CPT code 36253: Renal angiography, second-order or higher, unilateral2026 Medicare rate & RVUs
Reports selective angiography of a second-order or higher renal artery branch on one side when diagnostic imaging requires catheter placement beyond the main renal artery.
Medicare pays $1,897.51 for 36253 nationally in the office and $304.95 in a hospital or facility. Local office rates run $1,653.38–$2,630.62.
Medicare rate · 36253
Renal angiography, second-order or higher, unilateral
- Work RVUs
- 7.12
- Total RVUs
- 56.81
- Global days
- 000
National rate · 2026
$1,897.51
Office setting, before claim adjustments.
See every locality for 36253 →Billed by an NP, PA or therapist? →
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 10 sections
What 36253 covers
This service involves advancing a catheter into a second-order or higher branch of a renal artery on one side, injecting contrast, and obtaining and interpreting angiographic images. Interventional radiologists and other physicians who perform vascular catheter procedures commonly provide it in an angiography suite or catheterization laboratory. The study may assess renal arterial anatomy or suspected renovascular disease, including stenosis or fibromuscular dysplasia.
Select this code when the documented catheterization reaches a second-order or more distal renal arterial branch on one side; the renal angiography service includes the selective catheter placement and its imaging and interpretation. Document the treated side, catheter position, and diagnostic findings. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; use the bilateral renal angiography code when both sides meet its criteria. Assistant-at-surgery payment is restricted, and 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 36253 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$1653.38 to $2630.62
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,680.96 | $287.48 |
| Alaska | $2,109.18 | $413.11 |
| Arizona | $1,842.73 | $299.55 |
| Arkansas | $1,653.38 | $285.37 |
| Atlanta, GA | $1,930.21 | $312.18 |
| Austin, TX | $1,989.19 | $304.26 |
| Bakersfield, CA | $2,047.04 | $301.60 |
| Baltimore area, MD | $2,027.29 | $318.48 |
| Beaumont, TX | $1,748.69 | $299.47 |
| Brazoria, TX | $1,878.27 | $300.05 |
| Chicago, IL | $1,945.38 | $344.87 |
| Chico, CA | $2,044.42 | $298.98 |
| Colorado | $1,998.26 | $303.78 |
| Connecticut | $2,033.97 | $318.79 |
| Dallas, TX | $1,888.95 | $302.77 |
| Delaware | $1,876.16 | $302.72 |
| Detroit, MI | $1,860.61 | $323.79 |
| East St. Louis, IL | $1,796.89 | $331.74 |
| El Centro, CA | $2,044.57 | $299.13 |
| Fort Lauderdale, FL | $1,942.45 | $329.19 |
| Fort Worth, TX | $1,873.03 | $302.77 |
| Fresno, CA | $2,044.42 | $298.98 |
| Galveston, TX | $1,882.94 | $301.53 |
| Hanford, CA | $2,044.42 | $298.98 |
| Hawaii, Guam, HI | $2,108.48 | $297.75 |
| Houston, TX | $1,899.05 | $317.64 |
| Idaho | $1,751.59 | $286.44 |
| Indiana | $1,763.39 | $287.09 |
| Iowa | $1,741.21 | $284.02 |
| Kansas | $1,726.42 | $286.75 |
| Kentucky | $1,714.04 | $298.26 |
| King County, WA | $2,274.09 | $320.03 |
| Los Angeles, CA | $2,195.72 | $311.73 |
| Madera, CA | $2,044.42 | $298.98 |
| Manhattan, NY | $2,194.06 | $343.51 |
| Marin County, CA | $2,572.62 | $327.12 |
| Merced, CA | $2,044.42 | $298.98 |
| Metropolitan Boston, MA | $2,220.30 | $318.79 |
| Metropolitan Kansas City, MO | $1,797.38 | $301.97 |
| Metropolitan Philadelphia, PA | $1,974.30 | $316.45 |
| Metropolitan St. Louis, MO | $1,819.31 | $303.20 |
