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

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 King County, WA, Medicare pays $2,821.12 for 36224 in the office and $344.53 when it’s performed in a hospital or facility.

$2,821.12Office (non-facility)
$344.53Hospital or facility
+20.0%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 King County, WA
  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 King County, WA 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. King County, WA pays $2,821.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

36224 in King County, WA vs other payment areas
  1. King County, WA · this page$2,821.12
  2. Rest of Washington · Washington$2,447.74−$373.38
  3. Los Angeles, CA · California$2,717.69−$103.43
  4. Washington, DC area · District of Columbia$2,739.32−$81.80
  5. Miami, FL · Florida$2,535.86−$285.26
  6. Chicago, IL · Illinois$2,447.03−$374.09
  7. Manhattan, NY · New York$2,739.01−$82.11

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

Every other payment area

36224 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$2,558.03$408.42
AlabamaAlabama$2,061.82$295.70
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

36224 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.

$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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 36224 in King County, WA
ComponentRVULocality factorAdjusted
Physician work6.09× 1.0506.3945
Practice expense62.32× 1.22776.4666
Malpractice1.96× 0.8171.6013
Total RVUs84.4625
Conversion factor× 33.4009

Office rate, King County, WA$2821.12

Office: (6.09 × 1.05 + 62.32 × 1.227 + 1.96 × 0.817) × $33.4009 = $2821.12

Facility: (6.09 × 1.05 + 1.89 × 1.227 + 1.96 × 0.817) × $33.4009 = $344.53

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

Codes related to 36224

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

Codes related to 36224
CodeHow it relatesOffice range, King County, WA
Same family
36223Carotid angiography, ipsilateral intracranial circulationCervicocerebral angiography with selective catheter placement in the common carotid or innominate artery.$2,293.79
36222Carotid angiography, common carotid, extracranialCarotid angiography from common carotid or innominate placement, with a different imaging scope.$1,497.08
Used instead
36226Vertebral angiography, direct vertebral selectionUsed for selective vertebral artery angiography rather than internal carotid circulation.$2,742.57
Add-on codes
36228Intracranial catheterization, additional intracranial branchAdditional selective intracranial branch catheterization and angiography may be reported with this study.$1,846.89

How 36224 has changed in King County, WA

36224 · Office / nonfacility

$2821.12

Effective 2026-10-01

The base rate is $499.42 higher than on 2025-10-01, moving from $2321.70 to $2821.12 (21.5%).

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

    $2321.70changed to$2821.12

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $2428.47changed to$2321.70

    • 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

    $2388.83changed to$2428.47

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2447.26changed to$2388.83

    • 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
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $2484.35changed to$2447.26

    • 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
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2587.47changed to$2484.35

    • 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

    $2439.05changed to$2587.47

    • 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
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $2309.03changed to$2439.05

    • 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
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $2211.82changed to$2309.03

    • 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. January 1, 2018

    RVU18AR1

    $2151.79changed to$2211.82

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 45.56 changed to 46.72
    • Malpractice RVU 1.55 changed to 1.59
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $2072.59changed to$2151.79

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 6.50 changed to 6.25
    • Practice expense RVU 43.72 changed to 45.56
    • Malpractice RVU 1.47 changed to 1.55
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $2173.10changed to$2072.59

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 45.91 changed to 43.72
    • Malpractice RVU 1.59 changed to 1.47

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $2162.29changed to$2173.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1925.58changed to$2162.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 40.32 changed to 45.91
    • Malpractice RVU 1.05 changed to 1.59
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1926.69changed to$1925.58

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 42.83 changed to 40.32
    • Malpractice RVU 1.10 changed to 1.05
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1926.69

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,821.12$344.53RVU26D
2026-07-01$2,821.12$344.53RVU26C
2026-04-01$2,821.12$344.53RVU26B
2026-01-01$2,821.12$344.53RVU26A
2025-10-01$2,321.70$376.97RVU25D
2025-07-01$2,321.70$376.97RVU25C
2025-04-01$2,321.70$376.97RVU25B
2025-01-01$2,321.70$376.97RVU25A
2024-10-01$2,428.47$383.72RVU24D
2024-07-01$2,428.47$383.72RVU24C
2024-04-01$2,428.47$383.72RVU24B
2024-03-09$2,428.47$383.72RVU24AR
2024-01-01$2,388.83$377.45RVU24A
2023-10-01$2,447.26$382.94RVU23D
2023-07-01$2,447.26$382.94RVU23C
2023-04-01$2,447.26$382.94RVU23B
2023-01-01$2,447.26$382.94RVU23A
2022-10-01$2,484.35$380.75RVU22D
2022-07-01$2,484.35$380.75RVU22C
2022-04-01$2,484.35$380.75RVU22B
2022-01-01$2,484.35$380.75RVU22A
2021-10-01$2,587.47$381.45RVU21D
2021-07-01$2,587.47$381.45RVU21C
2021-04-01$2,587.47$381.45RVU21B
2021-01-01$2,587.47$381.45RVU21A
2020-10-01$2,439.05$391.15RVU20D
2020-07-01$2,439.05$391.15RVU20C
2020-04-01$2,439.05$391.15RVU20B
2020-01-01$2,439.05$391.15RVU20A
2019-10-01$2,309.03$393.09RVU19D
2019-07-01$2,309.03$393.09RVU19C
2019-04-01$2,309.03$393.09RVU19B
2019-01-01$2,309.03$393.09RVU19A
2018-10-01$2,211.82$388.74RVU18D
2018-07-01$2,211.82$388.74RVU18C
2018-04-01$2,211.82$388.74RVU18B
2018-01-01$2,211.82$388.74RVU18AR1
2017-10-01$2,151.79$373.89RVU17D
2017-07-01$2,151.79$373.89RVU17C
2017-04-01$2,151.79$373.89RVU17B
2017-01-01$2,151.79$373.89RVU17A
2016-10-01$2,072.59$368.81RVU16D
2016-07-01$2,072.59$368.81RVU16C
2016-04-01$2,072.59$368.81RVU16B
2016-01-01$2,072.59$368.81RVU16A
2015-10-01$2,173.10$374.77RVU15D
2015-07-01$2,173.10$374.77RVU15C
2015-04-01$2,162.29$372.90RVU15B
2015-01-01$2,162.29$372.90RVU15A
2014-10-01$1,925.58$365.48RVU14D
2014-07-01$1,925.58$365.48RVU14C
2014-04-01$1,925.58$365.48RVU14B
2014-01-01$1,925.58$365.48RVU14A
2013-10-01$1,926.69$359.68RVU13D
2013-07-01$1,926.69$359.68RVU13C
2013-04-01$1,926.69$359.68RVU13B
2013-01-01$1,926.69$359.68RVU13AR

Price 36224 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 36224 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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