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CPT code 36221: Aortic arch angiography, nonselective thoracic aorta2026 Medicare rate & RVUs in Alaska

Report this service for nonselective catheter placement in the thoracic aorta with angiographic imaging of the aortic arch and its major vessel origins.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In Alaska, Medicare pays $1,054.92 for 36221 in the office and $229.65 when it’s performed in a hospital or facility.

$1,054.92Office (non-facility)
$229.65Hospital or facility
+10.7%vs the national office rate ($952.93)

Check a contract rate as a % of Medicare · 36221 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 36221 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alaska
  2. What 36221 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 36221 covers

A catheter is positioned in the thoracic aorta without selective advancement into an arch branch, and contrast images show the aortic arch and the origins of its major vessels. The service is commonly performed by an interventional radiologist, vascular surgeon, or other physician performing catheter angiography in a hospital or catheterization suite to assess arch anatomy or suspected vascular disease. The code includes the catheter placement and the radiological supervision, interpretation, image documentation, and report for the arch study.

Report 36221 when the documented catheter position and images support a nonselective arch angiogram; selective branch catheterization and the specific territory imaged point to a different cervicocerebral angiography code. The code is priced as bilateral, so modifier 50 does not increase payment. It has a 0-day global period, with same-day preoperative and postoperative care included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

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 Alaska compares for 36221

Across 109 of 109 payment localities, the office rate for 36221 runs from $826.21 in Arkansas to $1,304.53 in San Benito County, CA. Alaska pays $1,054.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

36221 in Alaska vs other payment areas
  1. Alaska · this page$1,054.92
  2. Los Angeles, CA · California$1,093.59+$38.67
  3. Washington, DC area · District of Columbia$1,104.77+$49.85
  4. Miami, FL · Florida$1,031.50−$23.42
  5. Chicago, IL · Illinois$996.73−$58.19
  6. Manhattan, NY · New York$1,107.54+$52.62
  7. Alabama · Alabama$840.47−$214.45

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

Every other payment area

36221 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$826.21$160.57
ArizonaArizona$923.95$173.07
Bakersfield, CACalifornia$1,019.94$170.65
Chico, CACalifornia$1,017.49$168.20
El Centro, CACalifornia$1,017.65$168.35
Fresno, CACalifornia$1,017.49$168.20
Hanford, CACalifornia$1,017.49$168.20
Madera, CACalifornia$1,017.49$168.20

36221 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.

$826.21

$1,161.01

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

View every state and territory as a table
36221 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,054.921
AL$840.471
AR$826.211
AZ$923.951
CA$1,017.49–$1,304.5329
CO$998.771
CT$1,023.031
DC$1,104.771
DE$940.991
FL$933.06–$1,031.503
GA$872.81–$972.082
GU$1,049.221
HI$1,049.221
IA$867.201
ID$873.461
IL$900.66–$998.504
IN$879.421
KS$861.671
KY$862.101
LA$860.21–$910.092
MA$991.02–$1,109.142
MD$961.28–$1,104.773
ME$877.94–$934.682
MI$887.62–$945.712
MN$954.831
MO$842.40–$914.813
MS$834.541
MT$952.871
NC$888.791
ND$935.071
NE$872.991
NH$981.781
NJ$1,034.11–$1,090.252
NM$892.961
NV$948.701
NY$904.24–$1,137.165
OH$883.981
OK$861.131
OR$940.82–$1,035.552
PA$886.06–$993.632
PR$961.221
RI$978.351
SC$887.981
SD$932.971
TN$866.641
TX$879.22–$995.888
UT$902.141
VA$930.57–$1,104.772
VI$961.221
VT$930.121
WA$989.55–$1,134.332
WI$898.721
WV$861.701
WY$945.111

See 36221 in every payment locality

How the 36221 rate is calculated

Each of 36221’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 · 36221

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.82

3.82 RVUs× 1.000 GPCI

Practice expense23.81

23.81 RVUs× 1.000 GPCI

Malpractice0.90

0.90 RVUs× 1.000 GPCI

Adjusted RVUs

28.5300

Conversion factor

$33.4009

Medicare rate

$952.93

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

The exact Alaska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,447

Code
36221
Physician work
3.82
Practice expense
23.81
Malpractice
0.90

GPCI2026.csv

5

Locality
Alaska
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Office calculation for 36221 in Alaska
ComponentRVULocality factorAdjusted
Physician work3.82× 1.5005.7300
Practice expense23.81× 1.06525.3576
Malpractice0.90× 0.5510.4959
Total RVUs31.5835
Conversion factor× 33.4009

Office rate, Alaska$1054.92

Office: (3.82 × 1.5 + 23.81 × 1.065 + 0.9 × 0.551) × $33.4009 = $1054.92

Facility: (3.82 × 1.5 + 0.61 × 1.065 + 0.9 × 0.551) × $33.4009 = $229.65

Open 36221 in the RVU calculator

Payment rules and modifiers for 36221

The CMS indicators that decide how 36221 is paid alongside other services.

