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CPT code 36253: Renal angiography, second-order or higher, unilateral2026 Medicare rate & RVUs in Washington, DC area

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.

CMS RVU26DEffective Oct 1, 2026One payment locality1.8K Medicare services in 2024

In Washington, DC area, Medicare pays $2,203.86 for 36253 in the office and $327.83 when it’s performed in a hospital or facility.

$2,203.86Office (non-facility)
$327.83Hospital or facility
+16.1%vs the national office rate ($1,897.51)

Check a contract rate as a % of Medicare · 36253 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 36253 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 36253 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 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.

How Washington, DC area compares for 36253

Across 109 of 109 payment localities, the office rate for 36253 runs from $1,653.38 in Arkansas to $2,630.62 in San Benito County, CA. Washington, DC area pays $2,203.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

36253 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$2,203.86
  2. Los Angeles, CA · California$2,195.72−$8.14
  3. Miami, FL · Florida$2,009.29−$194.57
  4. Chicago, IL · Illinois$1,945.38−$258.48
  5. Manhattan, NY · New York$2,194.06−$9.80
  6. Alaska · Alaska$2,109.18−$94.68
  7. Alabama · Alabama$1,680.96−$522.90

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

Every other payment area

36253 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$1,653.38$285.37
ArizonaArizona$1,842.73$299.55
Bakersfield, CACalifornia$2,047.04$301.60
Chico, CACalifornia$2,044.42$298.98
El Centro, CACalifornia$2,044.57$299.13
Fresno, CACalifornia$2,044.42$298.98
Hanford, CACalifornia$2,044.42$298.98
Madera, CACalifornia$2,044.42$298.98

36253 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.

$1,653.38

$2,337.52

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

View every state and territory as a table
36253 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,109.181
AL$1,680.961
AR$1,653.381
AZ$1,842.731
CA$2,044.42–$2,630.6229
CO$1,998.261
CT$2,033.971
DC$2,203.861
DE$1,876.161
FL$1,840.56–$2,009.293
GA$1,727.08–$1,930.212
GU$2,108.481
HI$2,108.481
IA$1,741.211
ID$1,751.591
IL$1,772.22–$1,965.884
IN$1,763.391
KS$1,726.421
KY$1,714.041
LA$1,708.79–$1,805.312
MA$1,981.75–$2,220.302
MD$1,917.04–$2,203.863
ME$1,755.97–$1,871.992
MI$1,759.46–$1,860.612
MN$1,924.091
MO$1,671.76–$1,819.313
MS$1,663.221
MT$1,897.451
NC$1,777.661
ND$1,880.051
NE$1,753.691
NH$1,960.671
NJ$2,059.86–$2,175.332
NM$1,768.101
NV$1,894.231
NY$1,807.26–$2,246.045
OH$1,755.901
OK$1,716.511
OR$1,882.25–$2,074.752
PA$1,762.20–$1,974.302
PR$1,915.001
RI$1,952.651
SC$1,769.191
SD$1,877.991
TN$1,735.541
TX$1,748.69–$1,989.198
UT$1,796.691
VA$1,861.15–$2,203.862
VI$1,915.001
VT$1,866.681
WA$1,979.98–$2,274.092
WI$1,808.691
WV$1,696.601
WY$1,889.861

See 36253 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,461

Code
36253
Physician work
7.12
Practice expense
48.81
Malpractice
0.88

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 36253 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work7.12× 1.0547.5045
Practice expense48.81× 1.17857.4982
Malpractice0.88× 1.1130.9794
Total RVUs65.9821
Conversion factor× 33.4009

Office rate, Washington, DC area$2203.86

Office: (7.12 × 1.054 + 48.81 × 1.178 + 0.88 × 1.113) × $33.4009 = $2203.86

Facility: (7.12 × 1.054 + 1.13 × 1.178 + 0.88 × 1.113) × $33.4009 = $327.83

Open 36253 in the RVU calculator

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

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)0The 150% bilateral adjustment doesn’t apply.
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 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%).

When to use modifier 51

Codes related to 36253

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

Codes related to 36253
CodeHow it relatesOffice range, Washington, DC area
Same family
36251Renal angiography, unilateral, main arteryUnilateral renal angiography with selective catheter placement limited to the first-order renal artery.$1,421.75
36252Renal angiography, bilateral, first-order arteriesBilateral renal angiography with first-order selective catheter placement.$1,552.08
36254Renal catheterization, second-order or more, bilateralBilateral counterpart for selective catheterization of second-order or higher renal branches.$2,214.17

How 36253 has changed in Washington, DC area

36253 · Office / nonfacility

$2203.86

Effective 2026-10-01

The base rate is $21.30 higher than on 2025-10-01, moving from $2182.56 to $2203.86 (1.0%).

