$1,083.82
36251 describes unilateral catheterization at the main renal artery level; 36254 requires more selective branch catheterization on both sides.
On this page
CMS RVU26D · Effective 2026-10-01
36254 Renal catheterization Medicare reimbursement rates in Alabama
Reports selective catheter placement in second-order or more distal renal artery branches on both sides, with diagnostic renal angiographic imaging. Compare 36254 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 36254 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$1685.42
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$331.39
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular catheterization
About 36254: Bilateral selective renal branch catheterization
Reports selective catheter placement in second-order or more distal renal artery branches on both sides, with diagnostic renal angiographic imaging.
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.
CMS billing rules for 36254
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.70 · 13%
- Practice expense (office) RVU47.75 · 84%
- Malpractice RVU1.73 · 3%
138
Medicare services in 2024 · #4617 by national volume
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.
36254 compared with similar codes
Office rates for Alabama, from the same CMS release.
$1,187.62
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.
$1,680.96
36253 describes second-order-or-more renal branch catheterization on one side. 36254 is the corresponding bilateral code.
Compare 36254 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$1685.42
Facility
$331.39
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 36254 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
4,462
- Code
- 36254
- Physician work
- 7.70
- Practice expense
- 47.75
- Malpractice
- 1.73
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.70 | × 1.000 | 7.7000 |
| Practice expense | 47.75 | × 0.875 | 41.7813 |
| Malpractice | 1.73 | × 0.566 | 0.9792 |
| Total RVUs | 50.4604 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$1685.42
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.7 | 1 |
| Practice expense | 47.75 | 0.875 |
| Malpractice | 1.73 | 0.566 |
(7.7 × 1 + 47.75 × 0.875 + 1.73 × 0.566) × $33.4009 = $1685.42
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.7 | 1 |
| Practice expense | 1.42 | 0.875 |
| Malpractice | 1.73 | 0.566 |
(7.7 × 1 + 1.42 × 0.875 + 1.73 × 0.566) × $33.4009 = $331.39
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,45936251,,Ins cath ren art 1st unilat,A,,4.97,30.79,,0.80,,0.95,36.71,6.72,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46036252,,Ins cath ren art 1st bilat,A,,6.57,32.17,,1.22,,1.48,40.22,9.27,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46136253,,Ins cath ren art 2nd+ unilat,A,,7.12,48.81,,1.13,,0.88,56.81,9.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46236254,,Ins cath ren art 2nd+ bilat,A,,7.70,47.75,,1.42,,1.73,57.18,10.85,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46336260,,Insertion of infusion pump,A,,9.66,6.72,NA,6.72,,2.58,18.96,18.96,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46436261,,Revision of infusion pump,A,,5.49,5.25,NA,5.25,,1.46,12.20,12.20,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46536262,,Removal of infusion pump,A,,4.01,4.38,NA,4.38,,1.08,9.47,9.47,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515