Billing code 36224: Carotid angiographyMedicare rate & RVUs in Ohio

Reports selective catheter angiography of one internal carotid artery when images document both the ipsilateral extracranial and intracranial circulation.

CMS RVU26DEffective Oct 1, 20261 payment locality24.1K Medicare services in 2024

Medicare pays $2,169.85 for 36224 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$2,169.85Office (non-facility)
$327.04Hospital 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 36224 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 36224 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 36224 covers

A physician advances a catheter selectively into an internal carotid artery and injects contrast to image that side’s extracranial and intracranial carotid circulation. Arch and cervical carotid imaging may be included when performed. Neurointerventional and diagnostic radiologists commonly perform the study in a hospital angiography suite; the service represents diagnostic imaging, not catheter placement alone.

Report the code when the record supports selective internal carotid catheterization, imaging of both circulation regions, and an interpretation of the findings. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS does not pay an assistant at surgery; 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.

36224 in Ohio

36224 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$2,169.85$327.04

How the 36224 rate is calculated

Each of 36224’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 · 36224

RVUs × geographic indexes × conversion factor

Work6.09

6.09 RVUs× 1.000 GPCI

Practice expense62.32

62.32 RVUs× 1.000 GPCI

Malpractice1.96

1.96 RVUs× 1.000 GPCI

Adjusted RVUs

70.3700

Conversion factor

$33.4009

Medicare rate

$2,350.42

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 36224

The CMS indicators that decide how 36224 is paid alongside other services.

CMS payment indicators · 36224

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

36224 without 50 · national office

$2,350.42

Carotid angiography

36224-50 · Bilateral: 150%

$3,525.63

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

36224 compared with similar codes

Compare codes · National

5 codes, side by side

  • 36224

    Carotid angiography6.09 wRVU

    $2,350.42

  • 36223

    Carotid angiography5.61 wRVU

    $1,915.54−$434.88

  • 36222

    Carotid angiography5.15 wRVU

    $1,259.55−$1,090.87

  • 36226

    Vertebral angiography6.09 wRVU

    $2,285.96−$64.46

  • 36228

    Intracranial catheterization4.14 wRVU

    $1,541.12−$809.30

How to choose

36223Carotid angiography
36223 is based on selective placement in the common carotid or innominate artery; 36224 requires selective internal carotid placement and imaging of the ipsilateral extracranial and intracranial circulation.
36222Carotid angiography
36222 describes selective common carotid or innominate placement with extracranial carotid imaging. Choose 36224 when the catheter is selectively placed in the internal carotid and both circulation regions are imaged.
36226Vertebral angiography
36226 covers selective vertebral artery angiography. 36224 applies to the internal carotid artery and its ipsilateral extracranial and intracranial circulation.
36228Intracranial catheterization
36228 is for selective catheterization and angiography of an additional intracranial branch; 36224 covers the internal carotid circulation study.

36224 billing questions

Does catheter placement alone support 36224?

No. The study includes angiography of the ipsilateral extracranial and intracranial carotid circulation; catheter placement without that imaging does not describe the service.

When should 36223 be considered instead?

Use 36223 when the selective catheter position is in the common carotid or innominate artery and the documented imaging meets that code’s criteria. 36224 is for selective placement in the internal carotid artery.

What documentation supports reporting 36224?

Document the side, selective internal carotid catheter position, imaging of both the ipsilateral extracranial and intracranial circulation, and the angiographic interpretation.

How is bilateral internal carotid angiography paid?

CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.

Are same-day services included in the global period?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this procedure. 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
RVUs for 36224PPRRVU2026_Oct_nonQPP.csv, line 4,450 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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