Billing code 36216: Arterial catheterizationMedicare rate & RVUs in Nebraska

Reports selective catheter placement into a second-order thoracic or brachiocephalic arterial branch during a diagnostic or interventional vascular procedure.

CMS RVU26DEffective Oct 1, 20261 payment locality2.5K Medicare services in 2024

Medicare pays $989.97 for 36216 in the office in Nebraska (Nebraska). Which amount applies depends on the service address.

$989.97Office (non-facility)
$217.39Hospital or facility

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 36216 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nebraska
  2. What 36216 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 36216 covers

A physician advances a catheter through an arterial route into a second-order branch in the thoracic or brachiocephalic arterial distribution. This selective positioning may support angiography or an endovascular procedure, commonly in a hospital catheterization or angiography suite. Interventional radiologists, vascular surgeons, and other physicians performing catheter-based vascular services may report the placement when the documented catheter path reaches this branch level.

Choose the code from the vessel hierarchy and the catheter tip’s destination, not from the number of imaging runs or the clinical diagnosis. The record should identify the access route, vessels traversed, target branch, and related imaging or intervention. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and reduces others under its standard multiple procedure rule. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.

36216 in Nebraska

36216 office and facility rates by payment locality
Payment localityOfficeFacility
Nebraska$989.97$217.39

How the 36216 rate is calculated

Each of 36216’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 · 36216

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.14Practice expense 26.08Malpractice 1.13

32.3500 adjusted RVUs×$33.4009 conversion factor=$1,080.52

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 36216

The CMS indicators that decide how 36216 is paid alongside other services.

CMS payment indicators · 36216

Arterial catheterization

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

36216 without 51 · national office

$1,080.52

Arterial catheterization

36216-51 · Second procedure: 50%

$540.26

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

36216 compared with similar codes

Compare codes

36216 vs 36215 vs 36217 vs 36218 vs 36222: national Medicare rates

Swap in your local Medicare rate.

  • 36216
    Arterial catheterization · 5.14 wRVU
    $1,080.52
  • 36215
    Arterial catheterization · 4.07 wRVU
    $1,064.15−$16.37
  • 36217
    Arterial catheterization · 6.13 wRVU
    $1,976.00+$895.48
  • 36218
    Arterial catheterization · 0.98 wRVU
    $229.80−$850.72
  • 36222
    Carotid angiography · 5.15 wRVU
    $1,259.55+$179.03

How to choose

36215Arterial catheterization
Use 36215 when the catheter reaches a first-order branch; use 36216 when it is advanced into a second-order branch.
36217Arterial catheterization
Use 36217 when the catheter reaches a third-order or more selective branch, rather than stopping at the second-order level represented by 36216.
36218Arterial catheterization
36218 reports an additional qualifying branch after the initial selective placement; 36216 identifies the second-order placement itself.
36222Carotid angiography
36222 is for a defined cervicocerebral angiography service that includes catheter placement. Do not use 36216 to separately represent placement already included in that service.

36216 billing questions

How does 36216 differ from 36215 and 36217?

Select by catheter destination within the arterial tree: 36215 represents a first-order branch, 36216 a second-order branch, and 36217 a third-order or more selective branch.

Can 36216 be reported for each additional branch selected?

Use 36216 for the qualifying second-order placement. For each additional second-order or more selective branch in the same vascular family, consider add-on code 36218 when its reporting criteria are met.

What documentation supports 36216?

Document the access route, the vessels traversed, the target branch and its order, and the diagnostic or therapeutic service associated with the catheter placement.

Should 36216 be reported with cervicocerebral angiography codes?

Codes such as 36222 describe cervicocerebral angiography services that include catheter placement. Do not separately add 36216 for catheter work already represented by that service.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

How does CMS reduce payment when other procedures are performed in the session?

The highest-valued procedure is paid in full, and other procedures subject to the standard multiple procedure rule are paid at 50%.

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 36216PPRRVU2026_Oct_nonQPP.csv, line 4,444 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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