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CPT code 36246: Selective catheterization, second-order branch2026 Medicare rate & RVUs in Fort Worth, TX

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 Fort Worth, TX, Medicare pays $786.50 for 36246 in the office and $218.07 when it’s performed in a hospital or facility.

$786.50Office (non-facility)
$218.07Hospital or facility
−1.4%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 Fort Worth, TX
  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 Fort Worth, TX 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. Fort Worth, TX pays $786.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

36246 in Fort Worth, TX vs other payment areas
  1. Fort Worth, TX · this page$786.50
  2. Austin, TX · Texas$829.05+$42.55
  3. Beaumont, TX · Texas$741.50−$45.00
  4. Brazoria, TX · Texas$786.14−$0.36
  5. Dallas, TX · Texas$792.04+$5.54
  6. Galveston, TX · Texas$789.03+$2.53
  7. Houston, TX · Texas$808.24+$21.74

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

Every other payment area

36246 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$763.97$216.87
Los Angeles, CACalifornia$902.58$220.58
Washington, DC areaDistrict of Columbia$917.45$238.33
Miami, FLFlorida$876.15$276.02
Chicago, ILIllinois$847.51$268.12
Manhattan, NYNew York$926.08$256.19
AlaskaAlaska$902.84$288.86
AlabamaAlabama$707.78$203.35

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 Fort Worth, TX 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

100

Locality
Fort Worth, TX
Physician work
1.009
Practice expense
0.986
Malpractice
0.871
Office calculation for 36246 in Fort Worth, TX
ComponentRVULocality factorAdjusted
Physician work4.89× 1.0094.9340
Practice expense17.95× 0.98617.6987
Malpractice1.05× 0.8710.9146
Total RVUs23.5473
Conversion factor× 33.4009

Office rate, Fort Worth, TX$786.50

Office: (4.89 × 1.009 + 17.95 × 0.986 + 1.05 × 0.871) × $33.4009 = $786.50

Facility: (4.89 × 1.009 + 0.69 × 0.986 + 1.05 × 0.871) × $33.4009 = $218.07

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, Fort Worth, TX
Same family
36245Selective catheterization, first-order abdominal or leg branchReports first-order placement in an abdominal, pelvic, or lower-extremity arterial family.$1,182.15
36247Selective catheterization, third order or beyondReports third-order placement in the same arterial regions.$1,337.81
Add-on codes
36248Selective catheterization, additional abdominal or limb branchAdd-on code for additional qualifying branch selections in the vascular family.$110.95
Used instead
36200Aortic catheterization, nonselective placementDescribes aortic catheter placement rather than selective second-order branch placement.$558.24

How 36246 has changed in Fort Worth, TX

36246 · Office / nonfacility

$786.50

Effective 2026-10-01

The base rate is $19.57 higher than on 2025-10-01, moving from $766.93 to $786.50 (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

    $766.93changed to$786.50

    • 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 1.011 changed to 1.009
    • Practice expense GPCI 0.998 changed to 0.986
    • Malpractice GPCI 0.902 changed to 0.871

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $815.42changed to$766.93

    • 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

    $802.11changed to$815.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $839.24changed to$802.11

    • 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 1.013 changed to 1.011
    • Practice expense GPCI 0.996 changed to 0.998
    • Malpractice GPCI 0.721 changed to 0.902

  5. January 1, 2023

    RVU23A

    $875.40changed to$839.24

    • 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 1.016 changed to 1.013
    • Practice expense GPCI 0.995 changed to 0.996
    • Malpractice GPCI 0.539 changed to 0.721

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $895.12changed to$875.40

    • 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

    $869.59changed to$895.12

    • 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 1.011 changed to 1.016
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $841.17changed to$869.59

    • 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 1.007 changed to 1.011
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $823.29changed to$841.17

    • 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

    $824.76changed to$823.29

    • 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 1.006 changed to 1.007
    • Practice expense GPCI 0.991 changed to 0.986
    • Malpractice GPCI 0.760 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $899.34changed to$824.76

    • 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 1.005 changed to 1.006
    • Practice expense GPCI 0.995 changed to 0.991
    • Malpractice GPCI 0.772 changed to 0.760

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $902.42changed to$899.34

    • 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

    $897.93changed to$902.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $891.39changed to$897.93

    • 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 1.002 changed to 1.005
    • Practice expense GPCI 0.987 changed to 0.995
    • Malpractice GPCI 0.799 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $913.65changed to$891.39

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.979 changed to 0.987
    • Malpractice GPCI 0.826 changed to 0.799

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $913.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$786.50$218.07RVU26D
2026-07-01$786.50$218.07RVU26C
2026-04-01$786.50$218.07RVU26B
2026-01-01$786.50$218.07RVU26A
2025-10-01$766.93$237.18RVU25D
2025-07-01$766.93$237.18RVU25C
2025-04-01$766.93$237.18RVU25B
2025-01-01$766.93$237.18RVU25A
2024-10-01$815.42$244.02RVU24D
2024-07-01$815.42$244.02RVU24C
2024-04-01$815.42$244.02RVU24B
2024-03-09$815.42$244.02RVU24AR
2024-01-01$802.11$240.04RVU24A
2023-10-01$839.24$241.16RVU23D
2023-07-01$839.24$241.16RVU23C
2023-04-01$839.24$241.16RVU23B
2023-01-01$839.24$241.16RVU23A
2022-10-01$875.40$241.48RVU22D
2022-07-01$875.40$241.48RVU22C
2022-04-01$875.40$241.48RVU22B
2022-01-01$875.40$241.48RVU22A
2021-10-01$895.12$243.46RVU21D
2021-07-01$895.12$243.46RVU21C
2021-04-01$895.12$243.46RVU21B
2021-01-01$895.12$243.46RVU21A
2020-10-01$869.59$254.44RVU20D
2020-07-01$869.59$254.44RVU20C
2020-04-01$869.59$254.44RVU20B
2020-01-01$869.59$254.44RVU20A
2019-10-01$841.17$258.04RVU19D
2019-07-01$841.17$258.04RVU19C
2019-04-01$841.17$258.04RVU19B
2019-01-01$841.17$258.04RVU19A
2018-10-01$823.29$258.56RVU18D
2018-07-01$823.29$258.56RVU18C
2018-04-01$823.29$258.56RVU18B
2018-01-01$823.29$258.56RVU18AR1
2017-10-01$824.76$259.98RVU17D
2017-07-01$824.76$259.98RVU17C
2017-04-01$824.76$259.98RVU17B
2017-01-01$824.76$259.98RVU17A
2016-10-01$899.34$273.76RVU16D
2016-07-01$899.34$273.76RVU16C
2016-04-01$899.34$273.76RVU16B
2016-01-01$899.34$273.76RVU16A
2015-10-01$902.42$275.30RVU15D
2015-07-01$902.42$275.30RVU15C
2015-04-01$897.93$273.93RVU15B
2015-01-01$897.93$273.93RVU15A
2014-10-01$891.39$272.99RVU14D
2014-07-01$891.39$272.99RVU14C
2014-04-01$891.39$272.99RVU14B
2014-01-01$891.39$272.99RVU14A
2013-10-01$913.65$264.47RVU13D
2013-07-01$913.65$264.47RVU13C
2013-04-01$913.65$264.47RVU13B
2013-01-01$913.65$264.47RVU13AR

Price 36246 for an earlier date of service

Where the Fort Worth, TX rate applies

Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Fort Worth, TXGPCI2026.csv, line 100 (RVU26D)

Open CMS sourceHow we calculate rates

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