CPT code 36228: Intracranial catheterization, additional intracranial branch2026 Medicare rate & RVUs

Reports selective catheter placement and angiography of an additional intracranial branch, such as an anterior or middle cerebral artery branch, during cerebral angiography.

CMS RVU26DEffective Oct 1, 2026109 payment localities2K Medicare services in 2024

Medicare pays $1,541.12 for 36228 nationally in the office and $224.79 in a hospital or facility. Local office rates run $1,326.89–$2,133.11.

Medicare rate · 36228

Intracranial catheterization, additional intracranial branch

Office or facility?

Work RVUs
4.14
Total RVUs
46.14
Global days
ZZZ

National rate · 2026

$1,541.12

Office setting, before claim adjustments.

See every locality for 36228 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 36228 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 36228 covers

This add-on describes selective catheterization of an additional second- or third-order intracranial branch within a vascular family, with angiography of the selected vessel and its supplied intracranial branches when performed. Neurointerventional physicians and other physicians performing diagnostic cerebral angiography may use it when they advance the catheter beyond an internal carotid or vertebral artery into a qualifying intracranial branch. The service is commonly performed in a hospital angiography suite.

Report 36228 with the applicable primary angiography service, commonly 36224 for an internal carotid artery study or 36226 for a vertebral artery study; it is not reported alone. Documentation should identify the vascular family, the additional branch selectively catheterized, and the angiography performed. Report the code for each qualifying additional branch. It is an add-on paid within the primary procedure's global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the single-procedure amount.

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 36228 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$1326.89 to $2133.11

$1326.89$1730.00$2133.11
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

36228 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$1,351.00$199.22
Alaska$1,676.89$275.00
Arizona$1,492.23$216.71
Arkansas$1,326.89$196.16
Atlanta, GA$1,572.81$235.42
Austin, TX$1,614.54$221.87
Bakersfield, CA$1,655.16$212.46
Baltimore area, MD$1,653.57$241.15
Beaumont, TX$1,415.77$217.91
Brazoria, TX$1,519.52$215.04

36228 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.

$1,326.89

$1,892.25

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

View every state and territory as a table
36228 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,676.891
AL$1,351.001
AR$1,326.891
AZ$1,492.231
CA$1,651.39–$2,133.1129
CO$1,619.041
CT$1,658.251
DC$1,795.191
DE$1,520.721
FL$1,505.52–$1,669.713
GA$1,403.94–$1,572.812
GU$1,706.651
HI$1,706.651
IA$1,397.131
ID$1,407.541
IL$1,450.12–$1,615.554
IN$1,417.651
KS$1,387.341
KY$1,386.641
LA$1,383.28–$1,467.662
MA$1,605.45–$1,804.422
MD$1,554.84–$1,795.193
ME$1,414.66–$1,511.302
MI$1,429.39–$1,526.462
MN$1,546.791
MO$1,352.88–$1,476.173
MS$1,340.301
MT$1,541.021
NC$1,433.081
ND$1,512.751
NE$1,407.071
NH$1,590.711
NJ$1,675.95–$1,769.892
NM$1,438.251
NV$1,534.501
NY$1,459.18–$1,847.015
OH$1,423.611
OK$1,385.471
OR$1,521.51–$1,681.522
PA$1,427.37–$1,608.382
PR$1,555.311
RI$1,583.301
SC$1,430.971
SD$1,509.401
TN$1,395.691
TX$1,415.77–$1,614.548
UT$1,454.941
VA$1,504.04–$1,795.192
VI$1,555.311
VT$1,503.971
WA$1,603.32–$1,846.892
WI$1,451.151
WV$1,384.191
WY$1,528.701

How the 36228 rate is calculated

Each of 36228’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 · 36228

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.14

4.14 RVUs× 1.000 GPCI

Practice expense40.57

40.57 RVUs× 1.000 GPCI

Malpractice1.43

1.43 RVUs× 1.000 GPCI

Adjusted RVUs

46.1400

Conversion factor

$33.4009

Medicare rate

$1,541.12

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

Payment rules and modifiers for 36228

The CMS indicators that decide how 36228 is paid alongside other services.

CMS payment indicators · 36228

Intracranial catheterization, additional intracranial branch

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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

36228 without 50 · national office

$1,541.12

Intracranial catheterization, additional intracranial branch

36228-50 · Bilateral: 150%

$2,311.68

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

36228 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 36228

    Intracranial catheterization, additional intracranial branch4.14 wRVU

    $1,541.12

  • 36224

    Carotid angiography, internal carotid, both circulations6.09 wRVU

    $2,350.42+$809.30

  • 36226

    Vertebral angiography, direct vertebral selection6.09 wRVU

    $2,285.96+$744.84

  • 36227

    External carotid angiography, selective placement, unilateral2.04 wRVU

    $273.55−$1,267.57

How to choose

36224Carotid angiographyInternal carotid, both circulations
36224 reports the primary internal carotid angiography service. Use 36228 for an additional selective catheter placement into a qualifying intracranial branch within that vascular family.
36226Vertebral angiographyDirect vertebral selection
36226 reports the primary vertebral artery angiography service. Add 36228 when an additional qualifying intracranial branch in that vascular family is selectively catheterized.
36227External carotid angiographySelective placement, unilateral
36227 concerns selective external carotid catheterization and imaging; 36228 concerns an additional intracranial branch within a vascular family.

36228 billing questions

When is 36228 reported instead of 36224 or 36226?

Use 36224 or 36226 for the applicable internal carotid or vertebral artery angiography service. Add 36228 when the catheter is selectively advanced into an additional qualifying intracranial branch within that vascular family.

Can 36228 be billed by itself?

No. It is an add-on code and must be reported with the applicable primary procedure, commonly 36224 or 36226.

How many units of 36228 should be reported?

Report a unit for each qualifying additional second- or third-order intracranial branch selectively catheterized. The record should identify each branch and the angiography performed.

What supports reporting 36228?

Document the parent vascular family, the specific additional intracranial branch entered selectively, and the imaging performed. Imaging branches from a catheter that remains in the internal carotid or vertebral artery alone does not establish this additional selective catheterization.

How is bilateral 36228 handled?

For a bilateral procedure reported with modifier 50, CMS pays 150% of the single-procedure amount. The add-on must still be reported with its applicable primary procedure.

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 36228PPRRVU2026_Oct_nonQPP.csv, line 4,454 (RVU26D)

Open CMS sourceHow we calculate rates

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