CPT code 36223: Carotid angiography, ipsilateral intracranial circulation2026 Medicare rate & RVUs in California
Reports unilateral catheterization in the common carotid or innominate artery with angiography of the ipsilateral intracranial carotid circulation.
Medicare pays $2,052.65–$2,648.25 for 36223 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 36223 covers
A physician selectively places a catheter in a common carotid artery or the innominate artery and images the ipsilateral intracranial carotid circulation. The service includes angiography of the extracranial carotid or cervical circulation when performed, along with the associated radiological supervision and interpretation. Interventional radiologists, neurointerventionalists, and other physicians performing diagnostic cervicocerebral angiography commonly report it in a hospital angiography suite or catheterization lab, such as during evaluation of carotid disease or a suspected intracranial vascular lesion.
Report the code for each unilateral service when the catheter position and imaged territory meet these criteria. The report should identify the catheterized vessel, side, angiographic territory, and physician interpretation. Catheter placement and the associated imaging supervision and interpretation are included. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.
Where 36223 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$2052.65 to $2648.25
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $2,057.19 | $283.56 |
| Chico, CA | $2,052.65 | $279.02 |
| El Centro, CA | $2,052.93 | $279.30 |
| Fresno, CA | $2,052.65 | $279.02 |
| Hanford, CA | $2,052.65 | $279.02 |
| Los Angeles, CA | $2,209.83 | $295.42 |
| Madera, CA | $2,052.65 | $279.02 |
| Marin County, CA | $2,587.57 | $305.81 |
| Merced, CA | $2,052.65 | $279.02 |
| Modesto, CA | $2,052.65 | $279.02 |
| Napa, CA | $2,430.64 | $297.75 |
| Oxnard, CA | $2,203.39 | $290.59 |
| Redding, CA | $2,052.65 | $279.02 |
| Rest of California | $2,052.65 | $279.02 |
| Riverside, CA | $2,070.94 | $297.31 |
| Sacramento, CA | $2,168.17 | $286.11 |
| Salinas, CA | $2,160.55 | $284.97 |
| San Benito County, CA | $2,648.25 | $314.70 |
| San Diego, CA | $2,222.53 | $287.07 |
| San Francisco, CA | $2,585.63 | $303.86 |
| San Luis Obispo, CA | $2,124.50 | $281.29 |
| Santa Clara County, CA | $2,640.32 | $306.76 |
| Santa Cruz, CA | $2,252.25 | $286.05 |
| Santa Maria, CA | $2,171.68 | $284.77 |
| Santa Rosa, CA | $2,275.66 | $288.42 |
| Stockton, CA | $2,052.65 | $279.02 |
| Vallejo, CA | $2,427.84 | $294.96 |
| Visalia, CA | $2,052.65 | $279.02 |
| Yuba City, CA | $2,052.65 | $279.02 |
How the 36223 rate is calculated
Each of 36223’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 · 36223
RVUs × geographic indexes × conversion factor
Work5.61
5.61 RVUs× 1.000 GPCI
Practice expense50.03
50.03 RVUs× 1.000 GPCI
Malpractice1.71
1.71 RVUs× 1.000 GPCI
Adjusted RVUs
57.3500
Conversion factor
$33.4009
Medicare rate
$1,915.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36223
The CMS indicators that decide how 36223 is paid alongside other services.
CMS payment indicators · 36223
Carotid angiography, ipsilateral intracranial circulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
36223 without 50 · national office
$1,915.54
Carotid angiography, ipsilateral intracranial circulation
36223-50 · Bilateral: 150%
$2,873.31
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
36223 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36222Carotid angiographyCommon carotid, extracranial
- Choose 36222 for ipsilateral extracranial carotid angiography without imaging the intracranial carotid circulation. 36223 includes that intracranial territory.
- 36224Carotid angiographyInternal carotid, both circulations
- 36224 requires selective catheter placement in the internal carotid artery; 36223 describes placement in the common carotid or innominate artery.
- 36221Aortic arch angiographyNonselective thoracic aorta
- 36221 covers nonselective thoracic aorta catheterization and angiography of the aortic arch and great-vessel origins, rather than selective carotid or innominate catheterization with intracranial imaging.
36223 billing questions
How is 36223 different from 36222?
36223 includes imaging of the ipsilateral intracranial carotid circulation. Use 36222 when the angiography is limited to the ipsilateral extracranial carotid circulation.
How is 36223 different from 36224?
36223 describes catheter placement in the common carotid or innominate artery. 36224 describes selective catheter placement in the internal carotid artery.
Can catheter placement or imaging interpretation be billed separately?
The catheter placement and associated radiological supervision and interpretation are included in 36223 for the described service.
How should bilateral services be reported?
Report bilateral performance with modifier 50; CMS pays the bilateral procedure at 150%.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
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
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