CPT code 36227: External carotid angiography, selective placement, unilateral2026 Medicare rate & RVUs in Iowa
Reports selective catheter placement in an external carotid artery with angiography of its circulation, including intracranial imaging when performed.
In Iowa, Medicare pays $244.85 for 36227 in the office and $93.57 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 36227 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 36227 covers
A physician, commonly an interventional radiologist or neurointerventional specialist, advances a catheter selectively into an external carotid artery and performs angiography of that artery’s circulation. The study may help evaluate head and neck vascular findings, such as a suspected vascular lesion or bleeding source, and may be performed during a diagnostic or interventional angiography session. Intracranial imaging is included when performed as part of this external carotid study.
Report 36227 as an add-on with an appropriate primary cervicocerebral angiography procedure, not by itself. Documentation should identify the catheterized external carotid artery, the angiographic work performed, and the clinical findings supporting the study. CMS treats payment for this add-on as within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150%.
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 Iowa compares for 36227
Across 109 of 109 payment localities, the office rate for 36227 runs from $237.12 in Arkansas to $352.17 in San Benito County, CA. Iowa pays $244.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$244.85
- Los Angeles, CA · California$302.67+$57.82
- Washington, DC area · District of Columbia$312.39+$67.54
- Miami, FL · Florida$314.28+$69.43
- Chicago, IL · Illinois$303.06+$58.21
- Manhattan, NY · New York$320.40+$75.55
- Alaska · Alaska$309.82+$64.97
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $241.17 | $96.50 |
| ArkansasArkansas | $237.12 | $95.10 |
| ArizonaArizona | $264.73 | $104.52 |
| Bakersfield, CACalifornia | $283.99 | $102.79 |
| Chico, CACalifornia | $282.27 | $101.07 |
| El Centro, CACalifornia | $282.38 | $101.18 |
| Fresno, CACalifornia | $282.27 | $101.07 |
| Hanford, CACalifornia | $282.27 | $101.07 |
| Madera, CACalifornia | $282.27 | $101.07 |
| Merced, CACalifornia | $282.27 | $101.07 |
| Modesto, CACalifornia | $282.27 | $101.07 |
| Napa, CACalifornia | $325.58 | $107.67 |
| Oxnard, CACalifornia | $300.71 | $105.29 |
| Redding, CACalifornia | $282.27 | $101.07 |
| Rest of CaliforniaCalifornia | $282.27 | $101.07 |
| Riverside, CACalifornia | $289.22 | $108.02 |
| Sacramento, CACalifornia | $295.88 | $103.59 |
| Salinas, CACalifornia | $294.80 | $103.18 |
| San Diego, CACalifornia | $301.66 | $103.92 |
| Marin County, CACalifornia | $343.60 | $110.48 |
| San Francisco, CACalifornia | $342.86 | $109.74 |
| San Benito County, CACalifornia | $352.17 | $113.76 |
| Santa Clara County, CACalifornia | $349.15 | $110.74 |
| San Luis Obispo, CACalifornia | $290.17 | $101.86 |
| Santa Cruz, CACalifornia | $304.41 | $103.53 |
| Santa Maria, CACalifornia | $295.88 | $103.10 |
| Santa Rosa, CACalifornia | $307.41 | $104.38 |
| Stockton, CACalifornia | $282.27 | $101.07 |
| Vallejo, CACalifornia | $324.52 | $106.61 |
| Visalia, CACalifornia | $282.27 | $101.07 |
| Yuba City, CACalifornia | $282.27 | $101.07 |
| ColoradoColorado | $281.37 | $105.46 |
