CPT Code 36590: Removal of Tunneled Central Venous Catheter Without Subcutaneous Port or Pump

Learn about CPT Code 36590, used for removing a central venous device without a subcutaneous port.

What is tunneled central venous catheter removal?

Tunneled central venous catheter (CVC) removal, reported under CPT code 36590, refers to the removal procedure of a central venous access device that does not have a subcutaneous pump or port.

This procedure involves carefully extracting the catheter that was previously tunneled beneath the skin for long-term vascular access, often used for chemotherapy, dialysis, or parenteral nutrition. Performed by a qualified health care professional, it requires documentation that distinguishes it from procedures involving a device with a subcutaneous port or pump, central or peripheral insertion.

CPT code 36590, which pertains when a tunneled central venous catheter is removed as a standalone procedure, and the proper coding process ensures accurate Medicare reimbursement, especially when done during the postoperative period or on the same day as other services.

Documentation requirements

Documentation must include:

Indication for catheter removal (e.g., infection, catheter malfunction, end of treatment)
Description of the catheter confirming it is a tunneled central venous catheter without a subcutaneous port or pump
Details of the procedural technique, such as incision, dissection, or traction used during the removal procedure
Anesthesia used and the patient's tolerance of the procedure
Method of hemostasis and wound closure
Any post-procedure instructions provided to the patient

These details help healthcare providers accurately document the procedure performed, ensure proper reimbursement, and avoid claim denials when billing Medicare or other insurance payers.

Billing guidelines

Do not report CPT code 36590 for removal of a device with a subcutaneous port or pump—instead, use CPT codes 36589 (removal of tunneled central venous catheter with port) or 36595 (mechanical removal with separate procedure).
The code includes local anesthesia and basic wound care; these are not separately billable.
Fluoroscopy (e.g., 77001) may be reported separately if it is medically necessary and documented.
Do not report an E/M service on the same day unless it is unrelated to the removal procedure and supported by separate documentation.
Ensure the device is accurately described as a tunneled central venous catheter without subcutaneous port, to avoid confusion with central venous access devices that include ports or pumps.

These billing practices enable healthcare providers, coders, and medical billing services to maintain accurate coding, support proper reimbursement, and comply with directives from medicare administrative contractors (MACs) and the national correct coding initiative (NCCI).

Other related CPT codes

36589 – Removal of tunneled catheter with subcutaneous port
36596 – Mechanical removal of catheter (e.g., sheath)
36598 – Contrast injection for catheter evaluation

Frequently asked questions

No. This code is not appropriate for PICC lines. For peripherally inserted central catheters (PICC), refer to the 36584–36585 series, which are specific to peripheral insertion and removal of access devices without subcutaneous ports.

Yes. These are considered bundled services within the removal of a tunneled central venous access device and do not require separate reporting unless unrelated to the catheter procedure.

No. Imaging such as fluoroscopy is not bundled in this code. If medically necessary and properly documented, it may be billed separately as a distinct procedure or service, especially when evaluating the tunneled central venous access route or confirming separate venous access.