Billing code 36254: Renal catheterizationMedicare rate & RVUs
Reports selective catheter placement in second-order or more distal renal artery branches on both sides, with diagnostic renal angiographic imaging.
Medicare pays $1,909.86 for 36254 nationally in the office and $362.40 in a hospital or facility. Local office rates run $1,656.96–$2,616.29.
Medicare rate · 36254
Renal catheterization
- Work RVUs
- 7.7
- Total RVUs
- 57.18
- Global days
- 000
National rate · 2026
$1,909.86
Office setting, before claim adjustments.
See every locality for 36254 →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 36254 covers
This service covers selective catheter placement into second-order or more distal branches of the renal arteries on both sides, together with diagnostic renal angiographic imaging. It is typically performed by an interventional radiologist, vascular surgeon, or other physician evaluating suspected renovascular disease, such as renal artery stenosis. The catheterization must reach the more selective branch level bilaterally; imaging only the main renal arteries does not establish this code’s level of service.
Choose the code based on the documented catheter positions and the sides examined. The report should identify the right and left renal branches selected and describe the angiographic study. 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 occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. 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.
Where 36254 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
$1656.96 to $2616.29
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,685.42 | $331.39 |
| Alaska* | $2,116.18 | $468.13 |
| Arizona | $1,852.10 | $352.61 |
| Arkansas | $1,656.96 | $327.69 |
| Atlanta | $1,947.77 | $375.54 |
| Austin | $1,996.29 | $359.08 |
| Bakersfield | $2,045.27 | $349.25 |
| Baltimore/Surr. Cntys | $2,044.10 | $383.67 |
| Beaumont | $1,762.22 | $354.03 |
| Brazoria | $1,884.85 | $351.32 |
| Chicago | $1,994.47 | $439.27 |
| Chico | $2,040.53 | $344.51 |
| Colorado | $2,002.37 | $355.87 |
| Connecticut | $2,049.95 | $383.33 |
| Dallas | $1,897.59 | $356.32 |
| Dc + Md/Va Suburbs | $2,214.17 | $391.26 |
| Delaware | $1,886.17 | $357.28 |
| Detroit | $1,893.68 | $400.38 |
| East St. Louis | $1,840.86 | $417.20 |
| El Centro | $2,040.82 | $344.80 |
| Fort Lauderdale | $1,977.29 | $409.71 |
| Fort Worth | $1,882.40 | $356.60 |
| Fresno | $2,040.53 | $344.51 |
| Galveston | $1,890.82 | $354.19 |
| Hanford-Corcoran | $2,040.53 | $344.51 |
| Hawaii, Guam | $2,104.04 | $344.57 |
| Houston | $1,922.48 | $385.85 |
| Idaho | $1,751.82 | $328.15 |
| Indiana | $1,763.74 | $329.24 |
| Iowa | $1,739.45 | $323.52 |
| Kansas | $1,728.09 | $329.19 |
| Kentucky | $1,727.92 | $352.22 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $2,192.86 | $362.21 |
| Madera | $2,040.53 | $344.51 |
| Manhattan | $2,218.56 | $420.40 |
| Merced | $2,040.53 | $344.51 |
| Metropolitan Boston | $2,223.46 | $375.79 |
| Metropolitan Kansas City | $1,811.25 | $358.18 |
| Metropolitan Philadelphia | $1,991.04 | $380.13 |