| ConnecticutConnecticut | $293.62 | $115.56 |
| DelawareDelaware | $269.50 | $106.15 |
| Fort Lauderdale, FLFlorida | $293.48 | $126.00 |
| Rest of FloridaFlorida | $276.39 | $118.33 |
| Atlanta, GAGeorgia | $281.06 | $113.08 |
| Rest of GeorgiaGeorgia | $257.88 | $110.40 |
| Hawaii, Guam, HIHawaii | $289.58 | $101.60 |
| IdahoIdaho | $247.42 | $95.31 |
| East St. Louis, ILIllinois | $280.87 | $128.76 |
| Rest of IllinoisIllinois | $269.79 | $118.84 |
| Suburban Chicago, ILIllinois | $295.75 | $125.95 |
| IndianaIndiana | $248.98 | $95.72 |
| KansasKansas | $245.15 | $95.69 |
| KentuckyKentucky | $251.32 | $104.33 |
| New Orleans, LALouisiana | $265.67 | $110.09 |
| Rest of LouisianaLouisiana | $251.52 | $105.19 |
| Metropolitan Boston, MAMassachusetts | $309.60 | $112.19 |
| Rest of MassachusettsMassachusetts | $279.97 | $105.88 |
| Baltimore area, MDMaryland | $293.20 | $115.80 |
| Rest of MarylandMaryland | $274.66 | $107.34 |
| Rest of MaineMaine | $250.65 | $98.54 |
| Southern Maine, MEMaine | $263.89 | $100.04 |
| Detroit, MIMichigan | $282.02 | $122.47 |
| Rest of MichiganMichigan | $260.37 | $109.42 |
| MinnesotaMinnesota | $263.60 | $93.47 |
| Metropolitan Kansas City, MOMissouri | $261.85 | $106.60 |
| Metropolitan St. Louis, MOMissouri | $264.78 | $107.38 |
| Rest of MissouriMissouri | $247.64 | $105.12 |
| MississippiMississippi | $242.35 | $100.00 |
| MontanaMontana | $273.51 | $108.18 |
| North CarolinaNorth Carolina | $253.41 | $99.15 |
| North DakotaNorth Dakota | $260.66 | $95.32 |
| NebraskaNebraska | $245.90 | $93.30 |
| New HampshireNew Hampshire | $278.37 | $106.26 |
| Northern New JerseyNew Jersey | $308.72 | $116.93 |
| Rest of New JerseyNew Jersey | $295.29 | $114.74 |
| New MexicoNew Mexico | $262.67 | $111.06 |
| NevadaNevada | $270.11 | $104.61 |
| NYC suburbs and Long Island, NYNew York | $331.24 | $134.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $298.63 | $117.59 |
| Queens, NYNew York | $320.94 | $125.52 |
| Rest of New YorkNew York | $257.92 | $100.85 |
| OhioOhio | $257.74 | $106.79 |
| OklahomaOklahoma | $249.06 | $101.41 |
| Portland, OROregon | $289.48 | $105.79 |
| Rest of OregonOregon | $266.37 | $101.70 |
| Metropolitan Philadelphia, PAPennsylvania | $286.50 | $114.39 |
| Rest of PennsylvaniaPennsylvania | $257.30 | $105.52 |
| Puerto RicoPuerto Rico | $275.25 | $108.10 |
| Rhode IslandRhode Island | $278.57 | $107.78 |
| South CarolinaSouth Carolina | $256.34 | $103.57 |
| South DakotaSouth Dakota | $259.14 | $93.80 |
| TennesseeTennessee | $246.78 | $96.50 |
| Austin, TXTexas | $281.87 | $106.95 |
| Beaumont, TXTexas | $255.48 | $105.02 |
| Brazoria, TXTexas | $267.67 | $103.82 |
| Dallas, TXTexas | $270.35 | $105.68 |
| Fort Worth, TXTexas | $268.79 | $105.77 |
| Galveston, TXTexas | $269.08 | $104.90 |
| Houston, TXTexas | $280.98 | $116.80 |
| Rest of TexasTexas | $262.08 | $105.18 |
| UtahUtah | $260.32 | $104.90 |
| VirginiaVirginia | $264.05 | $101.52 |
| Virgin Islands, VIUnited States Virgin Islands | $275.25 | $108.10 |
| VermontVermont | $260.99 | $97.31 |
| Rest of WashingtonWashington | $278.99 | $104.89 |
| King County, WAWashington | $314.69 | $111.82 |
| WisconsinWisconsin | $250.81 | $92.42 |
| West VirginiaWest Virginia | $258.85 | $115.17 |
| WyomingWyoming | $267.91 | $102.57 |
36227 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.
