Billing code 36221: Aortic arch angiographyMedicare rate & RVUs
Report this service for nonselective catheter placement in the thoracic aorta with angiographic imaging of the aortic arch and its major vessel origins.
Medicare pays $952.93 for 36221 nationally in the office and $178.03 in a hospital or facility. Local office rates run $826.21–$1,304.53.
Medicare rate · 36221
Aortic arch angiography
- Work RVUs
- 3.82
- Total RVUs
- 28.53
- Global days
- 000
National rate · 2026
$952.93
Office setting, before claim adjustments.
See every locality for 36221 →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.
On this page 10 sections
What 36221 covers
A catheter is positioned in the thoracic aorta without selective advancement into an arch branch, and contrast images show the aortic arch and the origins of its major vessels. The service is commonly performed by an interventional radiologist, vascular surgeon, or other physician performing catheter angiography in a hospital or catheterization suite to assess arch anatomy or suspected vascular disease. The code includes the catheter placement and the radiological supervision, interpretation, image documentation, and report for the arch study.
Report 36221 when the documented catheter position and images support a nonselective arch angiogram; selective branch catheterization and the specific territory imaged point to a different cervicocerebral angiography code. The code is priced as bilateral, so modifier 50 does not increase payment. It has a 0-day global period, with same-day preoperative and postoperative care included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; 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 36221 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
$826.21 to $1304.53
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $840.47 | $162.43 |
| Alaska* | $1,054.92 | $229.65 |
| Arizona | $923.95 | $173.07 |
| Arkansas | $826.21 | $160.57 |
| Atlanta | $972.08 | $184.78 |
| Austin | $995.88 | $176.04 |
| Bakersfield | $1,019.94 | $170.65 |
| Baltimore/Surr. Cntys | $1,020.15 | $188.68 |
| Beaumont | $879.22 | $174.06 |
| Brazoria | $940.18 | $172.25 |
| Chicago | $996.73 | $217.95 |
| Chico | $1,017.49 | $168.20 |
| Colorado | $998.77 | $174.28 |
| Connecticut | $1,023.03 | $188.46 |
| Dallas | $946.63 | $174.82 |
| Dc + Md/Va Suburbs | $1,104.77 | $191.94 |
| Delaware | $940.99 | $175.38 |
| Detroit | $945.71 | $197.94 |
| East St. Louis | $919.79 | $206.88 |
| El Centro | $1,017.65 | $168.35 |
| Fort Lauderdale | $987.56 | $202.58 |
| Fort Worth | $939.06 | $175.01 |
| Fresno | $1,017.49 | $168.20 |
| Galveston | $943.21 | $173.73 |
| Hanford-Corcoran | $1,017.49 | $168.20 |
| Hawaii, Guam | $1,049.22 | $168.16 |
| Houston | $959.68 | $190.21 |
| Idaho | $873.46 | $160.55 |
| Indiana | $879.42 | $161.09 |
| Iowa | $867.20 | $158.17 |
| Kansas | $861.67 | $161.16 |
| Kentucky | $862.10 | $173.21 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,093.59 | $176.89 |
| Madera | $1,017.49 | $168.20 |
| Manhattan | $1,107.54 | $207.11 |
| Merced | $1,017.49 | $168.20 |
