CPT Code for Mediport Removal: The Complete Billing Guide for 2026

If you have ever stared at a surgical note for a Mediport removal and felt unsure about which code to pick, you are definitely not alone.

Mediports (also called implantable venous access ports or port-a-caths) are wonderful devices when patients need long-term intravenous therapy. But when treatment finishes, the device needs to come out. The problem is that insurance companies and coders often disagree on whether the removal is “simple” or “surgical.”

This guide walks you through everything you need to know about the correct CPT code for Mediport removal. We will look at the primary code, the exceptions, the documentation traps, and exactly how to get your claims paid the first time.

Let us clear up the confusion once and for all.

What Exactly Is a Mediport?

Before we talk about codes, let us quickly review what a Mediport actually is. Understanding the device helps you understand why the coding rules exist.

A Mediport is a small, round device made of plastic or titanium. Surgeons place it completely under the skin, usually on the upper chest. The device connects to a catheter that threads into a large vein near the heart (often the superior vena cava).

Patients love Mediports because they eliminate the need for repeated needle sticks. Nurses can access the port through the skin using a special needle.

But when therapy ends, the port becomes a foreign object. Leaving it in place carries small risks like infection or blood clots. That is why removal is usually recommended.

The Primary CPT Code for Mediport Removal

Let us get straight to the answer you came for.

The standard CPT code for Mediport removal is 36590.

Here is the official descriptor from the AMA:

36590: Removal of tunneled central venous access catheter, with subcutaneous port or pump

This code covers the removal of a completely implanted central venous access device. That is exactly what a Mediport is.

What 36590 Includes

When you bill 36590, the work includes several key elements:

• Making a small incision over the old port site

• Dissecting through scar tissue to expose the port

• Disconnecting the port from the catheter

• Removing the port body

• Pulling the catheter out of the vein

• Closing the incision with sutures or skin adhesive

• Applying a sterile dressing

The code assumes the procedure happens in an operating room or a procedure room. It also assumes the provider uses sterile technique and local anesthesia.

When to Use 36590

Use 36590 for any removal of a subcutaneous port that requires an incision. This is true even if the incision is small. The key is that the provider has to cut through skin to get to the device.

Most Mediport removals fall into this category. The port sits under the skin. You cannot just pull it out. You have to open the pocket, disconnect the parts, and close the wound.

The Confusion with “Simple” Removal Codes

Here is where things get tricky for many billers.

Some coders see the words “simple removal” and think about codes like 36591 or 36592. Those codes exist, but they mean something very different.

Let us break down the difference.

Code 36591: Collection of Blood

36591 describes the collection of blood from a completely implanted venous access device. This is not a removal code at all. It is a blood draw code.

Some people mistakenly use this when a nurse removes a needle from a port after an infusion. That is incorrect. Removing a needle from the septum of a port is not the same as removing the entire device from the body.

Code 36592: Catheter Irrigation

36592 describes the irrigation of a completely implanted venous access device. Again, this has nothing to do with physical removal of the port hardware.

These two codes are for accessing the port while it is still in place. Never use them for surgical removal.

Why the Confusion Happens

The confusion exists because some payers have outdated policies. Years ago, a few insurers considered Mediport removal a “minor procedure” that did not require an operating room. But that thinking has changed.

Today, almost all commercial payers and Medicare expect 36590 for true surgical removal. Using 36591 or 36592 for a removal will result in an immediate denial.

Important Note for Readers: Do not let anyone tell you that 36591 is the code for Mediport removal. That is a dangerous myth. Always use 36590 when the surgeon cuts the skin to take out the port.

Surgical Removal vs. Simple Removal: A Comparison Table

To make this crystal clear, here is a side-by-side comparison of what each code actually represents.

As you can see, only one code does the job correctly.

What About “Percutaneous” Removal?

A small number of providers claim they can remove a Mediport without making an incision. They talk about “percutaneous” removal where they pull the catheter through the skin without cutting.

In reality, this is almost never possible with a subcutaneous port.

The port body itself is too large to fit through a needle hole. The catheter might slide out, but the metal or plastic port housing will not. You cannot pull a quarter through a pinhole. The same logic applies here.

If a provider genuinely performs a removal through a tiny stab incision (sometimes called a “poke and pull” technique), most coders still recommend 36590. Why? Because the work involved is essentially the same. The provider still has to dissect down to the port, disconnect it, and close the opening.

Save yourself the denial. Use 36590.

Documentation Requirements for Clean Claims

Insurance companies love to deny Mediport removal claims for lack of documentation. You can avoid this by making sure the operative note includes specific elements.