$237.12
$317.22
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $309.82 | 1 |
| AL | $241.17 | 1 |
| AR | $237.12 | 1 |
| AZ | $264.73 | 1 |
| CA | $282.27–$352.17 | 29 |
| CO | $281.37 | 1 |
| CT | $293.62 | 1 |
| DC | $312.39 | 1 |
| DE | $269.50 | 1 |
| FL | $276.39–$314.28 | 3 |
| GA | $257.88–$281.06 | 2 |
| GU | $289.58 | 1 |
| HI | $289.58 | 1 |
| IA | $244.85 | 1 |
| ID | $247.42 | 1 |
| IL | $269.79–$303.06 | 4 |
| IN | $248.98 | 1 |
| KS | $245.15 | 1 |
| KY | $251.32 | 1 |
| LA | $251.52–$265.67 | 2 |
| MA | $279.97–$309.60 | 2 |
| MD | $274.66–$312.39 | 3 |
| ME | $250.65–$263.89 | 2 |
| MI | $260.37–$282.02 | 2 |
| MN | $263.60 | 1 |
| MO | $247.64–$264.78 | 3 |
| MS | $242.35 | 1 |
| MT | $273.51 | 1 |
| NC | $253.41 | 1 |
| ND | $260.66 | 1 |
| NE | $245.90 | 1 |
| NH | $278.37 | 1 |
| NJ | $295.29–$308.72 | 2 |
| NM | $262.67 | 1 |
| NV | $270.11 | 1 |
| NY | $257.92–$331.24 | 5 |
| OH | $257.74 | 1 |
| OK | $249.06 | 1 |
| OR | $266.37–$289.48 | 2 |
| PA | $257.30–$286.50 | 2 |
| PR | $275.25 | 1 |
| RI | $278.57 | 1 |
| SC | $256.34 | 1 |
| SD | $259.14 | 1 |
| TN | $246.78 | 1 |
| TX | $255.48–$281.87 | 8 |
| UT | $260.32 | 1 |
| VA | $264.05–$312.39 | 2 |
| VI | $275.25 | 1 |
| VT | $260.99 | 1 |
| WA | $278.99–$314.69 | 2 |
| WI | $250.81 | 1 |
| WV | $258.85 | 1 |
| WY | $267.91 | 1 |
How the 36227 rate is calculated
Each of 36227’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 · 36227
RVUs × geographic indexes × conversion factor
Work2.04
2.04 RVUs× 1.000 GPCI
Practice expense5.50
5.50 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
8.1900
Conversion factor
$33.4009
Medicare rate
$273.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,453
- Code
- 36227
- Physician work
- 2.04
- Practice expense
- 5.50
- Malpractice
- 0.65
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.04 | × 1.000 | 2.0400 |
| Practice expense | 5.50 | × 0.915 | 5.0325 |
| Malpractice | 0.65 | × 0.397 | 0.2581 |
| Total RVUs | 7.3306 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$244.85
Office: (2.04 × 1 + 5.5 × 0.915 + 0.65 × 0.397) × $33.4009 = $244.85
Facility: (2.04 × 1 + 0.55 × 0.915 + 0.65 × 0.397) × $33.4009 = $93.57
Payment rules and modifiers for 36227
The CMS indicators that decide how 36227 is paid alongside other services.
CMS payment indicators · 36227
External carotid angiography, selective placement, unilateral
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
36227 without 50 · national office
$273.55
External carotid angiography, selective placement, unilateral
36227-50 · Bilateral: 150%
$410.33
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).
How 36227 has changed in Iowa
36227 · Office / nonfacility
$244.85
Effective 2026-10-01
The base rate is $33.27 higher than on 2025-10-01, moving from $211.58 to $244.85 (15.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$211.58changed to$244.85
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.09 changed to 2.04
- Practice expense RVU 4.56 changed to 5.50
- Malpractice RVU 0.63 changed to 0.65
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$217.74changed to$211.58
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$214.19changed to$217.74
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$219.03changed to$214.19
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.52 changed to 4.56
- Malpractice RVU 0.59 changed to 0.63
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$218.67changed to$219.03
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.40 changed to 4.52
- Malpractice RVU 0.56 changed to 0.59
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$228.12changed to$218.67
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.66 changed to 4.40
- Malpractice RVU 0.52 changed to 0.56
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$230.86changed to$228.12
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.51 changed to 4.66
- Malpractice RVU 0.51 changed to 0.52
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$234.09changed to$230.86
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.61 changed to 4.51
- Malpractice RVU 0.53 changed to 0.51
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$236.79changed to$234.09
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.71 changed to 4.61
- Malpractice RVU 0.51 changed to 0.53
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$232.46changed to$236.79
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.61 changed to 4.71
- Malpractice RVU 0.50 changed to 0.51
