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CPT code 36246: Selective catheterization, second-order branch2026 Medicare rate & RVUs in Washington, DC area

Reports selective catheter placement into a second-order abdominal, pelvic, or lower-extremity arterial branch during angiography or endovascular treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality24.1K Medicare services in 2024

In Washington, DC area, Medicare pays $917.45 for 36246 in the office and $238.33 when it’s performed in a hospital or facility.

$917.45Office (non-facility)
$238.33Hospital or facility
+15.0%vs the national office rate ($797.95)

Check a contract rate as a % of Medicare · 36246 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 36246 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 36246 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 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.

How Washington, DC area compares for 36246

Across 109 of 109 payment localities, the office rate for 36246 runs from $696.40 in Arkansas to $1,064.64 in San Benito County, CA. Washington, DC area pays $917.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

36246 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$917.45
  2. Los Angeles, CA · California$902.58−$14.87
  3. Miami, FL · Florida$876.15−$41.30
  4. Chicago, IL · Illinois$847.51−$69.94
  5. Manhattan, NY · New York$926.08+$8.63
  6. Alaska · Alaska$902.84−$14.61
  7. Alabama · Alabama$707.78−$209.67

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

36246 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$696.40$201.19
ArizonaArizona$774.31$215.68
Bakersfield, CACalifornia$844.89$213.05
Chico, CACalifornia$842.01$210.16
El Centro, CACalifornia$842.18$210.34
Fresno, CACalifornia$842.01$210.16
Hanford, CACalifornia$842.01$210.16
Madera, CACalifornia$842.01$210.16

36246 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.

$696.40

$953.33

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

View every state and territory as a table
36246 office rate range by state
State / territoryOffice rate rangeLocalities
AK$902.841
AL$707.781
AR$696.401
AZ$774.311
CA$842.01–$1,064.6429
CO$830.601
CT$854.741
DC$917.451
DE$788.031
FL$789.21–$876.153
GA$739.93–$815.082
GU$865.321
HI$865.321
IA$725.841
ID$731.501
IL$765.53–$847.514
IN$736.151
KS$723.001
KY$728.421
LA$727.53–$767.342
MA$825.22–$917.102
MD$803.90–$917.453
ME$736.73–$779.612
MI$750.31–$801.022
MN$790.641
MO$714.30–$769.243
MS$705.461
MT$797.881
NC$745.121
ND$777.121
NE$729.971
NH$818.151
NJ$863.04–$906.552
NM$755.231
NV$792.691
NY$757.55–$951.775
OH$746.071
OK$725.981
OR$785.13–$858.132
PA$746.86–$832.242
PR$804.021
RI$817.051
SC$747.121
SD$774.661
TN$727.151
TX$741.50–$829.058
UT$758.401
VA$777.44–$917.452
VI$804.021
VT$774.631
WA$823.46–$935.792
WI$748.501
WV$734.521
WY$788.831

See 36246 in every payment locality

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.

How the rate is built · 36246

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.89

4.89 RVUs× 1.000 GPCI

Practice expense17.95

17.95 RVUs× 1.000 GPCI

Malpractice1.05

1.05 RVUs× 1.000 GPCI

Adjusted RVUs

23.8900

Conversion factor

$33.4009

Medicare rate

$797.95

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,456

Code
36246
Physician work
4.89
Practice expense
17.95
Malpractice
1.05

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 36246 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work4.89× 1.0545.1541
Practice expense17.95× 1.17821.1451
Malpractice1.05× 1.1131.1686
Total RVUs27.4678
Conversion factor× 33.4009

Office rate, Washington, DC area$917.45

Office: (4.89 × 1.054 + 17.95 × 1.178 + 1.05 × 1.113) × $33.4009 = $917.45

Facility: (4.89 × 1.054 + 0.69 × 1.178 + 1.05 × 1.113) × $33.4009 = $238.33

Open 36246 in the RVU calculator

Payment rules and modifiers for 36246

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

CMS payment indicators · 36246

Selective catheterization, second-order branch

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

36246 without 50 · national office

$797.95

Selective catheterization, second-order branch

36246-50 · Bilateral: 150%

$1,196.93

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 36246

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

Codes related to 36246
CodeHow it relatesOffice range, Washington, DC area
Same family
36245Selective catheterization, first-order abdominal or leg branchReports first-order placement in an abdominal, pelvic, or lower-extremity arterial family.$1,391.51
36247Selective catheterization, third order or beyondReports third-order placement in the same arterial regions.$1,570.91
Add-on codes
36248Selective catheterization, additional abdominal or limb branchAdd-on code for additional qualifying branch selections in the vascular family.$127.88
Used instead
36200Aortic catheterization, nonselective placementDescribes aortic catheter placement rather than selective second-order branch placement.$654.78

How 36246 has changed in Washington, DC area

36246 · Office / nonfacility

$917.45

Effective 2026-10-01

The base rate is $22.89 higher than on 2025-10-01, moving from $894.56 to $917.45 (2.6%).