Required Elements in the Operative Note

Every removal note should clearly state:

1. Reason for removal – Completed therapy, infection, thrombosis, patient preference, or device malfunction.

2. Location of the port – Right chest, left chest, upper arm, etc.

3. Type of anesthesia – Local with or without sedation.

4. Step-by-step description – Incision, dissection, port exposure, disconnection, catheter removal, closure.

5. Any complications – Bleeding, difficult dissection, broken catheter fragments.

6. Final count – That the entire device was removed intact (or note if any fragments remain).

Sample Documentation Language

Here is an example of good documentation:

*“The patient’s right chest was prepped and draped in sterile fashion. After local anesthesia with 1% lidocaine, a 2-cm incision was made over the previously placed port. Sharp and blunt dissection was carried down to the port pocket. The port was identified and grasped. The catheter was disconnected from the port body. The port was removed. The catheter was then gently withdrawn from the internal jugular vein without resistance. The incision was closed with 4-0 monocryl and Dermabond was applied. A sterile dressing was placed. The patient tolerated the procedure well.”*

This note clearly supports 36590.

Medicare and Payer-Specific Rules

Medicare does cover Mediport removal when it is medically necessary. However, Medicare uses something called National Correct Coding Initiative (NCCI) edits. These edits can bundle 36590 with other services.

Common Bundling Issues

If the same provider removes a Mediport and performs another procedure in the same anatomical area on the same day, you may only get paid for the major procedure.

For example:

• Port removal + central line placement = Only the placement may be paid.

• Port removal + lymph node biopsy = Check NCCI edits carefully.

Medicare Payment for 36590

As of 2026, Medicare assigns 36590 to the surgical fee schedule. The exact reimbursement varies by geographic location, but you can expect a range of $300 to $600 for the professional component in a facility setting.

The facility (hospital or ASC) bills separately for the supplies, room, and nursing staff.

Commercial Payer Variations

Some commercial payers require prior authorization for port removal. This seems odd because removal is usually straightforward. But always check your contracts.

A few insurers also want you to use a different code: 36589. That code describes removal of a tunneled central venous catheter without a subcutaneous port. That is not the same as a Mediport. Do not let a payer force you into using the wrong code. Appeal if necessary.

Real-World Scenarios and Coding Decisions

Let us walk through several patient scenarios. Each one will help you feel more confident in your code selection.

Scenario 1: Routine Mediport Removal

A 58-year-old woman finishes six months of chemotherapy for breast cancer. Her oncologist schedules an elective port removal. The surgeon makes a 2-cm incision over the port, removes the device, and closes with sutures.

Correct code: 36590

Why: This is the standard, expected use of the code.

Scenario 2: Port Removal During Another Surgery

A 72-year-old man needs an inguinal hernia repair. He also has a port that he no longer uses. The surgeon asks if he can remove the port during the same operation while the patient is already under anesthesia.

Correct code: 36590 with modifier -51 (multiple procedures) or -59 (distinct procedural service), depending on payer rules.

Why: The port removal is a separate procedure from the hernia repair. It happens in a different anatomical region (chest vs. groin). Most payers will reimburse it at a reduced rate.

Scenario 3: Infected Port Removal

A 45-year-old woman presents with redness, swelling, and purulent drainage around her port site. The surgeon takes her to the operating room for an urgent removal. The procedure is more difficult because of the infection and scar tissue.

Correct code: 36590

Why: Infection does not change the code. It may support a higher level of evaluation and management (E/M) code for the office visit, but the surgical code remains 36590.

Scenario 4: Broken Catheter During Removal

During a routine removal, the catheter fractures. A small piece remains in the vein. The surgeon attempts to retrieve it but cannot. The patient goes to interventional radiology for snare retrieval the next day.

Correct code for the initial removal: 36590

Correct code for the retrieval: 37187 (percutaneous venous foreign body retrieval)

Why: The removal was still performed. The complication does not change the original code.

Scenario 5: Port Removal in Interventional Radiology

An interventional radiologist removes a port using fluoroscopy. They make a small incision and use imaging to guide the catheter withdrawal.

Correct code: 36590

Why: The specialty of the provider does not change the code. Radiology, surgery, or cardiology – all use 36590.

Modifiers That Commonly Apply to 36590

Modifiers tell the payer that something about the procedure was different. Here are the modifiers you will see most often with Mediport removal.

Modifier -50: Bilateral Procedure

Can you have two ports? Yes. Some patients have ports on both sides. If the surgeon removes two ports during the same session, you may append modifier -50 to 36590. However, many payers prefer you bill 36590 twice with modifier -59 on the second line.

Check your specific payer manual.

Modifier -52: Reduced Services

If the surgeon starts a removal but cannot finish because of an unexpected issue (like severe scarring that makes the procedure unsafe), you may use modifier -52. You will need to attach a note explaining why the service was reduced.

Modifier -76: Repeat Procedure by Same Physician

If a patient returns to the operating room on the same day for a second removal attempt (perhaps the first one failed due to a broken catheter), modifier -76 tells the payer this is a repeat procedure.

