CPT code 36247: Selective catheterization, third order or beyond2026 Medicare rate & RVUs in California
Reports selective catheter advancement into a third-order-or-more abdominal, pelvic, or lower-extremity artery branch during angiography or endovascular treatment.
Medicare pays $1,452.20–$1,860.19 for 36247 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 36247 covers
This service covers selective catheter advancement into a third-order-or-more branch of the abdominal, pelvic, or lower-extremity arterial system. Interventional radiologists, vascular surgeons, and other physicians performing catheter-based vascular care may report it during peripheral angiography, embolization, or endovascular treatment for conditions such as peripheral arterial disease or bleeding. The code represents catheter selection, not the imaging study or the therapeutic work itself.
Choose the code based on the order of the branch reached within its vascular family and the most selective catheter position documented. It represents the initial third-order-or-more selection; additional qualifying branch selections may be reported with 36248. Document the artery entered, its branch order, catheter position, and any additional selections. Diagnostic imaging or treatment may be separately reportable when supported by the applicable coding rules. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment is restricted; 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 36247 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$1452.20 to $1860.19
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $1,455.01 | $252.46 |
| Chico, CA | $1,452.20 | $249.65 |
| El Centro, CA | $1,452.37 | $249.81 |
| Fresno, CA | $1,452.20 | $249.65 |
| Hanford, CA | $1,452.20 | $249.65 |
| Los Angeles, CA | $1,559.14 | $261.13 |
| Madera, CA | $1,452.20 | $249.65 |
| Marin County, CA | $1,818.65 | $271.57 |
| Merced, CA | $1,452.20 | $249.65 |
| Modesto, CA | $1,452.20 | $249.65 |
| Napa, CA | $1,710.36 | $264.22 |
| Oxnard, CA | $1,554.10 | $257.19 |
| Redding, CA | $1,452.20 | $249.65 |
| Rest of California | $1,452.20 | $249.65 |
| Riverside, CA | $1,462.88 | $260.33 |
| Sacramento, CA | $1,531.40 | $255.33 |
| Salinas, CA | $1,525.91 | $254.23 |
| San Benito County, CA | $1,860.19 | $278.00 |
| San Diego, CA | $1,567.58 | $255.31 |
| San Francisco, CA | $1,817.53 | $270.45 |
| San Luis Obispo, CA | $1,500.63 | $250.90 |
| Santa Clara County, CA | $1,855.59 | $273.40 |
| Santa Cruz, CA | $1,587.01 | $253.89 |
| Santa Maria, CA | $1,533.20 | $253.85 |
| Santa Rosa, CA | $1,603.43 | $256.04 |
| Stockton, CA | $1,452.20 | $249.65 |
| Vallejo, CA | $1,708.74 | $262.60 |
| Visalia, CA | $1,452.20 | $249.65 |
| Yuba City, CA | $1,452.20 | $249.65 |
How the 36247 rate is calculated
Each of 36247’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 · 36247
RVUs × geographic indexes × conversion factor
Work5.89
5.89 RVUs× 1.000 GPCI
Practice expense33.72
33.72 RVUs× 1.000 GPCI
Malpractice0.99
0.99 RVUs× 1.000 GPCI
Adjusted RVUs
40.6000
Conversion factor
$33.4009
Medicare rate
$1,356.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36247
The CMS indicators that decide how 36247 is paid alongside other services.
CMS payment indicators · 36247
Selective catheterization, third order or beyond
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
36247 without 50 · national office
$1,356.08
Selective catheterization, third order or beyond
36247-50 · Bilateral: 150%
$2,034.12
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).
36247 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36245Selective catheterizationFirst-order abdominal or leg branch
- Use 36245 for first-order branch selection; this code requires catheter advancement to a third-order-or-more branch.
- 36246Selective catheterizationSecond-order branch
- Use 36246 when the selected branch is second order. This code applies when the catheter reaches a third-order-or-more branch.
- 36248Selective catheterizationAdditional abdominal or limb branch
- 36248 reports additional qualifying branch selections. This code represents the initial third-order-or-more selection.
- 36200Aortic catheterizationNonselective placement
- 36200 describes nonselective catheter placement in the aorta. This code requires selective advancement into a distal arterial branch.
36247 billing questions
How do I distinguish this code from 36246?
Use 36246 when the catheter reaches a second-order branch. Use 36247 when it is advanced into a third-order-or-more branch within the vascular family.
When is 36248 reported with this code?
Report 36248 for each additional qualifying second-order-or-more selective branch reached within the same vascular family, when supported by the procedure documentation.
Does this code include angiographic imaging or treatment?
No. It represents selective catheter placement. Angiography or an endovascular treatment may be separately reportable when the service and documentation meet the applicable coding requirements.
What should the catheterization report document?
Identify the artery reached, its branch order within the vascular family, the catheter position, and any additional branches selected.
How does Medicare handle bilateral work and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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