CPT code 36253: Renal angiography, second-order or higher, unilateral2026 Medicare rate & RVUs in Houston, TX

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 Houston, TX, Medicare pays $1,899.05 for 36253 in the office and $317.64 when it’s performed in a hospital or facility.

$1,899.05Office (non-facility)
$317.64Hospital or facility
+0.1%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $1,899.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

36253 in Houston, TX vs other payment areas
  1. Houston, TX · this page$1,899.05
  2. Austin, TX · Texas$1,989.19+$90.14
  3. Beaumont, TX · Texas$1,748.69−$150.36
  4. Brazoria, TX · Texas$1,878.27−$20.78
  5. Dallas, TX · Texas$1,888.95−$10.10
  6. Fort Worth, TX · Texas$1,873.03−$26.02
  7. Galveston, TX · Texas$1,882.94−$16.11

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

Every other payment area

36253 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$1,811.51$300.17
Los Angeles, CACalifornia$2,195.72$311.73
Washington, DC areaDistrict of Columbia$2,203.86$327.83
Miami, FLFlorida$2,009.29$351.44
Chicago, ILIllinois$1,945.38$344.87
Manhattan, NYNew York$2,194.06$343.51
AlaskaAlaska$2,109.18$413.11
AlabamaAlabama$1,680.96$287.48

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
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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 36253 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work7.12× 1.0087.1770
Practice expense48.81× 0.99348.4683
Malpractice0.88× 1.3761.2109
Total RVUs56.8562
Conversion factor× 33.4009

Office rate, Houston, TX$1899.05

Office: (7.12 × 1.008 + 48.81 × 0.993 + 0.88 × 1.376) × $33.4009 = $1899.05

Facility: (7.12 × 1.008 + 1.13 × 0.993 + 0.88 × 1.376) × $33.4009 = $317.64

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

How 36253 has changed in Houston, TX

36253 · Office / nonfacility

$1899.05

Effective 2026-10-01

The base rate is $21.41 higher than on 2025-10-01, moving from $1877.64 to $1899.05 (1.1%).

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

    $1877.64changed to$1899.05

    • 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 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1985.09changed to$1877.64

    • 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

    $1952.69changed to$1985.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2092.86changed to$1952.69

    • 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 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $2215.81changed to$2092.86

    • 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 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2340.28changed to$2215.81

    • 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

    $2316.32changed to$2340.28

    • 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 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $2283.06changed to$2316.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 54.51 changed to 54.87
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $2281.96changed to$2283.06

    • 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

    $2262.38changed to$2281.96

    • 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
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $2328.99changed to$2262.38

    • 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 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $2333.33changed to$2328.99

    • 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

    $2321.72changed to$2333.33

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $2315.78changed to$2321.72

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $2321.65changed to$2315.78

    • 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 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $2321.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,899.05$317.64RVU26D
2026-07-01$1,899.05$317.64RVU26C
2026-04-01$1,899.05$317.64RVU26B
2026-01-01$1,899.05$317.64RVU26A
2025-10-01$1,877.64$349.55RVU25D
2025-07-01$1,877.64$349.55RVU25C
2025-04-01$1,877.64$349.55RVU25B
2025-01-01$1,877.64$349.55RVU25A
2024-10-01$1,985.09$358.12RVU24D
2024-07-01$1,985.09$358.12RVU24C
2024-04-01$1,985.09$358.12RVU24B
2024-03-09$1,985.09$358.12RVU24AR
2024-01-01$1,952.69$352.28RVU24A
2023-10-01$2,092.86$360.03RVU23D
2023-07-01$2,092.86$360.03RVU23C
2023-04-01$2,092.86$360.03RVU23B
2023-01-01$2,092.86$360.03RVU23A
2022-10-01$2,215.81$363.74RVU22D
2022-07-01$2,215.81$363.74RVU22C
2022-04-01$2,215.81$363.74RVU22B
2022-01-01$2,215.81$363.74RVU22A
2021-10-01$2,340.28$365.50RVU21D
2021-07-01$2,340.28$365.50RVU21C
2021-04-01$2,340.28$365.50RVU21B
2021-01-01$2,340.28$365.50RVU21A
2020-10-01$2,316.32$379.67RVU20D
2020-07-01$2,316.32$379.67RVU20C
2020-04-01$2,316.32$379.67RVU20B
2020-01-01$2,316.32$379.67RVU20A
2019-10-01$2,283.06$378.15RVU19D
2019-07-01$2,283.06$378.15RVU19C
2019-04-01$2,283.06$378.15RVU19B
2019-01-01$2,283.06$378.15RVU19A
2018-10-01$2,281.96$379.87RVU18D
2018-07-01$2,281.96$379.87RVU18C
2018-04-01$2,281.96$379.87RVU18B
2018-01-01$2,281.96$379.87RVU18AR1
2017-10-01$2,262.38$382.99RVU17D
2017-07-01$2,262.38$382.99RVU17C
2017-04-01$2,262.38$382.99RVU17B
2017-01-01$2,262.38$382.99RVU17A
2016-10-01$2,328.99$398.37RVU16D
2016-07-01$2,328.99$398.37RVU16C
2016-04-01$2,328.99$398.37RVU16B
2016-01-01$2,328.99$398.37RVU16A
2015-10-01$2,333.33$400.44RVU15D
2015-07-01$2,333.33$400.44RVU15C
2015-04-01$2,321.72$398.44RVU15B
2015-01-01$2,321.72$398.44RVU15A
2014-10-01$2,315.78$410.65RVU14D
2014-07-01$2,315.78$410.65RVU14C
2014-04-01$2,315.78$410.65RVU14B
2014-01-01$2,315.78$410.65RVU14A
2013-10-01$2,321.65$390.40RVU13D
2013-07-01$2,321.65$390.40RVU13C
2013-04-01$2,321.65$390.40RVU13B
2013-01-01$2,321.65$390.40RVU13AR

Price 36253 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

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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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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