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CPT code 36247: Selective catheterization, third order or beyond2026 Medicare rate & RVUs in Puerto Rico

Reports selective catheter advancement into a third-order-or-more abdominal, pelvic, or lower-extremity artery branch during angiography or endovascular treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality65.6K Medicare services in 2024

In Puerto Rico, Medicare pays $1,367.97 for 36247 in the office and $258.68 when it’s performed in a hospital or facility.

$1,367.97Office (non-facility)
$258.68Hospital or facility
+0.9%vs the national office rate ($1,356.08)

Check a contract rate as a % of Medicare · 36247 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 36247 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 36247 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 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.

How Puerto Rico compares for 36247

Across 109 of 109 payment localities, the office rate for 36247 runs from $1,181.23 in Arkansas to $1,860.19 in San Benito County, CA. Puerto Rico pays $1,367.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

36247 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,367.97
  2. Los Angeles, CA · California$1,559.14+$191.17
  3. Washington, DC area · District of Columbia$1,570.91+$202.94
  4. Miami, FL · Florida$1,452.81+$84.84
  5. Chicago, IL · Illinois$1,405.91+$37.94
  6. Manhattan, NY · New York$1,570.50+$202.53
  7. Alaska · Alaska$1,512.80+$144.83

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

Every other payment area

36247 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,200.94$240.87
ArkansasArkansas$1,181.23$238.72
ArizonaArizona$1,316.40$253.19
Bakersfield, CACalifornia$1,455.01$252.46
Chico, CACalifornia$1,452.20$249.65
El Centro, CACalifornia$1,452.37$249.81
Fresno, CACalifornia$1,452.20$249.65
Hanford, CACalifornia$1,452.20$249.65

36247 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.

$1,181.23

$1,656.20

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

View every state and territory as a table
36247 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,512.801
AL$1,200.941
AR$1,181.231
AZ$1,316.401
CA$1,452.20–$1,860.1929
CO$1,423.281
CT$1,453.681
DC$1,570.911
DE$1,340.211
FL$1,323.15–$1,452.813
GA$1,240.79–$1,381.332
GU$1,496.461
HI$1,496.461
IA$1,240.401
ID$1,248.551
IL$1,276.71–$1,413.394
IN$1,256.861
KS$1,231.551
KY$1,228.251
LA$1,225.17–$1,294.122
MA$1,412.20–$1,579.002
MD$1,368.85–$1,570.913
ME$1,253.47–$1,333.742
MI$1,262.36–$1,339.342
MN$1,365.461
MO$1,199.79–$1,302.083
MS$1,190.891
MT$1,356.011
NC$1,268.681
ND$1,336.431
NE$1,248.791
NH$1,398.121
NJ$1,470.77–$1,550.922
NM$1,269.241
NV$1,351.681
NY$1,289.94–$1,609.875
OH$1,258.351
OK$1,228.191
OR$1,341.75–$1,475.782
PA$1,261.90–$1,412.182
PR$1,367.971
RI$1,393.411
SC$1,265.521
SD$1,334.121
TN$1,238.281
TX$1,252.36–$1,418.028
UT$1,285.131
VA$1,327.21–$1,570.912
VI$1,367.971
VT$1,328.481
WA$1,410.42–$1,615.532
WI$1,285.891
WV$1,222.791
WY$1,347.481

See 36247 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,457

Code
36247
Physician work
5.89
Practice expense
33.72
Malpractice
0.99

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 36247 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work5.89× 1.0005.8900
Practice expense33.72× 1.01134.0909
Malpractice0.99× 0.9850.9751
Total RVUs40.9561
Conversion factor× 33.4009

Office rate, Puerto Rico$1367.97

Office: (5.89 × 1 + 33.72 × 1.011 + 0.99 × 0.985) × $33.4009 = $1367.97

Facility: (5.89 × 1 + 0.87 × 1.011 + 0.99 × 0.985) × $33.4009 = $258.68

Open 36247 in the RVU calculator

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

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

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).

When to use modifier 50

Codes related to 36247

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

Codes related to 36247
CodeHow it relatesOffice range, Puerto Rico
Same family
36245Selective catheterization, first-order abdominal or leg branchFor selective catheter placement in a first-order abdominal, pelvic, or lower-extremity branch.$1,209.53
36246Selective catheterization, second-order branchFor selective catheter placement in a second-order branch in the same arterial territory.$804.02
Add-on codes
36248Selective catheterization, additional abdominal or limb branchAdd-on code for each additional qualifying selective branch in the vascular family.$113.00

How 36247 has changed in Puerto Rico

36247 · Office / nonfacility

$1367.97

Effective 2026-10-01

The base rate is $51.26 higher than on 2025-10-01, moving from $1316.71 to $1367.97 (3.9%).

