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

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, 2026One payment locality2K Medicare services in 2024

In Puerto Rico, Medicare pays $1,555.31 for 36228 in the office and $224.50 when it’s performed in a hospital or facility.

$1,555.31Office (non-facility)
$224.50Hospital or facility
+0.9%vs the national office rate ($1,541.12)

Check a contract rate as a % of Medicare · 36228 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 36228 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36228 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 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.

How Puerto Rico compares for 36228

Across 109 of 109 payment localities, the office rate for 36228 runs from $1,326.89 in Arkansas to $2,133.11 in San Benito County, CA. Puerto Rico pays $1,555.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

36228 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,555.31
  2. Los Angeles, CA · California$1,778.72+$223.41
  3. Washington, DC area · District of Columbia$1,795.19+$239.88
  4. Miami, FL · Florida$1,669.71+$114.40
  5. Chicago, IL · Illinois$1,610.71+$55.40
  6. Manhattan, NY · New York$1,797.48+$242.17
  7. Alaska · Alaska$1,676.89+$121.58

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

Every other payment area

36228 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,351.00$199.22
ArkansasArkansas$1,326.89$196.16
ArizonaArizona$1,492.23$216.71
Bakersfield, CACalifornia$1,655.16$212.46
Chico, CACalifornia$1,651.39$208.70
El Centro, CACalifornia$1,651.63$208.93
Fresno, CACalifornia$1,651.39$208.70
Hanford, CACalifornia$1,651.39$208.70

36228 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.

$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

See 36228 in every payment locality

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,454

Code
36228
Physician work
4.14
Practice expense
40.57
Malpractice
1.43

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36228 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.14× 1.0004.1400
Practice expense40.57× 1.01141.0163
Malpractice1.43× 0.9851.4085
Total RVUs46.5648
Conversion factor× 33.4009

Office rate, Puerto Rico$1555.31

Office: (4.14 × 1 + 40.57 × 1.011 + 1.43 × 0.985) × $33.4009 = $1555.31

Facility: (4.14 × 1 + 1.16 × 1.011 + 1.43 × 0.985) × $33.4009 = $224.50

Open 36228 in the RVU calculator

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

Codes related to 36228

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

Codes related to 36228
CodeHow it relatesOffice range, Puerto Rico
Primary code
36224Carotid angiography, internal carotid, both circulationsCommon primary internal carotid angiography service for an additional intracranial branch.$2,372.34
36226Vertebral angiography, direct vertebral selectionCommon primary vertebral artery angiography service for an additional intracranial branch.$2,307.20
Same family
36223Carotid angiography, ipsilateral intracranial circulationCervicocerebral angiography code with intracranial imaging from carotid or innominate catheter placement.$1,933.07
36227External carotid angiography, selective placement, unilateralCervicocerebral angiography code for selective external carotid catheterization and imaging.$275.25

How 36228 has changed in Puerto Rico

36228 · Office / nonfacility

$1555.31

Effective 2026-10-01

The base rate is $298.45 higher than on 2025-10-01, moving from $1256.86 to $1555.31 (23.7%).

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

    $1256.86changed to$1555.31

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.25 changed to 4.14
    • Practice expense RVU 33.01 changed to 40.57
    • Malpractice RVU 1.39 changed to 1.43
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1288.75changed to$1256.86

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 32.90 changed to 33.01
    • Malpractice RVU 1.36 changed to 1.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1267.72changed to$1288.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1290.02changed to$1267.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 32.30 changed to 32.90
    • Malpractice RVU 1.28 changed to 1.36
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $1281.95changed to$1290.02

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $1332.20changed to$1281.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 32.82 changed to 32.30
    • Malpractice RVU 1.18 changed to 1.28
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $1396.40changed to$1332.20

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 34.39 changed to 32.82
    • Malpractice RVU 1.12 changed to 1.18

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $1368.37changed to$1396.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 32.35 changed to 34.39
    • Malpractice RVU 1.07 changed to 1.12
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $1364.24changed to$1368.37