CMS payment indicators · 36221

Aortic arch angiography, nonselective thoracic aorta

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36221 without 51 · national office

$952.93

Aortic arch angiography, nonselective thoracic aorta

36221-51 · Second procedure: 50%

$476.47

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 36221

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

Codes related to 36221
CodeHow it relatesOffice range, Alaska
Used instead
36222Carotid angiography, common carotid, extracranialUsed for selective catheterization and angiography of a carotid or innominate territory rather than an arch-only study.$1,393.75
36223Carotid angiography, ipsilateral intracranial circulationUse when selective catheterization supports the intracranial and extracranial carotid angiography service.$2,092.20
36225Subclavian angiography, unilateral selective placementUsed for selective subclavian angiography rather than nonselective aortic arch imaging.$1,961.29
36226Vertebral angiography, direct vertebral selectionUsed for selective vertebral angiography when that vessel territory is catheterized and imaged.$2,490.07

How 36221 has changed in Alaska

36221 · Office / nonfacility

$1054.92

Effective 2026-10-01

The base rate is $32.99 higher than on 2025-10-01, moving from $1021.93 to $1054.92 (3.2%).

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

    $1021.93changed to$1054.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.92 changed to 3.82
    • Practice expense RVU 23.31 changed to 23.81
    • Malpractice RVU 0.87 changed to 0.90
    • Practice expense GPCI 1.081 changed to 1.065
    • Malpractice GPCI 0.592 changed to 0.551

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1088.20changed to$1021.93

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 24.32 changed to 23.31
    • Malpractice RVU 0.88 changed to 0.87

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1070.44changed to$1088.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1147.20changed to$1070.44

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 24.97 changed to 24.32
    • Malpractice RVU 0.84 changed to 0.88
    • Practice expense GPCI 1.100 changed to 1.081
    • Malpractice GPCI 0.603 changed to 0.592

  5. January 1, 2023

    RVU23A

    $1224.07changed to$1147.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 25.89 changed to 24.97
    • Malpractice RVU 0.89 changed to 0.84
    • Practice expense GPCI 1.118 changed to 1.100
    • Malpractice GPCI 0.614 changed to 0.603

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1278.40changed to$1224.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 27.05 changed to 25.89
    • Malpractice RVU 0.84 changed to 0.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1252.58changed to$1278.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 25.30 changed to 27.05
    • Malpractice RVU 0.82 changed to 0.84
    • Malpractice GPCI 0.661 changed to 0.614

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1222.21changed to$1252.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 24.59 changed to 25.30
    • Malpractice RVU 0.80 changed to 0.82
    • Practice expense GPCI 1.117 changed to 1.118
    • Malpractice GPCI 0.708 changed to 0.661

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1212.83changed to$1222.21

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 24.39 changed to 24.59

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1208.91changed to$1212.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 24.50 changed to 24.39
    • Malpractice RVU 0.79 changed to 0.80
    • Practice expense GPCI 1.112 changed to 1.117
    • Malpractice GPCI 0.710 changed to 0.708

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1286.31changed to$1208.91

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.17 changed to 3.92
    • Practice expense RVU 26.25 changed to 24.50
    • Malpractice RVU 0.86 changed to 0.79
    • Practice expense GPCI 1.107 changed to 1.112
    • Malpractice GPCI 0.712 changed to 0.710

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1285.38changed to$1286.31

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 26.11 changed to 26.25

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1278.98changed to$1285.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1281.25changed to$1278.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 26.65 changed to 26.11
    • Malpractice RVU 0.79 changed to 0.86
    • Practice expense GPCI 1.087 changed to 1.107
    • Malpractice GPCI 0.687 changed to 0.712

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1294.06changed to$1281.25

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 29.27 changed to 26.65
    • Malpractice RVU 0.83 changed to 0.79
    • Practice expense GPCI 1.067 changed to 1.087
    • Malpractice GPCI 0.661 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1294.06