| Metropolitan Boston | $1,109.14 | $183.90 |
| Metropolitan Kansas City | $903.72 | $176.09 |
| Metropolitan Philadelphia | $993.63 | $186.96 |
| Metropolitan St. Louis | $914.81 | $177.11 |
| Miami | $1,031.50 | $224.83 |
| Minnesota | $954.83 | $157.45 |
| Mississippi | $834.54 | $167.35 |
| Modesto | $1,017.49 | $168.20 |
| Montana** | $952.87 | $177.97 |
| Napa | $1,199.07 | $177.75 |
| Nebraska | $872.99 | $157.76 |
| Nevada** | $948.70 | $173.03 |
| New Hampshire | $981.78 | $175.10 |
| New Mexico | $892.96 | $182.38 |
| New Orleans | $910.09 | $180.91 |
| North Carolina | $888.79 | $165.81 |
| North Dakota** | $935.07 | $160.17 |
| Northern Nj | $1,090.25 | $191.37 |
| Nyc Suburbs/Long Island | $1,137.16 | $215.81 |
| Ohio | $883.98 | $176.49 |
| Oklahoma | $861.13 | $169.14 |
| Oxnard-Thousand Oaks-Ventura | $1,089.91 | $173.97 |
| Portland | $1,035.55 | $174.63 |
| Poughkpsie/N Nyc Suburbs | $1,040.53 | $192.02 |
| Puerto Rico | $961.22 | $177.80 |
| Queens | $1,119.12 | $203.19 |
| Redding | $1,017.49 | $168.20 |
| Rest Of California | $1,017.49 | $168.20 |
| Rest Of Florida | $933.06 | $192.25 |
| Rest Of Georgia | $872.81 | $181.60 |
| Rest Of Illinois | $900.66 | $193.18 |
| Rest Of Louisiana | $860.21 | $174.42 |
| Rest Of Maine | $877.94 | $165.03 |
| Rest Of Maryland | $961.28 | $177.08 |
| Rest Of Massachusetts | $991.02 | $175.05 |
| Rest Of Michigan | $887.62 | $180.13 |
| Rest Of Missouri | $842.40 | $174.43 |
| Rest Of New Jersey | $1,034.11 | $187.92 |
| Rest Of New York | $904.24 | $168.08 |
| Rest Of Oregon | $940.82 | $169.02 |
| Rest Of Pennsylvania | $886.06 | $174.70 |
| Rest Of Texas | $909.45 | $174.07 |
| Rest Of Washington | $989.55 | $173.58 |
| Rhode Island | $978.35 | $177.88 |
| Riverside-San Bernardino-Ontario | $1,027.15 | $177.86 |
| Sacramento-Roseville-Folsom | $1,073.20 | $171.99 |
| Salinas | $1,069.38 | $171.27 |
| San Diego-Chula Vista-Carlsbad | $1,098.86 | $172.08 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,274.85 | $182.24 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,273.83 | $181.22 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,304.53 | $187.12 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,300.35 | $182.94 |
| San Luis Obispo-Paso Robles | $1,051.69 | $169.08 |
| Santa Cruz-Watsonville | $1,112.64 | $171.14 |
| Santa Maria-Santa Barbara | $1,074.57 | $171.03 |
| Santa Rosa-Petaluma | $1,124.13 | $172.55 |
| Seattle (King Cnty) | $1,134.33 | $183.53 |
| South Carolina | $887.98 | $171.97 |
| South Dakota** | $932.97 | $158.07 |
| Southern Maine | $934.68 | $166.75 |
| Stockton | $1,017.49 | $168.20 |
| Suburban Chicago | $998.50 | $202.68 |
| Tennessee | $866.64 | $162.25 |
| Utah | $902.14 | $173.74 |
| Vallejo | $1,197.60 | $176.28 |
| Vermont | $930.12 | $162.97 |
| Virgin Islands | $961.22 | $177.80 |
| Virginia | $930.57 | $168.84 |
| Visalia | $1,017.49 | $168.20 |
| West Virginia | $861.70 | $188.31 |
| Wisconsin | $898.72 | $156.37 |
| Wyoming** | $945.11 | $170.21 |
| Yuba City | $1,017.49 | $168.20 |
36221 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.