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 32.25 changed to 32.35
    • Malpractice RVU 1.14 changed to 1.07
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $1360.23changed to$1364.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 32.22 changed to 32.25
    • Malpractice RVU 1.10 changed to 1.14

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $1127.30changed to$1360.23

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 30.95 changed to 32.22
    • Malpractice RVU 1.04 changed to 1.10
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $906.02changed to$1127.30

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 29.47 changed to 30.95
    • Malpractice RVU 0.95 changed to 1.04
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $939.26changed to$906.02

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 30.62 changed to 29.47
    • Malpractice RVU 1.03 changed to 0.95

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $934.59changed to$939.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $860.50changed to$934.59

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 28.32 changed to 30.62
    • Malpractice RVU 0.64 changed to 1.03
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $850.84changed to$860.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 30.37 changed to 28.32
    • Malpractice RVU 0.67 changed to 0.64
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $850.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,555.31$224.50RVU26D
2026-07-01$1,555.31$224.50RVU26C
2026-04-01$1,555.31$224.50RVU26B
2026-01-01$1,555.31$224.50RVU26A
2025-10-01$1,256.86$241.56RVU25D
2025-07-01$1,256.86$241.56RVU25C
2025-04-01$1,256.86$241.56RVU25B
2025-01-01$1,256.86$241.56RVU25A
2024-10-01$1,288.75$245.26RVU24D
2024-07-01$1,288.75$245.26RVU24C
2024-04-01$1,288.75$245.26RVU24B
2024-03-09$1,288.75$245.26RVU24AR
2024-01-01$1,267.72$241.26RVU24A
2023-10-01$1,290.02$245.80RVU23D
2023-07-01$1,281.95$246.02RVU23C
2023-04-01$1,281.95$246.02RVU23B
2023-01-01$1,281.95$246.02RVU23A
2022-10-01$1,332.20$246.99RVU22D
2022-07-01$1,332.20$246.99RVU22C
2022-04-01$1,332.20$246.99RVU22B
2022-01-01$1,332.20$246.99RVU22A
2021-10-01$1,396.40$246.97RVU21D
2021-07-01$1,396.40$246.97RVU21C
2021-04-01$1,396.40$246.97RVU21B
2021-01-01$1,396.40$246.97RVU21A
2020-10-01$1,368.37$251.92RVU20D
2020-07-01$1,368.37$251.92RVU20C
2020-04-01$1,368.37$251.92RVU20B
2020-01-01$1,368.37$251.92RVU20A
2019-10-01$1,364.24$253.36RVU19D
2019-07-01$1,364.24$253.36RVU19C
2019-04-01$1,364.24$253.36RVU19B
2019-01-01$1,364.24$253.36RVU19A
2018-10-01$1,360.23$251.65RVU18D
2018-07-01$1,360.23$251.65RVU18C
2018-04-01$1,360.23$251.65RVU18B
2018-01-01$1,360.23$251.65RVU18AR1
2017-10-01$1,127.30$226.56RVU17D
2017-07-01$1,127.30$226.56RVU17C
2017-04-01$1,127.30$226.56RVU17B
2017-01-01$1,127.30$226.56RVU17A
2016-10-01$906.02$202.27RVU16D
2016-07-01$906.02$202.27RVU16C
2016-04-01$906.02$202.27RVU16B
2016-01-01$906.02$202.27RVU16A
2015-10-01$939.26$204.35RVU15D
2015-07-01$939.26$204.35RVU15C
2015-04-01$934.59$203.33RVU15B
2015-01-01$934.59$203.33RVU15A
2014-10-01$860.50$197.38RVU14D
2014-07-01$860.50$197.38RVU14C
2014-04-01$860.50$197.38RVU14B
2014-01-01$860.50$197.38RVU14A
2013-10-01$850.84$188.10RVU13D
2013-07-01$850.84$188.10RVU13C
2013-04-01$850.84$188.10RVU13B
2013-01-01$850.84$188.10RVU13AR

Price 36228 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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