| Metropolitan St. Louis | $1,833.42 | $360.24 |
| Miami | $2,063.61 | $452.70 |
| Minnesota | $1,915.44 | $323.10 |
| Mississippi | $1,673.09 | $340.73 |
| Modesto | $2,040.53 | $344.51 |
| Montana** | $1,909.75 | $362.28 |
| Napa | $2,404.81 | $365.26 |
| Nebraska | $1,751.12 | $322.81 |
| Nevada** | $1,901.81 | $352.80 |
| New Hampshire | $1,968.03 | $357.12 |
| New Mexico | $1,789.10 | $370.08 |
| New Orleans | $1,823.62 | $367.46 |
| North Carolina | $1,782.15 | $338.36 |
| North Dakota** | $1,875.54 | $328.08 |
| Northern Nj | $2,185.18 | $390.12 |
| Nyc Suburbs/Long Island | $2,277.28 | $437.34 |
| Ohio | $1,771.57 | $358.74 |
| Oklahoma | $1,726.32 | $344.44 |
| Oxnard-Thousand Oaks-Ventura | $2,185.55 | $356.45 |
| Portland | $2,076.22 | $356.99 |
| Poughkpsie/N Nyc Suburbs | $2,085.09 | $390.61 |
| Puerto Rico | $1,926.54 | $362.05 |
| Queens | $2,242.13 | $413.03 |
| Redding | $2,040.53 | $344.51 |
| Rest Of California | $2,040.53 | $344.51 |
| Rest Of Florida | $1,868.75 | $389.38 |
| Rest Of Georgia | $1,748.71 | $368.37 |
| Rest Of Illinois | $1,803.64 | $390.81 |
| Rest Of Louisiana | $1,724.02 | $354.52 |
| Rest Of Maine | $1,760.43 | $336.76 |
| Rest Of Maryland | $1,926.84 | $360.80 |
| Rest Of Massachusetts | $1,986.78 | $357.30 |
| Rest Of Michigan | $1,778.56 | $365.73 |
| Rest Of Missouri | $1,688.27 | $354.35 |
| Rest Of New Jersey | $2,072.49 | $382.66 |
| Rest Of New York | $1,812.96 | $342.87 |
| Rest Of Oregon | $1,886.32 | $345.05 |
| Rest Of Pennsylvania | $1,775.90 | $355.33 |
| Rest Of Texas | $1,822.92 | $354.38 |
| Rest Of Washington | $1,983.93 | $354.45 |
| Rhode Island | $1,961.14 | $362.61 |
| Riverside-San Bernardino-Ontario | $2,059.11 | $363.09 |
| Sacramento-Roseville-Folsom | $2,152.28 | $352.58 |
| Salinas | $2,144.61 | $351.10 |
| San Diego-Chula Vista-Carlsbad | $2,203.71 | $352.95 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $2,556.94 | $375.02 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $2,554.98 | $373.05 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $2,616.29 | $384.84 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $2,608.25 | $376.81 |
| San Luis Obispo-Paso Robles | $2,109.11 | $346.55 |
| Santa Cruz-Watsonville | $2,231.35 | $351.19 |
| Santa Maria-Santa Barbara | $2,155.01 | $350.66 |
| Santa Rosa-Petaluma | $2,254.40 | $354.12 |
| Seattle (King Cnty) | $2,274.19 | $375.45 |
| South Carolina | $1,779.98 | $350.13 |
| South Dakota** | $1,871.50 | $324.03 |
| Southern Maine | $1,874.19 | $340.65 |
| Stockton | $2,040.53 | $344.51 |
| Suburban Chicago | $1,999.33 | $410.09 |
| Tennessee | $1,737.97 | $331.33 |
| Utah | $1,808.28 | $353.66 |
| Vallejo | $2,401.98 | $362.42 |
| Vermont | $1,865.37 | $333.38 |
| Virgin Islands | $1,926.54 | $362.05 |
| Virginia | $1,865.76 | $344.61 |
| Visalia | $2,040.53 | $344.51 |
| West Virginia | $1,725.84 | $381.09 |
| Wisconsin | $1,802.89 | $320.42 |
| Wyoming** | $1,894.84 | $347.38 |
| Yuba City | $2,040.53 | $344.51 |
36254 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.
