CPT 36160
Global XXX ActiveEstablish access to aorta
CPT 36160 Billing & Documentation Guide
CPT code 36160 (Establish access to aorta) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.46, a non-facility practice expense RVU of 13.51, and a malpractice RVU of 0.36, a total non-facility RVU of 16.33 and facility RVU of 3.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $565.07, though rates vary from $475.98 to $748.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36160, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 36160 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 36160 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 36160
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.46 | 2.46 |
| Practice Expense RVU | 13.51 | 0.38 |
| Malpractice RVU | 0.36 | 0.36 |
| Total RVU | 16.33 | 3.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36160
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $625.58 | $106.65 | $584.57 - $748.35 | 29 |
| Florida | $558.32 | $118.31 | $531.63 - $582.32 | 3 |
| Georgia | $527.17 | $108.79 | $499.01 - $555.32 | 2 |
| Illinois | $541.45 | $117.7 | $512.95 - $567.48 | 4 |
| Michigan | $522.81 | $111.01 | $507.73 - $537.89 | 2 |
| North Carolina | $510.86 | $101.69 | $510.86 - $510.86 | 1 |
| New York | $605.82 | $116.57 | $519.3 - $646.29 | 5 |
| Ohio | $506.27 | $105.87 | $506.27 - $506.27 | 1 |
| Pennsylvania | $537.76 | $108.19 | $507.77 - $567.74 | 2 |
| Texas | $538.04 | $106.28 | $503.97 - $570.4 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 36160
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36160 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01916 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01924 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 01925 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 01926 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35201 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 35206 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 35226 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 35266 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 36160
What does CPT code 36160 mean? +
CPT code 36160 represents: Establish access to aorta. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of XXX.
What is the Medicare reimbursement for CPT 36160? +
The 2026 Medicare national average non-facility payment for CPT 36160 is $565.07. Rates range from $475.98 to $748.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36160? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 36160? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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