$1,191.29
Use 36245 when the selected abdominal, pelvic, or lower-extremity branch is first order. Use 36246 when the catheter reaches a second-order branch.
On this page
CMS RVU26D · Effective 2026-10-01
36246 Selective catheterization Medicare reimbursement rates in Wyoming
Reports selective catheter placement into a second-order abdominal, pelvic, or lower-extremity arterial branch during angiography or endovascular treatment. Compare 36246 office and facility rates across CMS payment localities in Wyoming.
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 36246 in Wyoming?
Wyoming 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
$788.83
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$212.33
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Vascular catheterization
About 36246: Second-order selective arterial catheter placement
Reports selective catheter placement into a second-order abdominal, pelvic, or lower-extremity arterial branch during angiography or endovascular treatment.
This service covers advancing a catheter selectively into a second-order branch of the abdominal, pelvic, or lower-extremity arterial system. Interventional radiologists, vascular surgeons, and other physicians performing vascular procedures may use it to reach a target branch for diagnostic angiography or endovascular treatment in an angiography suite, catheterization laboratory, or operating room.
Choose the code according to the most selective branch reached in the vascular family: 36246 represents a second-order selection, while a third-order selection in that family is reported at the higher level. Document the access route, vascular family, target branch, and catheter position; catheter exchanges or imaging runs alone do not establish another selective placement. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 36246
- 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 RVU4.89 · 20%
- Practice expense (office) RVU17.95 · 75%
- Malpractice RVU1.05 · 4%
24.1K
Medicare services in 2024 · #1062 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.
36246 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$1,347.48
Use 36247 when the catheter is advanced to a third-order branch in the vascular family; 36246 represents second-order selection.
$111.18
36248 is an add-on for additional qualifying branch selections, not the initial second-order placement represented by 36246.
$561.10
36200 describes placement in the aorta. It does not represent selective catheter positioning in a second-order abdominal, pelvic, or lower-extremity branch.
Compare 36246 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
Wyoming** →
Office / nonfacility
$788.83
Facility
$212.33
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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 36246 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,456
- Code
- 36246
- Physician work
- 4.89
- Practice expense
- 17.95
- Malpractice
- 1.05
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.89 | × 1.000 | 4.8900 |
| Practice expense | 17.95 | × 1.000 | 17.9500 |
| Malpractice | 1.05 | × 0.740 | 0.7770 |
| Total RVUs | 23.6170 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$788.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.89 | 1 |
| Practice expense | 17.95 | 1 |
| Malpractice | 1.05 | 0.74 |
(4.89 × 1 + 17.95 × 1 + 1.05 × 0.74) × $33.4009 = $788.83
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.89 | 1 |
| Practice expense | 0.69 | 1 |
| Malpractice | 1.05 | 0.74 |
(4.89 × 1 + 0.69 × 1 + 1.05 × 0.74) × $33.4009 = $212.33
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.
36246 billing questions
How does 36246 differ from 36245 and 36247?
Select 36246 when the catheter reaches a second-order branch in the abdominal, pelvic, or lower-extremity arterial system. Use 36245 for first-order placement and 36247 for third-order placement in the vascular family.
Can angiography or treatment be reported separately?
36246 describes selective catheter placement, not the imaging or treatment itself. Report other services only when they were performed, documented, and separately reportable under their code instructions.
When is 36248 reported with 36246?
36248 is an add-on for an additional qualifying second-order, third-order, or more distal branch selection in the same vascular family. The record should show the additional branch catheterized.
Are units based on catheter exchanges or angiographic runs?
No. Select the code based on the order of the branch reached and the vascular family; a catheter exchange or another imaging run alone is not an additional selective placement.
How is bilateral reporting handled?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS facts for this code. The documentation should support selective catheterization on both sides.
Does the code have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
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.
4,45336227,,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
4,45636246,,Ins cath abd/l-ext art 2nd,A,,4.89,17.95,,0.69,,1.05,23.89,6.63,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45736247,,Ins cath abd/l-ext art 3rd,A,,5.89,33.72,,0.87,,0.99,40.60,7.75,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45836248,,Ins cath abd/l-ext art addl,A,,0.98,2.26,,0.14,,0.12,3.36,1.24,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,45936251,,Ins cath ren art 1st unilat,A,,4.97,30.79,,0.80,,0.95,36.71,6.72,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,