2025 CPT code 36558

Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older.

Modifiers may be applicable.Refer to current CPT guidelines for appropriate use.

Medical necessity should be established by documenting the clinical indication for central venous access, such as long-term medication administration, parenteral nutrition, or hemodialysis.

The physician is responsible for prepping and anesthetizing the patient, locating the target vein, inserting the catheter, creating the tunnel, securing the catheter, controlling bleeding, and irrigating the insertion site.

IMPORTANT For peripherally inserted central venous catheter with port, 5 years or older, use 36571. For insertion of a tunneled centrally inserted central venous catheter without a subcutaneous port or pump in a patient younger than 5 years old, see 36557. For a nontunneled centrally inserted central venous catheter in a patient less than 5 years old, see 36555, and for a patient 5 years of age or older, see 36556. For a peripherally inserted central venous catheter (PICC) without imaging guidance and without subcutaneous port or pump in patients younger than 5 years of age and patients 5 years old or older, report 36568 and 36569 respectively. For the same procedure with imaging guidance in patients younger than 5 years of age and patients age 5 years or older, report 36572 and 36573 respectively.

In simple words: A catheter is inserted into a large vein near the heart or directly into the heart for patients 5 years or older. This allows medications, nutrients, and fluids to be given directly into the bloodstream. The catheter is placed under the skin through a small tunnel in the chest.This procedure does not include a port or pump.

The provider places a catheter, without a subcutaneous port or pump, into one of the major veins carrying blood to the heart or directly into the right atrium. This is done to administer medication, nutrients, or fluids directly into the bloodstream for patients 5 years of age or older. The provider locates the target vein (brachiocephalic/innominate, iliac, subclavian, superior/inferior vena cava, or right atrium), inserts the catheter tip using a needle or cut-down approach, and may use ultrasound or fluoroscopy for guidance. A tunnel is created in the chest soft tissue, the catheter is passed through, and the tip is placed in the target vein. The external end of the catheter is covered with soft tissue and skin and secured with sutures. Bleeding is controlled, and the insertion site is irrigated with antibiotics.

Example 1: A 6-year-old patient requires long-term intravenous antibiotics for a severe infection. A tunneled central venous catheter is inserted without a port or pump for easier administration., A 70-year-old patient with end-stage renal disease needs regular hemodialysis. A tunneled central venous catheter is placed for vascular access during dialysis sessions., A 10-year-old patient with cancer requires chemotherapy. A tunneled central venous catheter is inserted for administering chemotherapy drugs and other supportive medications.

Documentation should include the type and size of the catheter, the insertion site and target vein, the method of insertion (needle or cut-down), the use of imaging guidance (if any), confirmation of catheter placement, and any complications encountered.

  • Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
  • Specialties:Interventional Radiology, Vascular Surgery, Critical Care Medicine, Oncology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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