presents with multiple varicose veins in their left leg.The physician performs endovenous ablation of the largest vein using 36482.Subsequently, two smaller veins are treated in the same session using 36483 (reported twice)., A patient undergoes endovenous ablation of a superficial vein in the right arm using 36482.During the same procedure, an additional smaller branch is treated using 36483., A patient with chronic venous insufficiency in their left leg has multiple incompetent veins.The physician performs the initial ablation (36482) on the largest vein, followed by ablation of three additional veins (36483 reported three times) during the same session.

* Pre-procedure assessment and documentation of venous insufficiency.* Ultrasound imaging to identify target veins.* Detailed procedural notes including the number of veins treated, access sites, and amount of chemical adhesive used.* Post-procedure imaging (optional, but may be required by payers).* Patient consent form.

** Always consult the most recent CPT manual and payer guidelines for accurate coding and reimbursement.

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