FeeBase
Log inGet started
Menu

CPT code 36218: Arterial catheterization, additional branch in same family2026 Medicare rate & RVUs in Puerto Rico

Report 36218 for each additional qualifying selective catheter placement in a second-order-or-higher branch of the same arterial family during a primary procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Puerto Rico, Medicare pays $231.78 for 36218 in the office and $46.40 when it’s performed in a hospital or facility.

$231.78Office (non-facility)
$46.40Hospital or facility
+0.9%vs the national office rate ($229.80)

Check a contract rate as a % of Medicare · 36218 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 36218 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36218 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 36218 covers

Code 36218 represents an additional selective catheter placement beyond the primary placement in the same arterial family. The physician advances the catheter into another qualifying branch, with the branch’s order determined by its route from the aorta. This work may occur during diagnostic arteriography or an endovascular procedure. Interventional radiologists, vascular surgeons, and other physicians performing arterial catheterization commonly report it in an angiography suite or operating room.

Report 36218 only with an eligible primary catheter-placement procedure; it is not a standalone service. The operative or angiography report should identify the catheter path, selected branches, and the additional placement that supports the code. CMS treats it as an add-on paid within the primary procedure’s global period. The number and order of branches documented should support the primary and additional placement codes reported.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 36218

Across 109 of 109 payment localities, the office rate for 36218 runs from $199.60 in Arkansas to $314.15 in San Benito County, CA. Puerto Rico pays $231.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

36218 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$231.78
  2. Los Angeles, CA · California$263.56+$31.78
  3. Washington, DC area · District of Columbia$266.19+$34.41
  4. Miami, FL · Florida$248.31+$16.53
  5. Chicago, IL · Illinois$240.06+$8.28
  6. Manhattan, NY · New York$266.79+$35.01
  7. Alaska · Alaska$255.37+$23.59

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

36218 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$203.00$42.55
ArkansasArkansas$199.60$42.08
ArizonaArizona$222.90$45.21
Bakersfield, CACalifornia$245.92$44.95
Chico, CACalifornia$245.34$44.37
El Centro, CACalifornia$245.38$44.41
Fresno, CACalifornia$245.34$44.37
Hanford, CACalifornia$245.34$44.37

36218 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$199.60

$279.75

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
36218 office rate range by state
State / territoryOffice rate rangeLocalities
AK$255.371
AL$203.001
AR$199.601
AZ$222.901
CA$245.34–$314.1529
CO$240.821
CT$246.561
DC$266.191
DE$226.971
FL$224.96–$248.313
GA$210.62–$234.352
GU$252.881
HI$252.881
IA$209.411
ID$210.901
IL$217.21–$240.574
IN$212.321
KS$208.071
KY$208.111
LA$207.65–$219.542
MA$238.97–$267.242
MD$231.83–$266.193
ME$211.94–$225.502
MI$214.17–$227.962
MN$230.371
MO$203.39–$220.693
MS$201.551
MT$229.781
NC$214.531
ND$225.631
NE$210.801
NH$236.711
NJ$249.27–$262.752
NM$215.431
NV$228.821
NY$218.21–$273.825
OH$213.321
OK$207.901
OR$226.95–$249.622
PA$213.83–$239.532
PR$231.781
RI$235.931
SC$214.301
SD$225.141
TN$209.261
TX$212.20–$240.098
UT$217.681
VA$224.51–$266.192
VI$231.781
VT$224.431
WA$238.62–$273.292
WI$216.961
WV$207.921
WY$227.971

See 36218 in every payment locality

How the 36218 rate is calculated

Each of 36218’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 36218

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense5.69

5.69 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

6.8800

Conversion factor

$33.4009

Medicare rate

$229.80

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,446

Code
36218
Physician work
0.98
Practice expense
5.69
Malpractice
0.21

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36218 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense5.69× 1.0115.7526
Malpractice0.21× 0.9850.2068
Total RVUs6.9394
Conversion factor× 33.4009

Office rate, Puerto Rico$231.78

Office: (0.98 × 1 + 5.69 × 1.011 + 0.21 × 0.985) × $33.4009 = $231.78

Facility: (0.98 × 1 + 0.2 × 1.011 + 0.21 × 0.985) × $33.4009 = $46.40

Open 36218 in the RVU calculator

Payment rules and modifiers for 36218

The CMS indicators that decide how 36218 is paid alongside other services.

