Billing code 36223: Carotid angiographyMedicare rate & RVUs in Ohio

Reports unilateral catheterization in the common carotid or innominate artery with angiography of the ipsilateral intracranial carotid circulation.

CMS RVU26DEffective Oct 1, 20261 payment locality18.1K Medicare services in 2024

Medicare pays $1,770.62 for 36223 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$1,770.62Office (non-facility)
$293.13Hospital 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 36223 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 36223 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 36223 covers

A physician selectively places a catheter in a common carotid artery or the innominate artery and images the ipsilateral intracranial carotid circulation. The service includes angiography of the extracranial carotid or cervical circulation when performed, along with the associated radiological supervision and interpretation. Interventional radiologists, neurointerventionalists, and other physicians performing diagnostic cervicocerebral angiography commonly report it in a hospital angiography suite or catheterization lab, such as during evaluation of carotid disease or a suspected intracranial vascular lesion.

Report the code for each unilateral service when the catheter position and imaged territory meet these criteria. The report should identify the catheterized vessel, side, angiographic territory, and physician interpretation. Catheter placement and the associated imaging supervision and interpretation are included. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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.

36223 in Ohio

36223 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$1,770.62$293.13

How the 36223 rate is calculated

Each of 36223’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 · 36223

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.61Practice expense 50.03Malpractice 1.71

57.3500 adjusted RVUs×$33.4009 conversion factor=$1,915.54

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

Payment rules and modifiers for 36223

The CMS indicators that decide how 36223 is paid alongside other services.

CMS payment indicators · 36223

Carotid angiography

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

36223 without 50 · national office

$1,915.54

Carotid angiography

36223-50 · Bilateral: 150%

$2,873.31

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

36223 compared with similar codes

Compare codes

36223 vs 36222 vs 36224 vs 36221: national Medicare rates

Swap in your local Medicare rate.

  • 36223
    Carotid angiography · 5.61 wRVU
    $1,915.54
  • 36222
    Carotid angiography · 5.15 wRVU
    $1,259.55−$655.99
  • 36224
    Carotid angiography · 6.09 wRVU
    $2,350.42+$434.88
  • 36221
    Aortic arch angiography · 3.82 wRVU
    $952.93−$962.61

How to choose

36222Carotid angiography
Choose 36222 for ipsilateral extracranial carotid angiography without imaging the intracranial carotid circulation. 36223 includes that intracranial territory.
36224Carotid angiography
36224 requires selective catheter placement in the internal carotid artery; 36223 describes placement in the common carotid or innominate artery.
36221Aortic arch angiography
36221 covers nonselective thoracic aorta catheterization and angiography of the aortic arch and great-vessel origins, rather than selective carotid or innominate catheterization with intracranial imaging.

36223 billing questions

How is 36223 different from 36222?

36223 includes imaging of the ipsilateral intracranial carotid circulation. Use 36222 when the angiography is limited to the ipsilateral extracranial carotid circulation.

How is 36223 different from 36224?

36223 describes catheter placement in the common carotid or innominate artery. 36224 describes selective catheter placement in the internal carotid artery.

Can catheter placement or imaging interpretation be billed separately?

The catheter placement and associated radiological supervision and interpretation are included in 36223 for the described service.

How should bilateral services be reported?

Report bilateral performance with modifier 50; CMS pays the bilateral procedure at 150%.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.

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 36223PPRRVU2026_Oct_nonQPP.csv, line 4,449 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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