2025 CPT code 36573

Insertion of a peripherally inserted central venous catheter (PICC) in patients 5 years and older, with imaging guidance; includes all imaging, documentation, and radiological supervision.

Always adhere to the most current CPT coding guidelines for central venous access devices.Ensure appropriate documentation to support medical necessity and proper coding.

Modifiers 26 (professional component) and TC (technical component) may be applicable depending on who performs what part of the procedure.Consult the NCCI edits for further guidance.

Medical necessity for PICC line placement is established when a patient requires intravenous access for therapies or monitoring that cannot be achieved reliably or safely using peripheral intravenous catheters.This includes situations such as long-term intravenous medication administration, TPN, frequent blood draws, or hemodynamic monitoring.

The clinical responsibility lies with the physician or qualified healthcare professional performing the PICC line insertion, including selecting the insertion site, performing the procedure under imaging guidance, confirming proper catheter placement, and securing the insertion site.The physician also manages any complications that may arise during or after the procedure.

IMPORTANT For patients younger than 5 years old, use CPT code 36572.For PICC insertion without imaging guidance in patients 5 years and older, use CPT code 36569.If a subcutaneous port or pump is used, refer to the appropriate CPT codes for those procedures.

In simple words: This code covers placing a long, thin tube (PICC line) into a large vein near the heart to give medicine or nutrients over a long time. It uses imaging (like X-rays or ultrasound) to make sure the tube is in the right place. This is for people aged 5 and up, and doesn't include placing an extra device under the skin.

This CPT code encompasses the insertion of a peripherally inserted central venous catheter (PICC) line in patients aged 5 years or older.The procedure necessitates the use of imaging guidance (e.g., fluoroscopy, ultrasound) for precise catheter placement into a central vein (e.g., superior vena cava, inferior vena cava, or right atrium).The code includes all associated imaging guidance, image documentation, and radiological supervision and interpretation integral to the procedure.No subcutaneous port or pump is involved.The procedure is typically performed for patients requiring prolonged intravenous access for medication delivery, nutrition, or other therapeutic interventions.

Example 1: A 7-year-old child with cancer requires long-term intravenous chemotherapy. A PICC line is inserted using ultrasound guidance to deliver chemotherapy agents effectively and safely over multiple treatment cycles., A 65-year-old patient with severe dehydration needs total parenteral nutrition (TPN). A PICC line is placed with fluoroscopic guidance to administer nutrients intravenously for several weeks., A 25-year-old patient with a central venous thrombosis needs repeated blood draws for monitoring purposes. A PICC line is inserted using ultrasound guidance as it provides easier access compared to repeated peripheral venipuncture.

* Patient demographics and medical history.* Indication for PICC line placement (e.g., chemotherapy, TPN, frequent blood draws).* Detailed description of the procedure, including the site of insertion and imaging guidance used.* Confirmation of catheter placement via chest X-ray or other appropriate imaging.* Documentation of the type of catheter used.* Indication of any complications or adverse events.* Post-procedure instructions given to the patient.

** Accurate coding requires comprehensive documentation of the procedure, including the type of imaging guidance used and confirmation of catheter placement.Always consult the most recent CPT coding guidelines and payer-specific billing rules for accurate reimbursement.

  • Revenue Code: P6C (Medicare Fee Schedule: Minor Procedures - Other)
  • RVU: RVUs vary based on geographic location, facility type, and other factors. Consult the Medicare Physician Fee Schedule (MPFS) or other relevant payer fee schedules for current payment rates.
  • Global Days : No global period is associated with this code.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC is applicable when the technical component (insertion of the catheter) is billed separately from the professional component (interpretation of imaging).
  • Fee Schedule : Refer to the Medicare Physician Fee Schedule (MPFS) or other payer fee schedules for historical reimbursement rates.Note that reimbursement rates are subject to change annually.
  • Specialties:Interventional Radiology, Oncology, Hematology
  • Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.