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

    $1316.71changed to$1367.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.04 changed to 5.89
    • Practice expense RVU 33.46 changed to 33.72
    • 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

    $1397.55changed to$1316.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 34.69 changed to 33.46
    • Malpractice RVU 1.03 changed to 0.99

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1374.74changed to$1397.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1458.48changed to$1374.74

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 35.71 changed to 34.69
    • Malpractice RVU 1.02 changed to 1.03
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $1449.36changed to$1458.48

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

  6. January 1, 2023

    RVU23A

    $1535.54changed to$1449.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 37.03 changed to 35.71
    • 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

    $1599.62changed to$1535.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 38.48 changed to 37.03
    • Malpractice RVU 1.03 changed to 1.02

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $1570.15changed to$1599.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 36.17 changed to 38.48
    • Malpractice RVU 1.02 changed to 1.03
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $1543.86changed to$1570.15

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 35.53 changed to 36.17
    • Malpractice RVU 1.03 changed to 1.02
    • 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

    $1538.90changed to$1543.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 35.44 changed to 35.53

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $1327.25changed to$1538.90

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 35.36 changed to 35.44
    • Malpractice RVU 1.05 changed to 1.03
    • 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

    $1185.95changed to$1327.25

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 6.29 changed to 6.04
    • Practice expense RVU 37.60 changed to 35.36
    • Malpractice RVU 1.11 changed to 1.05
    • 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

    $1187.26changed to$1185.95

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 37.47 changed to 37.60
    • Malpractice RVU 1.14 changed to 1.11

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $1181.35changed to$1187.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $1164.66changed to$1181.35

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 37.45 changed to 37.47
    • Malpractice RVU 1.13 changed to 1.14
    • 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

    $1183.15changed to$1164.66

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 41.58 changed to 37.45
    • Malpractice RVU 1.18 changed to 1.13
    • 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: $1183.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,367.97$258.68RVU26D
2026-07-01$1,367.97$258.68RVU26C
2026-04-01$1,367.97$258.68RVU26B
2026-01-01$1,367.97$258.68RVU26A
2025-10-01$1,316.71$281.54RVU25D
2025-07-01$1,316.71$281.54RVU25C
2025-04-01$1,316.71$281.54RVU25B
2025-01-01$1,316.71$281.54RVU25A
2024-10-01$1,397.55$289.03RVU24D
2024-07-01$1,397.55$289.03RVU24C
2024-04-01$1,397.55$289.03RVU24B
2024-03-09$1,397.55$289.03RVU24AR
2024-01-01$1,374.74$284.31RVU24A
2023-10-01$1,458.48$294.71RVU23D
2023-07-01$1,449.36$294.82RVU23C
2023-04-01$1,449.36$294.82RVU23B
2023-01-01$1,449.36$294.82RVU23A
2022-10-01$1,535.54$300.68RVU22D
2022-07-01$1,535.54$300.68RVU22C
2022-04-01$1,535.54$300.68RVU22B
2022-01-01$1,535.54$300.68RVU22A
2021-10-01$1,599.62$304.23RVU21D
2021-07-01$1,599.62$304.23RVU21C
2021-04-01$1,599.62$304.23RVU21B
2021-01-01$1,599.62$304.23RVU21A
2020-10-01$1,570.15$315.83RVU20D
2020-07-01$1,570.15$315.83RVU20C
2020-04-01$1,570.15$315.83RVU20B
2020-01-01$1,570.15$315.83RVU20A
2019-10-01$1,543.86$316.48RVU19D
2019-07-01$1,543.86$316.48RVU19C
2019-04-01$1,543.86$316.48RVU19B
2019-01-01$1,543.86$316.48RVU19A
2018-10-01$1,538.90$317.22RVU18D
2018-07-01$1,538.90$317.22RVU18C
2018-04-01$1,538.90$317.22RVU18B
2018-01-01$1,538.90$317.22RVU18AR1
2017-10-01$1,327.25$295.64RVU17D
2017-07-01$1,327.25$295.64RVU17C
2017-04-01$1,327.25$295.64RVU17B
2017-01-01$1,327.25$295.64RVU17A
2016-10-01$1,185.95$284.56RVU16D
2016-07-01$1,185.95$284.56RVU16C
2016-04-01$1,185.95$284.56RVU16B
2016-01-01$1,185.95$284.56RVU16A
2015-10-01$1,187.26$285.90RVU15D
2015-07-01$1,187.26$285.90RVU15C
2015-04-01$1,181.35$284.48RVU15B
2015-01-01$1,181.35$284.48RVU15A
2014-10-01$1,164.66$284.14RVU14D
2014-07-01$1,164.66$284.14RVU14C
2014-04-01$1,164.66$284.14RVU14B
2014-01-01$1,164.66$284.14RVU14A
2013-10-01$1,183.15$271.75RVU13D
2013-07-01$1,183.15$271.75RVU13C
2013-04-01$1,183.15$271.75RVU13B
2013-01-01$1,183.15$271.75RVU13AR

Price 36247 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

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
RVUs for 36247PPRRVU2026_Oct_nonQPP.csv, line 4,457 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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