| Miami, FL | $2,009.29 | $351.44 |
| Minnesota | $1,924.09 | $285.35 |
| Mississippi | $1,663.22 | $292.03 |
| Modesto, CA | $2,044.42 | $298.98 |
| Montana | $1,897.45 | $304.89 |
| Napa, CA | $2,416.46 | $317.47 |
| Nebraska | $1,753.69 | $283.76 |
| Nevada | $1,894.23 | $300.08 |
| New Hampshire | $1,960.67 | $302.82 |
| New Mexico | $1,768.10 | $307.73 |
| New Orleans, LA | $1,805.31 | $306.72 |
| North Carolina | $1,777.66 | $291.81 |
| North Dakota | $1,880.05 | $287.49 |
| Northern New Jersey | $2,175.33 | $327.97 |
| NYC suburbs and Long Island, NY | $2,246.04 | $352.49 |
| Ohio | $1,755.90 | $301.90 |
| Oklahoma | $1,716.51 | $294.36 |
| Oxnard, CA | $2,189.80 | $307.40 |
| Portland, OR | $2,074.75 | $305.42 |
| Poughkeepsie and northern NYC suburbs, NY | $2,069.26 | $325.41 |
| Puerto Rico | $1,915.00 | $304.92 |
| Queens, NY | $2,222.43 | $340.03 |
| Redding, CA | $2,044.42 | $298.98 |
| Rest of California | $2,044.42 | $298.98 |
| Rest of Florida | $1,840.56 | $318.07 |
| Rest of Georgia | $1,727.08 | $306.52 |
| Rest of Illinois | $1,772.22 | $318.21 |
| Rest of Louisiana | $1,708.79 | $299.38 |
| Rest of Maine | $1,755.97 | $290.82 |
| Rest of Maryland | $1,917.04 | $305.37 |
| Rest of Massachusetts | $1,981.75 | $304.79 |
| Rest of Michigan | $1,759.46 | $305.46 |
| Rest of Missouri | $1,671.76 | $298.98 |
| Rest of New Jersey | $2,059.86 | $320.79 |
| Rest of New York | $1,807.26 | $294.33 |
| Rest of Oregon | $1,882.25 | $296.07 |
| Rest of Pennsylvania | $1,762.20 | $300.24 |
| Rest of Texas | $1,811.51 | $300.17 |
| Rest of Washington | $1,979.98 | $303.02 |
| Rhode Island | $1,952.65 | $307.54 |
| Riverside, CA | $2,053.97 | $308.53 |
| Sacramento, CA | $2,158.17 | $306.03 |
| Salinas, CA | $2,150.46 | $304.69 |
| San Benito County, CA | $2,630.62 | $334.15 |
| San Diego, CA | $2,210.72 | $306.02 |
| San Francisco, CA | $2,571.62 | $326.12 |
| San Luis Obispo, CA | $2,114.52 | $300.60 |
| Santa Clara County, CA | $2,626.53 | $330.07 |
| Santa Cruz, CA | $2,239.38 | $304.42 |
| Santa Maria, CA | $2,161.16 | $304.24 |
| Santa Rosa, CA | $2,262.71 | $307.05 |
| South Carolina | $1,769.19 | $297.67 |
| South Dakota | $1,877.99 | $285.43 |
| Southern Maine, ME | $1,871.99 | $293.76 |
| Stockton, CA | $2,044.42 | $298.98 |
| Suburban Chicago, IL | $1,965.88 | $330.33 |
| Tennessee | $1,735.54 | $287.91 |
| Utah | $1,796.69 | $299.69 |
| Vallejo, CA | $2,415.02 | $316.03 |
| Vermont | $1,866.68 | $290.05 |
| Virgin Islands, VI | $1,915.00 | $304.92 |
| Virginia | $1,861.15 | $295.67 |
| Visalia, CA | $2,044.42 | $298.98 |
| Washington, DC area | $2,203.86 | $327.83 |
| West Virginia | $1,696.60 | $312.67 |
| Wisconsin | $1,808.69 | $283.03 |
| Wyoming | $1,889.86 | $297.31 |
| Yuba City, CA | $2,044.42 | $298.98 |
36253 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$1,653.38
$2,337.52
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,109.18 | 1 |
| AL | $1,680.96 | 1 |
| AR | $1,653.38 | 1 |
| AZ | $1,842.73 | 1 |
| CA | $2,044.42–$2,630.62 | 29 |
| CO | $1,998.26 | 1 |
| CT | $2,033.97 | 1 |
| DC | $2,203.86 | 1 |
| DE | $1,876.16 | 1 |
| FL | $1,840.56–$2,009.29 | 3 |
| GA | $1,727.08–$1,930.21 | 2 |
| GU | $2,108.48 | 1 |
| HI | $2,108.48 | 1 |
| IA | $1,741.21 | 1 |
| ID | $1,751.59 | 1 |
| IL | $1,772.22–$1,965.88 | 4 |
| IN | $1,763.39 | 1 |
| KS | $1,726.42 | 1 |
| KY | $1,714.04 | 1 |
| LA | $1,708.79–$1,805.31 | 2 |
| MA | $1,981.75–$2,220.30 | 2 |
| MD | $1,917.04–$2,203.86 | 3 |
