CPT code 36246: Selective catheterization, second-order branch2026 Medicare rate & RVUs

Medicare pays $797.95 for 36246 nationally in the office and $221.45 in a hospital or facility. Local office rates run $696.40–$1,064.64.

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

What 36246 covers

This service covers advancing a catheter selectively into a second-order branch of the abdominal, pelvic, or lower-extremity arterial system. Interventional radiologists, vascular surgeons, and other physicians performing vascular procedures may use it to reach a target branch for diagnostic angiography or endovascular treatment in an angiography suite, catheterization laboratory, or operating room.

Choose the code according to the most selective branch reached in the vascular family: 36246 represents a second-order selection, while a third-order selection in that family is reported at the higher level. Document the access route, vascular family, target branch, and catheter position; catheter exchanges or imaging runs alone do not establish another selective placement. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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.

Where 36246 pays more and less

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

109 of 109 payment localities

36246 rates by state

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

How the 36246 rate is calculated

Each of 36246’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.

Payment rules and modifiers for 36246

The CMS indicators that decide how 36246 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

36246 compared with similar codes

How to choose

36245Selective catheterizationFirst-order abdominal or leg branch

Use 36245 when the selected abdominal, pelvic, or lower-extremity branch is first order. Use 36246 when the catheter reaches a second-order branch.

36247Selective catheterizationThird order or beyond

Use 36247 when the catheter is advanced to a third-order branch in the vascular family; 36246 represents second-order selection.

36248Selective catheterizationAdditional abdominal or limb branch

36248 is an add-on for additional qualifying branch selections, not the initial second-order placement represented by 36246.

36200Aortic catheterizationNonselective placement

36200 describes placement in the aorta. It does not represent selective catheter positioning in a second-order abdominal, pelvic, or lower-extremity branch.

Codes related to 36246

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

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

Open CMS sourceHow we calculate rates