CPT code 36224: Carotid angiography, internal carotid, both circulations2026 Medicare rate & RVUs in Alabama

Reports selective catheter angiography of one internal carotid artery when images document both the ipsilateral extracranial and intracranial circulation.

CMS RVU26DEffective Oct 1, 2026One payment locality24.1K Medicare services in 2024

In Alabama, Medicare pays $2,061.82 for 36224 in the office and $295.70 when it’s performed in a hospital or facility.

$2,061.82Office (non-facility)
$295.70Hospital or facility
−12.3%vs the national office rate ($2,350.42)

Check a contract rate as a % of Medicare · 36224 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 36224 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 36224 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 36224 covers

A physician advances a catheter selectively into an internal carotid artery and injects contrast to image that side’s extracranial and intracranial carotid circulation. Arch and cervical carotid imaging may be included when performed. Neurointerventional and diagnostic radiologists commonly perform the study in a hospital angiography suite; the service represents diagnostic imaging, not catheter placement alone.

Report the code when the record supports selective internal carotid catheterization, imaging of both circulation regions, and an interpretation of the findings. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS does not pay an assistant at surgery; 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 Alabama compares for 36224

Across 109 of 109 payment localities, the office rate for 36224 runs from $2,025.17 in Arkansas to $3,262.46 in San Benito County, CA. Alabama pays $2,061.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

36224 in Alabama vs other payment areas
  1. Alabama · this page$2,061.82
  2. Los Angeles, CA · California$2,717.69+$655.87
  3. Washington, DC area · District of Columbia$2,739.32+$677.50
  4. Miami, FL · Florida$2,535.86+$474.04
  5. Chicago, IL · Illinois$2,447.03+$385.21
  6. Manhattan, NY · New York$2,739.01+$677.19
  7. Alaska · Alaska$2,558.03+$496.21

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

Every other payment area

36224 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$2,025.17$291.35
ArizonaArizona$2,276.47$320.62
Bakersfield, CACalifornia$2,528.52$316.33
Chico, CACalifornia$2,523.33$311.15
El Centro, CACalifornia$2,523.66$311.47
Fresno, CACalifornia$2,523.33$311.15
Hanford, CACalifornia$2,523.33$311.15
Madera, CACalifornia$2,523.33$311.15

36224 rates by state

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

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.

$2,025.17

$2,892.90

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

View every state and territory as a table
36224 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,558.031
AL$2,061.821
AR$2,025.171
AZ$2,276.471
CA$2,523.33–$3,262.4629
CO$2,471.741
CT$2,528.521
DC$2,739.321
DE$2,319.851
FL$2,291.76–$2,535.863
GA$2,138.18–$2,397.492
GU$2,608.031
HI$2,608.031
IA$2,134.011
ID$2,149.401
IL$2,206.18–$2,458.594
IN$2,164.821
KS$2,118.121
KY$2,113.811
LA$2,108.29–$2,236.512
MA$2,450.71–$2,755.382
MD$2,372.07–$2,739.323
ME$2,159.15–$2,307.532
MI$2,177.77–$2,322.482
MN$2,364.701
MO$2,061.47–$2,250.643
MS$2,044.001
MT$2,350.291
NC$2,187.321
ND$2,311.531
NE$2,149.421
NH$2,427.581
NJ$2,556.41–$2,700.732
NM$2,190.811
NV$2,341.571
NY$2,226.90–$2,812.965
OH$2,169.851
OK$2,113.101
OR$2,322.65–$2,567.972
PA$2,176.13–$2,452.062
PR$2,372.341
RI$2,415.911
SC$2,182.401
SD$2,306.951
TN$2,130.691
TX$2,158.43–$2,464.098
UT$2,218.851
VA$2,295.79–$2,739.322
VI$2,372.341
VT$2,297.271
WA$2,447.74–$2,821.122
WI$2,217.691
WV$2,105.951
WY$2,333.401

See 36224 in every payment locality

How the 36224 rate is calculated

Each of 36224’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 · 36224

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.09

6.09 RVUs× 1.000 GPCI

Practice expense62.32

62.32 RVUs× 1.000 GPCI

Malpractice1.96

1.96 RVUs× 1.000 GPCI

Adjusted RVUs

70.3700

Conversion factor

$33.4009

Medicare rate

$2,350.42

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,450

Code
36224
Physician work
6.09
Practice expense
62.32
Malpractice
1.96

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 36224 in Alabama
ComponentRVULocality factorAdjusted
Physician work6.09× 1.0006.0900
Practice expense62.32× 0.87554.5300
Malpractice1.96× 0.5661.1094
Total RVUs61.7294
Conversion factor× 33.4009

Office rate, Alabama$2061.82

Office: (6.09 × 1 + 62.32 × 0.875 + 1.96 × 0.566) × $33.4009 = $2061.82

Facility: (6.09 × 1 + 1.89 × 0.875 + 1.96 × 0.566) × $33.4009 = $295.70

Open 36224 in the RVU calculator

Payment rules and modifiers for 36224

The CMS indicators that decide how 36224 is paid alongside other services.