Modifier -78: Return to the OR for a Complication

If a patient goes home and then returns to the operating room later that day or the next day for treatment of a complication (like bleeding or a retained fragment), modifier -78 applies.

Modifier -79: Unrelated Procedure by the Same Physician

If a patient has a port removal and then, during the same postoperative period, needs an unrelated procedure, modifier -79 separates the two.

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Common Denial Reasons and How to Fix Them

Even experienced billers get denials sometimes. Here are the most common denial reasons for 36590 and exactly how to resolve each one.

Denial: “Procedure not separately payable”

Why this happens: The payer thinks the removal is included in another service, like an office visit or a surgical package.

How to fix it: Check if the removal happened during a global surgical period for another procedure. If it did, you may need to appeal with documentation showing the removal was unrelated to the prior surgery. If it was related, you may need to write off the charge.

Denial: “Missing medical necessity”

Why this happens: The operative note did not state why the port needed removal.

How to fix it: Add a note to the claim or submit an appeal with a copy of the operative note that clearly states the reason (e.g., “chemotherapy completed, no further need for venous access”).

Denial: “Code not valid for this place of service”

Why this happens: You billed 36590 for a removal performed in an office setting without procedure room capabilities.

How to fix it: This is a tough one. Some payers require port removals to happen in an ASC or hospital outpatient department. If you performed it in an office, you may need to use an unlisted code like 37799 and justify it.

Denial: “CPT code inconsistent with modifier”

Why this happens: You appended a modifier that does not make sense for 36590, such as modifier -25 (significant, separately identifiable E/M service) when the E/M service was not documented.

How to fix it: Review the documentation. Remove the incorrect modifier and resubmit.

Unlisted Code Alternative: 37799

Sometimes, despite your best efforts, a payer will reject 36590. In those rare cases, you may need to use an unlisted procedure code.

37799 is the unlisted code for vascular procedures.

When to Use 37799

• The payer specifically instructs you to use it (unlikely but possible).

• The removal technique is truly unique and not described by 36590.

• You are billing for a removal that involved an unusual approach, such as endoscopic removal.

How to Bill 37799

Billing an unlisted code requires extra work. You must:

1. Submit a paper claim (most electronic claims cannot process unlisted codes).

2. Attach a cover letter describing the procedure in detail.

3. Suggest a comparable code for pricing purposes (usually 36590).

4. Include the operative note.

Expect delays. Unlisted code claims often require manual review, which can take 30 to 60 days.

Facility Coding vs. Professional Coding

It is important to understand that 36590 is primarily a professional fee code. That means the surgeon or the provider bills it for their work.

Facilities (hospitals and ambulatory surgery centers) use different codes for the technical components.

Hospital Outpatient Department Coding

Hospitals typically bill the following for a Mediport removal:

• CPT 36590 (for the facility technical component, often with modifier -TC or reported on a UB-04)

• HCPCS C1769 (for the catheter or port removal, if supply costs are separate)

• Revenue code 360 (for operating room services)

Ambulatory Surgery Center (ASC) Coding

ASCs bill:

• CPT 36590 (on an ASC claim form)

• HCPCS A4300 (for the surgical tray, if applicable)

ASC payment rates for 36590 are typically lower than hospital outpatient rates.

What This Means for You

If you are a professional coder, you only worry about 36590 for the provider. If you are a facility coder, you still use 36590, but you report it on a different claim form.

Global Period for Mediport Removal

CPT 36590 carries a 10-day global period. That means the payment for the surgery includes:

• The day of the procedure

• Postoperative visits for 10 days after surgery

During those 10 days, you cannot bill separately for evaluation and management services related to the removal. The only exception is if the patient develops a new, unrelated problem, or if you need to bring them back to the operating room for a complication.

What Is Not Included in the Global Period

The global period does NOT include:

• Initial consultation or office visit where the decision for removal was made (bill that separately with modifier -57 if done on the same day as surgery, or with no modifier if done a day before)

• Treatment of unrelated conditions

• Return trips to the operating room for complications (use modifier -78)

Anesthesia Coding for Port Removal

Most Mediport removals happen with local anesthesia only. That means the surgeon provides the anesthetic. In that case, you do not bill a separate anesthesia code. The anesthesia is included in 36590.

However, some patients require monitored anesthesia care (MAC) or general anesthesia. This happens more often with:

• Pediatric patients

• Patients with severe anxiety

• Patients with difficult anatomy or extensive scar tissue

When a separate anesthesia provider (CRNA or anesthesiologist) delivers sedation or general anesthesia, you need to bill anesthesia codes.

The typical anesthesia code for a port removal is:

CPT 00300 – Anesthesia for procedures on the integumentary system on the anterior trunk, not otherwise specified

Base units for 00300 are usually 3 units. Time is added based on the anesthesia record.