$1,656.96
$2,328.41
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 | $2,116.18 | 1 |
| AL | $1,685.42 | 1 |
| AR | $1,656.96 | 1 |
| AZ | $1,852.10 | 1 |
| CA | $2,040.53–$2,616.29 | 29 |
| CO | $2,002.37 | 1 |
| CT | $2,049.95 | 1 |
| DC | $2,214.17 | 1 |
| DE | $1,886.17 | 1 |
| FL | $1,868.75–$2,063.61 | 3 |
| GA | $1,748.71–$1,947.77 | 2 |
| GU | $2,104.04 | 1 |
| HI | $2,104.04 | 1 |
| IA | $1,739.45 | 1 |
| ID | $1,751.82 | 1 |
| IL | $1,803.64–$1,999.33 | 4 |
| IN | $1,763.74 | 1 |
| KS | $1,728.09 | 1 |
| KY | $1,727.92 | 1 |
| LA | $1,724.02–$1,823.62 | 2 |
| MA | $1,986.78–$2,223.46 | 2 |
| MD | $1,926.84–$2,214.17 | 3 |
| ME | $1,760.43–$1,874.19 | 2 |
| MI | $1,778.56–$1,893.68 | 2 |
| MN | $1,915.44 | 1 |
| MO | $1,688.27–$1,833.42 | 3 |
| MS | $1,673.09 | 1 |
| MT | $1,909.75 | 1 |
| NC | $1,782.15 | 1 |
| ND | $1,875.54 | 1 |
| NE | $1,751.12 | 1 |
| NH | $1,968.03 | 1 |
| NJ | $2,072.49–$2,185.18 | 2 |
| NM | $1,789.10 | 1 |
| NV | $1,901.81 | 1 |
| NY | $1,812.96–$2,277.28 | 5 |
| OH | $1,771.57 | 1 |
| OK | $1,726.32 | 1 |
| OR | $1,886.32–$2,076.22 | 2 |
| PA | $1,775.90–$1,991.04 | 2 |
| PR | $1,926.54 | 1 |
| RI | $1,961.14 | 1 |
| SC | $1,779.98 | 1 |
| SD | $1,871.50 | 1 |
| TN | $1,737.97 | 1 |
| TX | $1,762.22–$1,996.29 | 8 |
| UT | $1,808.28 | 1 |
| VA | $1,865.76–$2,214.17 | 2 |
| VI | $1,926.54 | 1 |
| VT | $1,865.37 | 1 |
| WA | $1,983.93–$2,274.19 | 2 |
| WI | $1,802.89 | 1 |
| WV | $1,725.84 | 1 |
| WY | $1,894.84 | 1 |
How the 36254 rate is calculated
Each of 36254’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 · 36254
RVUs × geographic indexes × conversion factor
Work7.70
7.70 RVUs× 1.000 GPCI
Practice expense47.75
47.75 RVUs× 1.000 GPCI
Malpractice1.73
1.73 RVUs× 1.000 GPCI
Adjusted RVUs
57.1800
Conversion factor
$33.4009
Medicare rate
$1,909.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36254
The CMS indicators that decide how 36254 is paid alongside other services.
CMS payment indicators · 36254
Renal catheterization
| 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
36254 without 51 · national office
$1,909.86
Renal catheterization
36254-51 · Second procedure: 50%
$954.93
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%).
36254 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36251Renal angiography
- 36251 describes unilateral catheterization at the main renal artery level; 36254 requires more selective branch catheterization on both sides.
- 36252Renal angiography
- 36252 is bilateral but at the main renal artery level. Choose 36254 when second-order or more distal branches are selectively catheterized on both sides.
- 36253Renal angiography
- 36253 describes second-order-or-more renal branch catheterization on one side. 36254 is the corresponding bilateral code.
36254 billing questions
When should 36254 be selected instead of 36252?
Use 36254 when selective catheter placement reaches second-order or more distal renal artery branches on both sides. Code 36252 describes bilateral study at the main renal artery level.
Can 36254 be reported when distal branch selection is unilateral?
No. The bilateral code requires the qualifying branch-level service on both sides; 36253 is the unilateral second-order-or-more code.
Is renal angiographic imaging separately reported?
The diagnostic renal angiographic imaging is included in this service. The record should support the selective catheter positions and the imaging performed.
Should modifier 50 be appended?
The code is already priced as bilateral, and modifier 50 does not increase payment.
How does the multiple procedure reduction affect 36254?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What are the assistant and global-period rules?
The code has a 0-day global period, so same-day preoperative and postoperative care is included. Assistant-at-surgery payment is restricted, 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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