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

    $894.56changed to$917.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.02 changed to 4.89
    • Practice expense RVU 17.75 changed to 17.95
    • Malpractice RVU 1.02 changed to 1.05
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $951.91changed to$894.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 18.52 changed to 17.75
    • Malpractice RVU 1.04 changed to 1.02

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $936.38changed to$951.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1004.22changed to$936.38

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 19.05 changed to 18.52
    • Malpractice RVU 0.98 changed to 1.04
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $1073.10changed to$1004.22

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 19.75 changed to 19.05
    • Malpractice RVU 1.01 changed to 0.98
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1097.06changed to$1073.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 20.12 changed to 19.75
    • Malpractice RVU 0.99 changed to 1.01

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1052.58changed to$1097.06

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 18.57 changed to 20.12
    • Malpractice RVU 0.96 changed to 0.99
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1006.58changed to$1052.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.81 changed to 18.57
    • Malpractice RVU 0.97 changed to 0.96
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $984.63changed to$1006.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.34 changed to 17.81
    • Malpractice RVU 0.96 changed to 0.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $983.37changed to$984.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.35 changed to 17.34
    • Malpractice RVU 0.97 changed to 0.96
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1070.41changed to$983.37

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 5.27 changed to 5.02
    • Practice expense RVU 19.13 changed to 17.35
    • Malpractice RVU 1.02 changed to 0.97
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1074.32changed to$1070.41

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 19.11 changed to 19.13
    • Malpractice RVU 1.04 changed to 1.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1068.98changed to$1074.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1061.23changed to$1068.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 19.10 changed to 19.11
    • Malpractice RVU 0.94 changed to 1.04
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1090.68changed to$1061.23

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 21.22 changed to 19.10
    • Malpractice RVU 0.98 changed to 0.94
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1090.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$917.45$238.33RVU26D
2026-07-01$917.45$238.33RVU26C
2026-04-01$917.45$238.33RVU26B
2026-01-01$917.45$238.33RVU26A
2025-10-01$894.56$261.84RVU25D
2025-07-01$894.56$261.84RVU25C
2025-04-01$894.56$261.84RVU25B
2025-01-01$894.56$261.84RVU25A
2024-10-01$951.91$269.44RVU24D
2024-07-01$951.91$269.44RVU24C
2024-04-01$951.91$269.44RVU24B
2024-03-09$951.91$269.44RVU24AR
2024-01-01$936.38$265.04RVU24A
2023-10-01$1,004.22$275.24RVU23D
2023-07-01$1,004.22$275.24RVU23C
2023-04-01$1,004.22$275.24RVU23B
2023-01-01$1,004.22$275.24RVU23A
2022-10-01$1,073.10$285.65RVU22D
2022-07-01$1,073.10$285.65RVU22C
2022-04-01$1,073.10$285.65RVU22B
2022-01-01$1,073.10$285.65RVU22A
2021-10-01$1,097.06$287.54RVU21D
2021-07-01$1,097.06$287.54RVU21C
2021-04-01$1,097.06$287.54RVU21B
2021-01-01$1,097.06$287.54RVU21A
2020-10-01$1,052.58$294.66RVU20D
2020-07-01$1,052.58$294.66RVU20C
2020-04-01$1,052.58$294.66RVU20B
2020-01-01$1,052.58$294.66RVU20A
2019-10-01$1,006.58$293.94RVU19D
2019-07-01$1,006.58$293.94RVU19C
2019-04-01$1,006.58$293.94RVU19B
2019-01-01$1,006.58$293.94RVU19A
2018-10-01$984.63$294.46RVU18D
2018-07-01$984.63$294.46RVU18C
2018-04-01$984.63$294.46RVU18B
2018-01-01$984.63$294.46RVU18AR1
2017-10-01$983.37$296.63RVU17D
2017-07-01$983.37$296.63RVU17C
2017-04-01$983.37$296.63RVU17B
2017-01-01$983.37$296.63RVU17A
2016-10-01$1,070.41$312.79RVU16D
2016-07-01$1,070.41$312.79RVU16C
2016-04-01$1,070.41$312.79RVU16B
2016-01-01$1,070.41$312.79RVU16A
2015-10-01$1,074.32$314.84RVU15D
2015-07-01$1,074.32$314.84RVU15C
2015-04-01$1,068.98$313.28RVU15B
2015-01-01$1,068.98$313.28RVU15A
2014-10-01$1,061.23$308.13RVU14D
2014-07-01$1,061.23$308.13RVU14C
2014-04-01$1,061.23$308.13RVU14B
2014-01-01$1,061.23$308.13RVU14A
2013-10-01$1,090.68$296.28RVU13D
2013-07-01$1,090.68$296.28RVU13C
2013-04-01$1,090.68$296.28RVU13B
2013-01-01$1,090.68$296.28RVU13AR

Price 36246 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

36246 billing questions

How does 36246 differ from 36245 and 36247?

Select 36246 when the catheter reaches a second-order branch in the abdominal, pelvic, or lower-extremity arterial system. Use 36245 for first-order placement and 36247 for third-order placement in the vascular family.

Can angiography or treatment be reported separately?

36246 describes selective catheter placement, not the imaging or treatment itself. Report other services only when they were performed, documented, and separately reportable under their code instructions.

When is 36248 reported with 36246?

36248 is an add-on for an additional qualifying second-order, third-order, or more distal branch selection in the same vascular family. The record should show the additional branch catheterized.

Are units based on catheter exchanges or angiographic runs?

No. Select the code based on the order of the branch reached and the vascular family; a catheter exchange or another imaging run alone is not an additional selective placement.

How is bilateral reporting handled?

For a bilateral procedure, modifier 50 is paid at 150%. The documentation should support selective catheterization on both sides.

Does the code have a postoperative global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

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 36246PPRRVU2026_Oct_nonQPP.csv, line 4,456 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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