CMS payment indicators · 36224

Carotid angiography, internal carotid, both circulations

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

36224 without 50 · national office

$2,350.42

Carotid angiography, internal carotid, both circulations

36224-50 · Bilateral: 150%

$3,525.63

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).

When to use modifier 50

How 36224 has changed in Alabama

36224 · Office / nonfacility

$2061.82

Effective 2026-10-01

The base rate is $358.15 higher than on 2025-10-01, moving from $1703.67 to $2061.82 (21.0%).

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

    $1703.67changed to$2061.82

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.25 changed to 6.09
    • Practice expense RVU 52.14 changed to 62.32
    • Malpractice RVU 1.93 changed to 1.96
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1781.20changed to$1703.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 53.12 changed to 52.14
    • Malpractice RVU 1.91 changed to 1.93

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1752.13changed to$1781.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1841.59changed to$1752.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 53.21 changed to 53.12
    • Malpractice RVU 1.84 changed to 1.91
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $1917.29changed to$1841.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 53.61 changed to 53.21
    • Malpractice RVU 1.68 changed to 1.84
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1993.84changed to$1917.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 55.63 changed to 53.61
    • Malpractice RVU 1.62 changed to 1.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1905.41changed to$1993.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 51.11 changed to 55.63
    • Malpractice RVU 1.57 changed to 1.62
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1824.92changed to$1905.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 48.95 changed to 51.11
    • Malpractice RVU 1.67 changed to 1.57
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1750.05changed to$1824.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 46.72 changed to 48.95
    • Malpractice RVU 1.59 changed to 1.67

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$1750.05

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,061.82$295.70RVU26D
2026-07-01$2,061.82$295.70RVU26C
2026-04-01$2,061.82$295.70RVU26B
2026-01-01$2,061.82$295.70RVU26A
2025-10-01$1,703.67$318.45RVU25D
2025-07-01$1,703.67$318.45RVU25C
2025-04-01$1,703.67$318.45RVU25B
2025-01-01$1,703.67$318.45RVU25A
2024-10-01$1,781.20$324.73RVU24D
2024-07-01$1,781.20$324.73RVU24C
2024-04-01$1,781.20$324.73RVU24B
2024-03-09$1,781.20$324.73RVU24AR
2024-01-01$1,752.13$319.43RVU24A
2023-10-01$1,841.59$339.96RVU23D
2023-07-01$1,841.59$339.96RVU23C
2023-04-01$1,841.59$339.96RVU23B
2023-01-01$1,841.59$339.96RVU23A
2022-10-01$1,917.29$352.81RVU22D
2022-07-01$1,917.29$352.81RVU22C
2022-04-01$1,917.29$352.81RVU22B
2022-01-01$1,917.29$352.81RVU22A
2021-10-01$1,993.84$353.18RVU21D
2021-07-01$1,993.84$353.18RVU21C
2021-04-01$1,993.84$353.18RVU21B
2021-01-01$1,993.84$353.18RVU21A
2020-10-01$1,905.41$349.36RVU20D
2020-07-01$1,905.41$349.36RVU20C
2020-04-01$1,905.41$349.36RVU20B
2020-01-01$1,905.41$349.36RVU20A
2019-10-01$1,824.92$336.97RVU19D
2019-07-01$1,824.92$336.97RVU19C
2019-04-01$1,824.92$336.97RVU19B
2019-01-01$1,824.92$336.97RVU19A
2018-10-01$1,750.05$334.22RVU18D
2018-07-01$1,750.05$334.22RVU18C
2018-04-01$1,750.05$334.22RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 36224 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

36224 billing questions

Does catheter placement alone support 36224?

No. The study includes angiography of the ipsilateral extracranial and intracranial carotid circulation; catheter placement without that imaging does not describe the service.

When should 36223 be considered instead?

Use 36223 when the selective catheter position is in the common carotid or innominate artery and the documented imaging meets that code’s criteria. 36224 is for selective placement in the internal carotid artery.

What documentation supports reporting 36224?

Document the side, selective internal carotid catheter position, imaging of both the ipsilateral extracranial and intracranial circulation, and the angiographic interpretation.

How is bilateral internal carotid angiography paid?

CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.

Are same-day services included in the global period?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this procedure. 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 36224PPRRVU2026_Oct_nonQPP.csv, line 4,450 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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