$826.21
$1,161.01
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 | $1,054.92 | 1 |
| AL | $840.47 | 1 |
| AR | $826.21 | 1 |
| AZ | $923.95 | 1 |
| CA | $1,017.49–$1,304.53 | 29 |
| CO | $998.77 | 1 |
| CT | $1,023.03 | 1 |
| DC | $1,104.77 | 1 |
| DE | $940.99 | 1 |
| FL | $933.06–$1,031.50 | 3 |
| GA | $872.81–$972.08 | 2 |
| GU | $1,049.22 | 1 |
| HI | $1,049.22 | 1 |
| IA | $867.20 | 1 |
| ID | $873.46 | 1 |
| IL | $900.66–$998.50 | 4 |
| IN | $879.42 | 1 |
| KS | $861.67 | 1 |
| KY | $862.10 | 1 |
| LA | $860.21–$910.09 | 2 |
| MA | $991.02–$1,109.14 | 2 |
| MD | $961.28–$1,104.77 | 3 |
| ME | $877.94–$934.68 | 2 |
| MI | $887.62–$945.71 | 2 |
| MN | $954.83 | 1 |
| MO | $842.40–$914.81 | 3 |
| MS | $834.54 | 1 |
| MT | $952.87 | 1 |
| NC | $888.79 | 1 |
| ND | $935.07 | 1 |
| NE | $872.99 | 1 |
| NH | $981.78 | 1 |
| NJ | $1,034.11–$1,090.25 | 2 |
| NM | $892.96 | 1 |
| NV | $948.70 | 1 |
| NY | $904.24–$1,137.16 | 5 |
| OH | $883.98 | 1 |
| OK | $861.13 | 1 |
| OR | $940.82–$1,035.55 | 2 |
| PA | $886.06–$993.63 | 2 |
| PR | $961.22 | 1 |
| RI | $978.35 | 1 |
| SC | $887.98 | 1 |
| SD | $932.97 | 1 |
| TN | $866.64 | 1 |
| TX | $879.22–$995.88 | 8 |
| UT | $902.14 | 1 |
| VA | $930.57–$1,104.77 | 2 |
| VI | $961.22 | 1 |
| VT | $930.12 | 1 |
| WA | $989.55–$1,134.33 | 2 |
| WI | $898.72 | 1 |
| WV | $861.70 | 1 |
| WY | $945.11 | 1 |
How the 36221 rate is calculated
Each of 36221’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 · 36221
RVUs × geographic indexes × conversion factor
Work3.82
3.82 RVUs× 1.000 GPCI
Practice expense23.81
23.81 RVUs× 1.000 GPCI
Malpractice0.90
0.90 RVUs× 1.000 GPCI
Adjusted RVUs
28.5300
Conversion factor
$33.4009
Medicare rate
$952.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36221
The CMS indicators that decide how 36221 is paid alongside other services.
CMS payment indicators · 36221
Aortic arch angiography
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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
36221 without 51 · national office
$952.93
Aortic arch angiography
36221-51 · Second procedure: 50%
$476.47
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%).
36221 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36200Aortic catheterization
- 36200 describes aortic catheter placement. 36221 also includes the arch angiographic study and its interpretation, documentation, and report.
- 36222Carotid angiography
- 36221 is a nonselective thoracic aortic arch study. 36222 involves selective catheterization for angiography of a carotid or innominate territory.
- 36223Carotid angiography
- Choose 36223 when selective catheterization supports intracranial and extracranial carotid angiography; 36221 covers nonselective arch imaging.
- 36225Subclavian angiography
- 36225 is for selective subclavian angiography. 36221 reports nonselective catheter placement with imaging of the aortic arch.
36221 billing questions
When should 36221 be chosen instead of a selective carotid angiography code?
Use 36221 for nonselective catheter placement in the thoracic aorta with imaging of the arch. Selective catheterization and imaging of a carotid or other branch territory point to a selective angiography code.
Can the arch angiography interpretation be billed separately?
No. The radiological supervision and interpretation, image documentation, and report for the arch study are included in 36221.
Should modifier 50 be appended when both sides are evaluated?
The code is already priced as bilateral, and modifier 50 does not increase payment.
How does Medicare handle 36221 with other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
What documentation supports reporting 36221?
Document the catheter position in the thoracic aorta, the arch angiographic images obtained, and the interpretation and report. The record should support a nonselective arch study rather than selective branch catheterization.
Can an assistant surgeon or co-surgeon be reported for 36221?
Medicare does not pay an assistant at surgery for this code, and 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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