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$231.80changed to$232.46
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.64 changed to 4.61
- Malpractice RVU 0.46 changed to 0.50
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$240.93changed to$231.80
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.87 changed to 4.64
- Malpractice RVU 0.51 changed to 0.46
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$239.73changed to$240.93
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$228.58changed to$239.73
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 4.64 changed to 4.87
- Malpractice RVU 0.32 changed to 0.51
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$226.52changed to$228.58
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 4.98 changed to 4.64
- Malpractice RVU 0.33 changed to 0.32
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $226.52
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $244.85 | $93.57 | RVU26D |
| 2026-07-01 | $244.85 | $93.57 | RVU26C |
| 2026-04-01 | $244.85 | $93.57 | RVU26B |
| 2026-01-01 | $244.85 | $93.57 | RVU26A |
| 2025-10-01 | $211.58 | $103.20 | RVU25D |
| 2025-07-01 | $211.58 | $103.20 | RVU25C |
| 2025-04-01 | $211.58 | $103.20 | RVU25B |
| 2025-01-01 | $211.58 | $103.20 | RVU25A |
| 2024-10-01 | $217.74 | $105.29 | RVU24D |
| 2024-07-01 | $217.74 | $105.29 | RVU24C |
| 2024-04-01 | $217.74 | $105.29 | RVU24B |
| 2024-03-09 | $217.74 | $105.29 | RVU24AR |
| 2024-01-01 | $214.19 | $103.57 | RVU24A |
| 2023-10-01 | $219.03 | $106.16 | RVU23D |
| 2023-07-01 | $219.03 | $106.16 | RVU23C |
| 2023-04-01 | $219.03 | $106.16 | RVU23B |
| 2023-01-01 | $219.03 | $106.16 | RVU23A |
| 2022-10-01 | $218.67 | $106.93 | RVU22D |
| 2022-07-01 | $218.67 | $106.93 | RVU22C |
| 2022-04-01 | $218.67 | $106.93 | RVU22B |
| 2022-01-01 | $218.67 | $106.93 | RVU22A |
| 2021-10-01 | $228.12 | $106.91 | RVU21D |
| 2021-07-01 | $228.12 | $106.91 | RVU21C |
| 2021-04-01 | $228.12 | $106.91 | RVU21B |
| 2021-01-01 | $228.12 | $106.91 | RVU21A |
| 2020-10-01 | $230.86 | $109.75 | RVU20D |
| 2020-07-01 | $230.86 | $109.75 | RVU20C |
| 2020-04-01 | $230.86 | $109.75 | RVU20B |
| 2020-01-01 | $230.86 | $109.75 | RVU20A |
| 2019-10-01 | $234.09 | $109.22 | RVU19D |
| 2019-07-01 | $234.09 | $109.22 | RVU19C |
| 2019-04-01 | $234.09 | $109.22 | RVU19B |
| 2019-01-01 | $234.09 | $109.22 | RVU19A |
| 2018-10-01 | $236.79 | $108.47 | RVU18D |
| 2018-07-01 | $236.79 | $108.47 | RVU18C |
| 2018-04-01 | $236.79 | $108.47 | RVU18B |
| 2018-01-01 | $236.79 | $108.47 | RVU18AR1 |
| 2017-10-01 | $232.46 | $108.80 | RVU17D |
| 2017-07-01 | $232.46 | $108.80 | RVU17C |
| 2017-04-01 | $232.46 | $108.80 | RVU17B |
| 2017-01-01 | $232.46 | $108.80 | RVU17A |
| 2016-10-01 | $231.80 | $107.65 | RVU16D |
| 2016-07-01 | $231.80 | $107.65 | RVU16C |
| 2016-04-01 | $231.80 | $107.65 | RVU16B |
| 2016-01-01 | $231.80 | $107.65 | RVU16A |
| 2015-10-01 | $240.93 | $109.57 | RVU15D |
| 2015-07-01 | $240.93 | $109.57 | RVU15C |
| 2015-04-01 | $239.73 | $109.03 | RVU15B |
| 2015-01-01 | $239.73 | $109.03 | RVU15A |
| 2014-10-01 | $228.58 | $104.92 | RVU14D |
| 2014-07-01 | $228.58 | $104.92 | RVU14C |
| 2014-04-01 | $228.58 | $104.92 | RVU14B |
| 2014-01-01 | $228.58 | $104.92 | RVU14A |
| 2013-10-01 | $226.52 | $100.37 | RVU13D |
| 2013-07-01 | $226.52 | $100.37 | RVU13C |
| 2013-04-01 | $226.52 | $100.37 | RVU13B |
| 2013-01-01 | $226.52 | $100.37 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
36227 billing questions
Can 36227 be reported by itself?
No. It is an add-on code and must be reported with an eligible primary cervicocerebral angiography procedure.
How is 36227 different from 36224?
36227 describes selective catheter placement and angiography of the external carotid circulation. 36224 concerns selective placement in the internal carotid artery and angiography of its circulation.
Does 36227 include the angiographic imaging?
Yes. Angiography of the external carotid circulation is part of the service, including intracranial imaging when performed.
How should bilateral external carotid studies be reported?
For a bilateral procedure, use modifier 50 as applicable. CMS pays 150% for the bilateral procedure.
What documentation supports reporting 36227?
Document the external carotid artery selectively catheterized, the angiography performed, and the clinical reason and findings for the study.
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
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