CPT 36216
Global 000 ActivePlace catheter in artery
CPT 36216 Billing & Documentation Guide
CPT code 36216 (Place catheter in artery) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.14, a non-facility practice expense RVU of 26.08, and a malpractice RVU of 1.13, a total non-facility RVU of 32.35 and facility RVU of 7.29. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1116.6, though rates vary from $939.39 to $1466.92 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36216, 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 36216 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 4 units of 36216 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 36216
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.14 | 5.14 |
| Practice Expense RVU | 26.08 | 1.02 |
| Malpractice RVU | 1.13 | 1.13 |
| Total RVU | 32.35 | 7.29 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36216
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 | $1229.05 | $238.61 | $1149.55 - $1466.92 | 29 |
| Florida | $1119.15 | $279.34 | $1061.18 - $1173.94 | 3 |
| Georgia | $1048.13 | $249.6 | $993.69 - $1102.56 | 2 |
| Illinois | $1086.1 | $277.33 | $1025.98 - $1134.95 | 4 |
| Michigan | $1042.76 | $256.8 | $1009.6 - $1075.92 | 2 |
| North Carolina | $1008.53 | $227.58 | $1008.53 - $1008.53 | 1 |
| New York | $1202.93 | $269.14 | $1025.75 - $1288.49 | 5 |
| Ohio | $1005.04 | $240.83 | $1005.04 - $1005.04 | 1 |
| Pennsylvania | $1066.81 | $246.94 | $1007.01 - $1126.61 | 2 |
| Texas | $1065.28 | $241.22 | $999.44 - $1127.08 | 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 36216
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36216 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 |
| 35231 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36216
What does CPT code 36216 mean? +
CPT code 36216 represents: Place catheter in artery. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36216? +
The 2026 Medicare national average non-facility payment for CPT 36216 is $1116.6. Rates range from $939.39 to $1466.92 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36216? +
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 36216? +
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 May 31, 2026.
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