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

    $2182.56changed to$2203.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.30 changed to 7.12
    • Practice expense RVU 49.30 changed to 48.81
    • Malpractice RVU 0.85 changed to 0.88
    • 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

    $2308.33changed to$2182.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 50.84 changed to 49.30
    • Malpractice RVU 0.88 changed to 0.85

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $2270.65changed to$2308.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2455.26changed to$2270.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 52.46 changed to 50.84
    • Malpractice RVU 0.86 changed to 0.88
    • 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

    $2620.93changed to$2455.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 54.16 changed to 52.46
    • Malpractice RVU 0.85 changed to 0.86
    • 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

    $2769.81changed to$2620.93

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 57.15 changed to 54.16
    • Malpractice RVU 0.81 changed to 0.85

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $2730.64changed to$2769.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 54.87 changed to 57.15
    • Malpractice RVU 0.79 changed to 0.81
    • 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

    $2678.04changed to$2730.64

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 54.51 changed to 54.87
    • 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

    $2676.88changed to$2678.04

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 54.53 changed to 54.51
    • Malpractice RVU 0.81 changed to 0.79

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $2661.59changed to$2676.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 54.30 changed to 54.53
    • Malpractice RVU 0.85 changed to 0.81
    • 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

    $2748.44changed to$2661.59

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 7.55 changed to 7.30
    • Practice expense RVU 56.12 changed to 54.30
    • Malpractice RVU 0.94 changed to 0.85
    • 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

    $2753.73changed to$2748.44

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 55.96 changed to 56.12
    • Malpractice RVU 0.99 changed to 0.94

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $2740.03changed to$2753.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $2732.03changed to$2740.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 55.50 changed to 55.96
    • Malpractice RVU 1.35 changed to 0.99
    • 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

    $2736.63changed to$2732.03

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 59.20 changed to 55.50
    • Malpractice RVU 1.41 changed to 1.35
    • 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: $2736.63

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,203.86$327.83RVU26D
2026-07-01$2,203.86$327.83RVU26C
2026-04-01$2,203.86$327.83RVU26B
2026-01-01$2,203.86$327.83RVU26A
2025-10-01$2,182.56$366.53RVU25D
2025-07-01$2,182.56$366.53RVU25C
2025-04-01$2,182.56$366.53RVU25B
2025-01-01$2,182.56$366.53RVU25A
2024-10-01$2,308.33$374.79RVU24D
2024-07-01$2,308.33$374.79RVU24C
2024-04-01$2,308.33$374.79RVU24B
2024-03-09$2,308.33$374.79RVU24AR
2024-01-01$2,270.65$368.67RVU24A
2023-10-01$2,455.26$384.73RVU23D
2023-07-01$2,455.26$384.73RVU23C
2023-04-01$2,455.26$384.73RVU23B
2023-01-01$2,455.26$384.73RVU23A
2022-10-01$2,620.93$396.29RVU22D
2022-07-01$2,620.93$396.29RVU22C
2022-04-01$2,620.93$396.29RVU22B
2022-01-01$2,620.93$396.29RVU22A
2021-10-01$2,769.81$397.77RVU21D
2021-07-01$2,769.81$397.77RVU21C
2021-04-01$2,769.81$397.77RVU21B
2021-01-01$2,769.81$397.77RVU21A
2020-10-01$2,730.64$412.36RVU20D
2020-07-01$2,730.64$412.36RVU20C
2020-04-01$2,730.64$412.36RVU20B
2020-01-01$2,730.64$412.36RVU20A
2019-10-01$2,678.04$409.84RVU19D
2019-07-01$2,678.04$409.84RVU19C
2019-04-01$2,678.04$409.84RVU19B
2019-01-01$2,678.04$409.84RVU19A
2018-10-01$2,676.88$412.03RVU18D
2018-07-01$2,676.88$412.03RVU18C
2018-04-01$2,676.88$412.03RVU18B
2018-01-01$2,676.88$412.03RVU18AR1
2017-10-01$2,661.59$417.13RVU17D
2017-07-01$2,661.59$417.13RVU17C
2017-04-01$2,661.59$417.13RVU17B
2017-01-01$2,661.59$417.13RVU17A
2016-10-01$2,748.44$435.91RVU16D
2016-07-01$2,748.44$435.91RVU16C
2016-04-01$2,748.44$435.91RVU16B
2016-01-01$2,748.44$435.91RVU16A
2015-10-01$2,753.73$438.49RVU15D
2015-07-01$2,753.73$438.49RVU15C
2015-04-01$2,740.03$436.30RVU15B
2015-01-01$2,740.03$436.30RVU15A
2014-10-01$2,732.03$451.20RVU14D
2014-07-01$2,732.03$451.20RVU14C
2014-04-01$2,732.03$451.20RVU14B
2014-01-01$2,732.03$451.20RVU14A
2013-10-01$2,736.63$427.61RVU13D
2013-07-01$2,736.63$427.61RVU13C
2013-04-01$2,736.63$427.61RVU13B
2013-01-01$2,736.63$427.61RVU13AR

Price 36253 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

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

Show the CMS file lines behind this rate
RVUs for 36253PPRRVU2026_Oct_nonQPP.csv, line 4,461 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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