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,054.92$229.65RVU26D
2026-07-01$1,054.92$229.65RVU26C
2026-04-01$1,054.92$229.65RVU26B
2026-01-01$1,054.92$229.65RVU26A
2025-10-01$1,021.93$244.62RVU25D
2025-07-01$1,021.93$244.62RVU25C
2025-04-01$1,021.93$244.62RVU25B
2025-01-01$1,021.93$244.62RVU25A
2024-10-01$1,088.20$250.85RVU24D
2024-07-01$1,088.20$250.85RVU24C
2024-04-01$1,088.20$250.85RVU24B
2024-03-09$1,088.20$250.85RVU24AR
2024-01-01$1,070.44$246.76RVU24A
2023-10-01$1,147.20$255.93RVU23D
2023-07-01$1,147.20$255.93RVU23C
2023-04-01$1,147.20$255.93RVU23B
2023-01-01$1,147.20$255.93RVU23A
2022-10-01$1,224.07$264.57RVU22D
2022-07-01$1,224.07$264.57RVU22C
2022-04-01$1,224.07$264.57RVU22B
2022-01-01$1,224.07$264.57RVU22A
2021-10-01$1,278.40$265.30RVU21D
2021-07-01$1,278.40$265.30RVU21C
2021-04-01$1,278.40$265.30RVU21B
2021-01-01$1,278.40$265.30RVU21A
2020-10-01$1,252.58$275.75RVU20D
2020-07-01$1,252.58$275.75RVU20C
2020-04-01$1,252.58$275.75RVU20B
2020-01-01$1,252.58$275.75RVU20A
2019-10-01$1,222.21$275.80RVU19D
2019-07-01$1,222.21$275.80RVU19C
2019-04-01$1,222.21$275.80RVU19B
2019-01-01$1,222.21$275.80RVU19A
2018-10-01$1,212.83$277.10RVU18D
2018-07-01$1,212.83$277.10RVU18C
2018-04-01$1,212.83$277.10RVU18B
2018-01-01$1,212.83$277.10RVU18AR1
2017-10-01$1,208.91$277.85RVU17D
2017-07-01$1,208.91$277.85RVU17C
2017-04-01$1,208.91$277.85RVU17B
2017-01-01$1,208.91$277.85RVU17A
2016-10-01$1,286.31$295.82RVU16D
2016-07-01$1,286.31$295.82RVU16C
2016-04-01$1,286.31$295.82RVU16B
2016-01-01$1,286.31$295.82RVU16A
2015-10-01$1,285.38$296.89RVU15D
2015-07-01$1,285.38$296.89RVU15C
2015-04-01$1,278.98$295.41RVU15B
2015-01-01$1,278.98$295.41RVU15A
2014-10-01$1,281.25$292.97RVU14D
2014-07-01$1,281.25$292.97RVU14C
2014-04-01$1,281.25$292.97RVU14B
2014-01-01$1,281.25$292.97RVU14A
2013-10-01$1,294.06$281.94RVU13D
2013-07-01$1,294.06$281.94RVU13C
2013-04-01$1,294.06$281.94RVU13B
2013-01-01$1,294.06$281.94RVU13AR

Price 36221 for an earlier date of service

Where the Alaska rate applies

Alaska is a Medicare payment area, not a city. Our Census mapping connects it to 355 cities and communities in Alaska. Some span more than one payment area; confirm with the service ZIP.

  • Adak
  • Akhiok
  • Akiachak
  • Akiak
  • Akutan
  • Alakanuk
  • Alatna
  • Alcan Border

Browse all communities in Alaska

36221 billing questions

When should 36221 be chosen instead of a selective carotid angiography code?

Use 36221 for nonselective catheter placement in the thoracic aorta with imaging of the arch. Selective catheterization and imaging of a carotid or other branch territory point to a selective angiography code.

Can the arch angiography interpretation be billed separately?

No. The radiological supervision and interpretation, image documentation, and report for the arch study are included in 36221.

Should modifier 50 be appended when both sides are evaluated?

The code is already priced as bilateral, and modifier 50 does not increase payment.

How does Medicare handle 36221 with other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.

What documentation supports reporting 36221?

Document the catheter position in the thoracic aorta, the arch angiographic images obtained, and the interpretation and report. The record should support a nonselective arch study rather than selective branch catheterization.

Can an assistant surgeon or co-surgeon be reported for 36221?

Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

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 36221PPRRVU2026_Oct_nonQPP.csv, line 4,447 (RVU26D)
Geographic factors for AlaskaGPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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