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

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 Arkansas, Medicare pays $826.21 for 36221 in the office and $160.57 when it’s performed in a hospital or facility.

$826.21Office (non-facility)
$160.57Hospital or facility
−13.3%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 Arkansas
  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 Arkansas 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. Arkansas pays $826.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

36221 in Arkansas vs other payment areas
  1. Arkansas · this page$826.21
  2. Los Angeles, CA · California$1,093.59+$267.38
  3. Washington, DC area · District of Columbia$1,104.77+$278.56
  4. Miami, FL · Florida$1,031.50+$205.29
  5. Chicago, IL · Illinois$996.73+$170.52
  6. Manhattan, NY · New York$1,107.54+$281.33
  7. Alaska · Alaska$1,054.92+$228.71

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

Every other payment area

36221 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$840.47$162.43
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 Arkansas 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

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Office calculation for 36221 in Arkansas
ComponentRVULocality factorAdjusted
Physician work3.82× 1.0003.8200
Practice expense23.81× 0.85920.4528
Malpractice0.90× 0.5150.4635
Total RVUs24.7363
Conversion factor× 33.4009

Office rate, Arkansas$826.21

Office: (3.82 × 1 + 23.81 × 0.859 + 0.9 × 0.515) × $33.4009 = $826.21

Facility: (3.82 × 1 + 0.61 × 0.859 + 0.9 × 0.515) × $33.4009 = $160.57

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, Arkansas
Used instead
36222Carotid angiography, common carotid, extracranialUsed for selective catheterization and angiography of a carotid or innominate territory rather than an arch-only study.$1,091.15
36223Carotid angiography, ipsilateral intracranial circulationUse when selective catheterization supports the intracranial and extracranial carotid angiography service.$1,652.22
36225Subclavian angiography, unilateral selective placementUsed for selective subclavian angiography rather than nonselective aortic arch imaging.$1,546.58
36226Vertebral angiography, direct vertebral selectionUsed for selective vertebral angiography when that vessel territory is catheterized and imaged.$1,970.26

How 36221 has changed in Arkansas

36221 · Office / nonfacility

$826.21

Effective 2026-10-01

The base rate is $36.40 higher than on 2025-10-01, moving from $789.81 to $826.21 (4.6%).

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

    $789.81changed to$826.21

    • 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 0.860 changed to 0.859
    • Malpractice GPCI 0.518 changed to 0.515

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $841.88changed to$789.81

    • 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

    $828.13changed to$841.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $868.62changed to$828.13

    • 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 0.853 changed to 0.860
    • Malpractice GPCI 0.492 changed to 0.518

  5. January 1, 2023

    RVU23A

    $908.85changed to$868.62

    • 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 0.847 changed to 0.853
    • Malpractice GPCI 0.465 changed to 0.492

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $949.86changed to$908.85

    • 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

    $941.21changed to$949.86

    • 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
    • Practice expense GPCI 0.859 changed to 0.847
    • Malpractice GPCI 0.521 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $930.65changed to$941.21

    • 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 0.872 changed to 0.859
    • Malpractice GPCI 0.576 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $923.35changed to$930.65

    • 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

    $921.39changed to$923.35

    • 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 0.870 changed to 0.872
    • Malpractice GPCI 0.555 changed to 0.576

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $980.61changed to$921.39

    • 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 0.867 changed to 0.870
    • Malpractice GPCI 0.534 changed to 0.555

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $979.78changed to$980.61

    • 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

    $974.91changed to$979.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $990.06changed to$974.91

    • 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 0.866 changed to 0.867
    • Malpractice GPCI 0.492 changed to 0.534

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1016.00changed to$990.06

    • 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 0.865 changed to 0.866
    • Malpractice GPCI 0.450 changed to 0.492

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1016.00

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$826.21$160.57RVU26D
2026-07-01$826.21$160.57RVU26C
2026-04-01$826.21$160.57RVU26B
2026-01-01$826.21$160.57RVU26A
2025-10-01$789.81$171.42RVU25D
2025-07-01$789.81$171.42RVU25C
2025-04-01$789.81$171.42RVU25B
2025-01-01$789.81$171.42RVU25A
2024-10-01$841.88$175.72RVU24D
2024-07-01$841.88$175.72RVU24C
2024-04-01$841.88$175.72RVU24B
2024-03-09$841.88$175.72RVU24AR
2024-01-01$828.13$172.85RVU24A
2023-10-01$868.62$177.48RVU23D
2023-07-01$868.62$177.48RVU23C
2023-04-01$868.62$177.48RVU23B
2023-01-01$868.62$177.48RVU23A
2022-10-01$908.85$181.93RVU22D
2022-07-01$908.85$181.93RVU22C
2022-04-01$908.85$181.93RVU22B
2022-01-01$908.85$181.93RVU22A
2021-10-01$949.86$182.33RVU21D
2021-07-01$949.86$182.33RVU21C
2021-04-01$949.86$182.33RVU21B
2021-01-01$949.86$182.33RVU21A
2020-10-01$941.21$190.68RVU20D
2020-07-01$941.21$190.68RVU20C
2020-04-01$941.21$190.68RVU20B
2020-01-01$941.21$190.68RVU20A
2019-10-01$930.65$191.82RVU19D
2019-07-01$930.65$191.82RVU19C
2019-04-01$930.65$191.82RVU19B
2019-01-01$930.65$191.82RVU19A
2018-10-01$923.35$192.87RVU18D
2018-07-01$923.35$192.87RVU18C
2018-04-01$923.35$192.87RVU18B
2018-01-01$923.35$192.87RVU18AR1
2017-10-01$921.39$192.95RVU17D
2017-07-01$921.39$192.95RVU17C
2017-04-01$921.39$192.95RVU17B
2017-01-01$921.39$192.95RVU17A
2016-10-01$980.61$204.86RVU16D
2016-07-01$980.61$204.86RVU16C
2016-04-01$980.61$204.86RVU16B
2016-01-01$980.61$204.86RVU16A
2015-10-01$979.78$205.60RVU15D
2015-07-01$979.78$205.60RVU15C
2015-04-01$974.91$204.58RVU15B
2015-01-01$974.91$204.58RVU15A
2014-10-01$990.06$202.70RVU14D
2014-07-01$990.06$202.70RVU14C
2014-04-01$990.06$202.70RVU14B
2014-01-01$990.06$202.70RVU14A
2013-10-01$1,016.00$195.49RVU13D
2013-07-01$1,016.00$195.49RVU13C
2013-04-01$1,016.00$195.49RVU13B
2013-01-01$1,016.00$195.49RVU13AR

Price 36221 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

  • Acorn
  • Adona
  • Alexander
  • Alicia
  • Alix
  • Alleene
  • Allport
  • Alma

Browse all communities in Arkansas

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 ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

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