| ME | $1,755.97–$1,871.99 | 2 |
| MI | $1,759.46–$1,860.61 | 2 |
| MN | $1,924.09 | 1 |
| MO | $1,671.76–$1,819.31 | 3 |
| MS | $1,663.22 | 1 |
| MT | $1,897.45 | 1 |
| NC | $1,777.66 | 1 |
| ND | $1,880.05 | 1 |
| NE | $1,753.69 | 1 |
| NH | $1,960.67 | 1 |
| NJ | $2,059.86–$2,175.33 | 2 |
| NM | $1,768.10 | 1 |
| NV | $1,894.23 | 1 |
| NY | $1,807.26–$2,246.04 | 5 |
| OH | $1,755.90 | 1 |
| OK | $1,716.51 | 1 |
| OR | $1,882.25–$2,074.75 | 2 |
| PA | $1,762.20–$1,974.30 | 2 |
| PR | $1,915.00 | 1 |
| RI | $1,952.65 | 1 |
| SC | $1,769.19 | 1 |
| SD | $1,877.99 | 1 |
| TN | $1,735.54 | 1 |
| TX | $1,748.69–$1,989.19 | 8 |
| UT | $1,796.69 | 1 |
| VA | $1,861.15–$2,203.86 | 2 |
| VI | $1,915.00 | 1 |
| VT | $1,866.68 | 1 |
| WA | $1,979.98–$2,274.09 | 2 |
| WI | $1,808.69 | 1 |
| WV | $1,696.60 | 1 |
| WY | $1,889.86 | 1 |
How the 36253 rate is calculated
Each of 36253’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 · 36253
RVUs × geographic indexes × conversion factor
Work7.12
7.12 RVUs× 1.000 GPCI
Practice expense48.81
48.81 RVUs× 1.000 GPCI
Malpractice0.88
0.88 RVUs× 1.000 GPCI
Adjusted RVUs
56.8100
Conversion factor
$33.4009
Medicare rate
$1,897.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36253
The CMS indicators that decide how 36253 is paid alongside other services.
CMS payment indicators · 36253
Renal angiography, second-order or higher, unilateral
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 51 · payment effect
With and without the modifier
36253 without 51 · national office
$1,897.51
Renal angiography, second-order or higher, unilateral
36253-51 · Second procedure: 50%
$948.76
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
36253 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36251Renal angiographyUnilateral, main artery
- Choose 36251 when selective catheterization is limited to the first-order renal artery on one side; choose 36253 when the catheter reaches a second-order or more distal branch.
- 36252Renal angiographyBilateral, first-order arteries
- 36252 describes bilateral renal angiography with first-order catheter placement. This code describes higher-order branch catheterization on one side.
- 36254Renal catheterizationSecond-order or more, bilateral
- 36254 is the bilateral code for second-order or higher renal branch catheterization. This code is for the corresponding unilateral study.
36253 billing questions
How does this differ from 36251?
Use 36251 for unilateral renal angiography when selective catheter placement is limited to the first-order renal artery. This code requires documented catheterization into a second-order or higher branch.
What is included in the renal angiography service?
The service includes selective catheter placement, contrast injection, and the angiographic imaging and interpretation. These elements are not separately reported as additional renal angiography services.
Should modifier 50 be appended for both kidneys?
No. Modifier 50 is inappropriate for this code. When the study meets the bilateral criteria, report 36254 instead.
What documentation supports selecting this code?
Document the side studied, the renal branch reached by the catheter, the angiographic images and findings, and the clinical reason for the study. The record should establish catheterization beyond the first-order renal artery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this service. 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
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