Billing code 36222: Carotid angiographyMedicare rate & RVUs in Texas
Reports selective catheterization of one common carotid or innominate artery with angiography of the same-side extracranial carotid circulation.
Medicare pays $1,162.50–$1,315.44 for 36222 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 9 sections
What 36222 covers
An interventional radiologist, vascular surgeon, or neurointerventional specialist selectively places a catheter in one common carotid artery or the innominate artery and images the ipsilateral extracranial carotid circulation. The service is typically performed in an angiography suite to assess cervical carotid anatomy, such as suspected stenosis. Aortic arch imaging is included when performed; this code’s imaging territory is extracranial rather than intracranial.
Report one unit for the unilateral service and document the catheterized artery, side, clinical indication, and angiographic territory. The code includes the selective catheter placement and the associated angiography; do not separately report those same elements as though they were distinct services. It has a 0-day global period, so same-day preoperative and postoperative care is included. With other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 identifies bilateral performance and CMS pays the bilateral procedure 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.
Where 36222 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$1162.50 to $1315.44
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $1,315.44 | $250.00 |
| Beaumont | $1,162.50 | $246.10 |
| Brazoria | $1,241.90 | $243.93 |
| Dallas | $1,250.71 | $247.70 |
| Fort Worth | $1,240.84 | $247.90 |
| Galveston | $1,246.09 | $246.10 |
| Houston | $1,270.07 | $270.08 |
| Rest Of Texas | $1,202.07 | $246.39 |
How the 36222 rate is calculated
Each of 36222’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 · 36222
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.15Practice expense 31.25Malpractice 1.31
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36222
The CMS indicators that decide how 36222 is paid alongside other services.
CMS payment indicators · 36222
Carotid angiography
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
36222 without 50 · national office
$1,259.55
Carotid angiography
36222-50 · Bilateral: 150%
$1,889.33
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).
36222 compared with similar codes
Compare codes
36222 vs 36221 vs 36223 vs 36224: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36221Aortic arch angiography
- 36221 describes nonselective catheter placement in the thoracic aorta and arch imaging. Use 36222 when the catheter is selectively placed in a common carotid or the innominate artery.
- 36223Carotid angiography
- Both involve selective common carotid or innominate catheter placement. Choose 36223 when the study includes the ipsilateral intracranial circulation as well as the extracranial carotid circulation.
- 36224Carotid angiography
- 36224 is for selective catheter placement in the internal carotid artery with intracranial angiography. 36222 uses common carotid or innominate placement and covers extracranial carotid angiography.
36222 billing questions
How is 36222 different from 36223?
36222 covers angiography of the ipsilateral extracranial carotid circulation. 36223 includes imaging of both the extracranial carotid and intracranial circulation.
Does 36222 include aortic arch imaging?
Yes, when arch imaging is performed, it is included in the service. Do not report it separately for the same study.
Can 36222 be reported bilaterally?
For bilateral performance, report modifier 50. CMS payment for the bilateral procedure is at 150%.
What documentation supports 36222?
Document the selectively catheterized common carotid or innominate artery, laterality, indication, and the extracranial carotid territory imaged.
How does the multiple procedure reduction affect 36222?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction.
Is same-day care included in the payment?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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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