$1,748.92
The catheter position distinguishes the codes: 36226 requires direct vertebral artery selection, while 36225 describes selection of the subclavian artery with imaging of the ipsilateral vertebral circulation.
On this page
CMS RVU26D · Effective 2026-10-01
36226 Vertebral angiography Medicare reimbursement rates in Vermont
Reports direct selective catheterization of one vertebral artery with angiographic evaluation of its cervical and intracranial circulation. Compare 36226 office and facility rates across CMS payment localities in Vermont.
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 36226 in Vermont?
Vermont 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
$2234.09
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$297.03
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Diagnostic angiography
About 36226: Selective vertebral artery catheterization with angiography
Reports direct selective catheterization of one vertebral artery with angiographic evaluation of its cervical and intracranial circulation.
Code 36226 covers advancing a catheter directly into a vertebral artery and imaging the ipsilateral vertebral circulation in the neck and intracranially. Neurointerventional radiologists, neuroradiologists, neurosurgeons, and other physicians may perform the study in a hospital angiography suite or another appropriately equipped setting. It is used in diagnostic cerebral angiography evaluating conditions such as vertebrobasilar stenosis, arterial dissection, aneurysm, or vascular malformation. The service includes the selective catheter placement and the associated angiographic imaging of that circulation.
Report one unit for each side selectively studied, with the catheter position and imaged territory documented. A catheter left in the subclavian artery, rather than advanced directly into the vertebral artery, points to 36225 instead. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 36226
- 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
- Bilateral procedure with modifier 50 is paid at 150%.
- 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 RVU6.09 · 9%
- Practice expense (office) RVU60.43 · 88%
- Malpractice RVU1.92 · 3%
21.8K
Medicare services in 2024 · #1114 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.
36226 compared with similar codes
Office rates for Vermont, from the same CMS release.
$2,297.27
36224 is for selective internal carotid catheterization and carotid circulation imaging; 36226 is for direct vertebral selection and vertebral circulation imaging.
$930.12
36221 describes arch-level angiography. It does not represent the direct selective catheter placement into a vertebral artery covered by 36226.
Compare 36226 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
Vermont →
Office / nonfacility
$2234.09
Facility
$297.03
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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 36226 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
4,452
- Code
- 36226
- Physician work
- 6.09
- Practice expense
- 60.43
- Malpractice
- 1.92
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.09 | × 1.000 | 6.0900 |
| Practice expense | 60.43 | × 0.990 | 59.8257 |
| Malpractice | 1.92 | × 0.506 | 0.9715 |
| Total RVUs | 66.8872 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$2234.09
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.09 | 1 |
| Practice expense | 60.43 | 0.99 |
| Malpractice | 1.92 | 0.506 |
(6.09 × 1 + 60.43 × 0.99 + 1.92 × 0.506) × $33.4009 = $2234.09
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.09 | 1 |
| Practice expense | 1.85 | 0.99 |
| Malpractice | 1.92 | 0.506 |
(6.09 × 1 + 1.85 × 0.99 + 1.92 × 0.506) × $33.4009 = $297.03
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.
36226 billing questions
How do I distinguish 36226 from 36225?
Use 36226 when the catheter is selectively advanced into the vertebral artery. Use 36225 when it remains in the subclavian artery for imaging of the ipsilateral vertebral circulation.
Does 36226 include the angiographic imaging?
Yes. The code encompasses selective catheter placement and angiography of the ipsilateral vertebral artery’s cervical and intracranial circulation.
How should bilateral vertebral studies be reported?
Report the bilateral service with modifier 50 when both sides are studied. CMS pays a bilateral procedure at 150%.
What documentation supports reporting 36226?
Document the side, selective catheter position within the vertebral artery, and the cervical and intracranial territory imaged.
Can 36226 be reported with carotid angiography?
It may be part of a multivessel cerebral angiographic examination when the carotid circulation is separately selectively catheterized and imaged. Document each catheter position and the circulation studied.
Can an assistant or co-surgeon be paid for this service?
CMS applies a statutory restriction to assistant-at-surgery payment for this code. 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.
4,44936223,,Place cath carotid/inom art,A,,5.61,50.03,,1.58,,1.71,57.35,8.90,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45036224,,Place cath carotd art,A,,6.09,62.32,,1.89,,1.96,70.37,9.94,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45136225,,Place cath subclavian art,A,,5.61,46.36,,1.51,,1.69,53.66,8.81,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45236226,,Place cath vertebral art,A,,6.09,60.43,,1.85,,1.92,68.44,9.86,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45336227,,Place cath xtrnl carotid,A,,2.04,5.50,,0.55,,0.65,8.19,3.24,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45436228,,Place cath intracranial art,A,,4.14,40.57,,1.16,,1.43,46.14,6.73,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45536245,,Ins cath abd/l-ext art 1st,A,,4.53,30.50,,0.81,,0.86,35.89,6.20,0,XXX,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817