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State-Specific and Local Coverage Determinations (LCDs)

Medicare uses Local Coverage Determinations (LCDs) to decide when a service is reasonable and necessary. While most LCDs cover 36590 without issue, a few regions have specific requirements.

Check Your MAC’s LCD

Before billing, search for your Medicare Administrative Contractor’s (MAC) LCD for “Central Venous Access Device Removal.”

Some MACs require documentation that:

• The port is no longer needed

• The patient has a functioning alternative venous access site if still on therapy

• The patient has no active systemic infection (unless the port itself is infected)

Example: Noridian LCD

Noridian (MAC for several western states) states that port removal is covered when:

• Therapy is completed, or

• The device is infected, or

• The device is thrombosed or malfunctioning

They specifically note that patient preference alone, without medical necessity, may not be covered. However, in practice, most removals for patient preference do get paid if the patient is done with therapy.

Frequently Asked Questions (FAQ)

Q1: Can a nurse or a medical assistant perform a Mediport removal and bill 36590?

No. Only a licensed independent practitioner (physician, nurse practitioner, or physician assistant) can perform surgical removal. The billing provider must have privileges to perform invasive procedures.

Q2: What is the difference between 36590 and 36591?

36590 is surgical removal of the entire port device. 36591 is a blood draw from an existing port. They are completely different.

Q3: Does Medicare cover routine Mediport removal after chemotherapy ends?

Yes, as long as the removal is medically necessary. “Therapy completed” is considered medically necessary because leaving a foreign body in place carries ongoing risks.

Q4: How much can I expect to get paid for 36590?

Professional fees range from $300 to $600 depending on your location and payer. Facility fees add another $1,000 to $2,500.

Q5: What code should I use if the port is in the arm instead of the chest?

Still use 36590. The location does not change the code. The device is the same.

Q6: Can I bill an office visit on the same day as a port removal?

Yes, if the office visit is for a separate, identifiable reason. Append modifier -25 to the E/M code. For example, if the patient comes in for chest pain and the surgeon decides to remove the port while they are there, you can bill both.

Q7: What if the port was placed by a different surgeon?

It does not matter. Bill 36590 for the removal regardless of who placed it.

Q8: Is a separate consent form required for removal?

Yes. Always. Removal is a surgical procedure. The patient must sign a specific consent form for the removal.

Q9: What happens if the catheter breaks during removal?

Code 36590 still applies for the attempted removal. You may also code a foreign body retrieval (37187) if another provider removes the fragment.

Q10: Do I need a modifier when billing 36590 with a diagnostic imaging code?

Usually yes. If the surgeon uses ultrasound or fluoroscopy during the removal, you may need modifier -59 on the imaging code to show it was a separate service. However, many payers consider imaging inherent to the removal.

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Additional Resources for Coders

For the most current information on CPT coding for vascular access procedures, bookmark these official resources:

• AMA CPT Network – Search for official CPT assistant articles on 36590.

• CMS NCCI Edits – Download the quarterly NCCI procedure-to-procedure edits.

• AHA Coding Clinic – Search for guidance on central venous access device removal.

Link to additional resource: CMS.gov – NCCI Edits and Policy

This link takes you directly to the official CMS page where you can download the latest NCCI edits. Checking these edits before you bill can save you from preventable denials.

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Putting It All Together: A Quick Reference Checklist

Before you submit a claim for a Mediport removal, run through this checklist.

• Is the code 36590?

• Does the operative note clearly describe an incision and dissection?

• Is the reason for removal documented (completed therapy, infection, etc.)?

• Did you check the global period? Is this within 10 days of another surgery?

• Did you append the correct modifier if another procedure happened on the same day?

• Did you avoid using 36591 or 36592?

• Did you check your payer’s LCD or coverage policy?

• Is the claim going to the correct place (professional vs. facility)?

If you answered yes to all of these, your claim has a very high chance of clean payment.

Conclusion

The correct CPT code for Mediport removal is almost always 36590. This code accurately describes the surgical work of incising the skin, dissecting to the port, removing the device, and closing the wound. Avoid the common trap of using 36591 or 36592, which are for blood collection and irrigation only. With proper documentation, attention to global periods, and careful modifier use, you can submit clean claims and get paid correctly every time.

Final Three-Line Summary

• Use CPT 36590 for all surgical removals of a subcutaneous Mediport, regardless of incision size or patient age.

• Never confuse 36591 or 36592 with removal; those codes are for accessing an existing port, not taking it out.

• Document the reason for removal clearly and check payer-specific LCDs to avoid denials and ensure smooth reimbursement.

Disclaimer: This article is for educational purposes only and does not constitute legal or medical advice. CPT codes are copyright of the American Medical Association. Always verify codes with your payer policies.

Author: Medical Billing Specialist Team
Date: APRIL 08, 2026