CPT 36226
Global 000 ActivePlace cath vertebral art
CPT 36226 Billing & Documentation Guide
CPT code 36226 (Place cath vertebral art) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.09, a non-facility practice expense RVU of 60.43, and a malpractice RVU of 1.92, a total non-facility RVU of 68.44 and facility RVU of 9.86. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2368.95, though rates vary from $1970.26 to $3170.72 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36226, 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 36226 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 1 units of 36226 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 36226
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.09 | 6.09 |
| Practice Expense RVU | 60.43 | 1.85 |
| Malpractice RVU | 1.92 | 1.92 |
| Total RVU | 68.44 | 9.86 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36226
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 | $2633.82 | $318.6 | $2453.43 - $3170.72 | 29 |
| Florida | $2353.39 | $390.25 | $2229.4 - $2466.77 | 3 |
| Georgia | $2206.02 | $339.4 | $2080.28 - $2331.75 | 2 |
| Illinois | $2276.97 | $386.38 | $2146.46 - $2391.39 | 4 |
| Michigan | $2188.97 | $351.7 | $2118.63 - $2259.31 | 2 |
| North Carolina | $2127.57 | $302.04 | $2127.57 - $2127.57 | 1 |
| New York | $2551.99 | $369.18 | $2165.99 - $2735.42 | 5 |
| Ohio | $2110.87 | $324.47 | $2110.87 - $2110.87 | 1 |
| Pennsylvania | $2250.84 | $334.32 | $2116.92 - $2384.75 | 2 |
| Texas | $2251.23 | $324.93 | $2099.75 - $2396.12 | 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 36226
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36226 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 | Anesthesia service included in surgical procedure |
| 01925 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01926 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36226
What does CPT code 36226 mean? +
CPT code 36226 represents: Place cath vertebral art. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36226? +
The 2026 Medicare national average non-facility payment for CPT 36226 is $2368.95. Rates range from $1970.26 to $3170.72 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36226? +
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 36226? +
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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