CMS payment indicators · 36218

Arterial catheterization, additional branch in same family

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 36218

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 36218
CodeHow it relatesOffice range, Puerto Rico
Add-on codes
36215Arterial catheterization, first-order thoracic branchA first-order selective placement may serve as the primary service for this additional-placement code.$1,073.82
36216Arterial catheterization, second-order branchA second-order selective placement may serve as the primary service for this add-on.$1,089.54
36217Arterial catheterization, third order or higherA third-order-or-higher primary placement may be paired with this additional-placement code.$1,994.15
Used instead
36248Selective catheterization, additional abdominal or limb branchCovers additional selective catheter placements in the abdominal or lower-extremity arterial family.$113.00

How 36218 has changed in Puerto Rico

36218 · Office / nonfacility

$231.78

Effective 2026-10-01

The base rate is $32.51 higher than on 2025-10-01, moving from $199.27 to $231.78 (16.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $199.27changed to$231.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.01 changed to 0.98
    • Practice expense RVU 4.91 changed to 5.69
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $208.09changed to$199.27

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.00 changed to 4.91

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $204.69changed to$208.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $212.72changed to$204.69

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.04 changed to 5.00
    • Malpractice RVU 0.19 changed to 0.21
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $211.46changed to$212.72

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $214.46changed to$211.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.97 changed to 5.04
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $228.57changed to$214.46

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.35 changed to 4.97
    • Malpractice RVU 0.15 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $237.49changed to$228.57

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice RVU 0.18 changed to 0.15
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $249.68changed to$237.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.70 changed to 5.35
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $259.56changed to$249.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.98 changed to 5.70

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $165.74changed to$259.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.08 changed to 5.98
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $146.44changed to$165.74

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.29 changed to 4.08
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $140.89changed to$146.44

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.05 changed to 4.29

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $140.19changed to$140.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $149.93changed to$140.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.53 changed to 4.05
    • Malpractice RVU 0.15 changed to 0.19
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $147.60changed to$149.93

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.85 changed to 4.53
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $147.60

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$231.78$46.40RVU26D
2026-07-01$231.78$46.40RVU26C
2026-04-01$231.78$46.40RVU26B
2026-01-01$231.78$46.40RVU26A
2025-10-01$199.27$50.09RVU25D
2025-07-01$199.27$50.09RVU25C
2025-04-01$199.27$50.09RVU25B
2025-01-01$199.27$50.09RVU25A
2024-10-01$208.09$51.21RVU24D
2024-07-01$208.09$51.21RVU24C
2024-04-01$208.09$51.21RVU24B
2024-03-09$208.09$51.21RVU24AR
2024-01-01$204.69$50.38RVU24A
2023-10-01$212.72$51.49RVU23D
2023-07-01$211.46$51.51RVU23C
2023-04-01$211.46$51.51RVU23B
2023-01-01$211.46$51.51RVU23A
2022-10-01$214.46$51.91RVU22D
2022-07-01$214.46$51.91RVU22C
2022-04-01$214.46$51.91RVU22B
2022-01-01$214.46$51.91RVU22A
2021-10-01$228.57$50.95RVU21D
2021-07-01$228.57$50.95RVU21C
2021-04-01$228.57$50.95RVU21B
2021-01-01$228.57$50.95RVU21A
2020-10-01$237.49$54.15RVU20D
2020-07-01$237.49$54.15RVU20C
2020-04-01$237.49$54.15RVU20B
2020-01-01$237.49$54.15RVU20A
2019-10-01$249.68$54.43RVU19D
2019-07-01$249.68$54.43RVU19C
2019-04-01$249.68$54.43RVU19B
2019-01-01$249.68$54.43RVU19A
2018-10-01$259.56$54.38RVU18D
2018-07-01$259.56$54.38RVU18C
2018-04-01$259.56$54.38RVU18B
2018-01-01$259.56$54.38RVU18AR1
2017-10-01$165.74$50.23RVU17D
2017-07-01$165.74$50.23RVU17C
2017-04-01$165.74$50.23RVU17B
2017-01-01$165.74$50.23RVU17A
2016-10-01$146.44$46.99RVU16D
2016-07-01$146.44$46.99RVU16C
2016-04-01$146.44$46.99RVU16B
2016-01-01$146.44$46.99RVU16A
2015-10-01$140.89$46.65RVU15D
2015-07-01$140.89$46.65RVU15C
2015-04-01$140.19$46.42RVU15B
2015-01-01$140.19$46.42RVU15A
2014-10-01$149.93$46.81RVU14D
2014-07-01$149.93$46.81RVU14C
2014-04-01$149.93$46.81RVU14B
2014-01-01$149.93$46.81RVU14A
2013-10-01$147.60$44.72RVU13D
2013-07-01$147.60$44.72RVU13C
2013-04-01$147.60$44.72RVU13B
2013-01-01$147.60$44.72RVU13AR

Price 36218 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

36218 billing questions

Can 36218 be reported by itself?

No. It is an add-on code and must be reported with an eligible primary catheter-placement procedure.

How is 36218 different from 36217?

Code 36217 represents a primary selective placement in a third-order-or-higher branch. Code 36218 represents an additional qualifying placement in the same arterial family.

What documentation supports an additional placement?

Document the catheter route, the branches selected, and which selection was additional to the primary placement. The recorded anatomy should support the order assigned to each branch.

Does 36218 describe the angiographic imaging?

No. It represents the additional catheter placement. The record should distinguish that work from any imaging or interpretation services reported separately.

Which primary codes may be paired with 36218?

It is used with an eligible primary selective catheter-placement code, such as 36215, 36216, or 36217, when the additional placement meets the same-family criteria.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 36218PPRRVU2026_Oct_nonQPP.csv, line 4,446 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 36218 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 36218 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist