CPT 36227
Global ZZZ ActivePlace cath xtrnl carotid
CPT 36227 Billing & Documentation Guide
CPT code 36227 (Place cath xtrnl carotid) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.04, a non-facility practice expense RVU of 5.5, and a malpractice RVU of 0.65, a total non-facility RVU of 8.19 and facility RVU of 3.24. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $279.83, though rates vary from $237.12 to $352.17 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36227, 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 36227 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 36227 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 36227
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.04 | 2.04 |
| Practice Expense RVU | 5.5 | 0.55 |
| Malpractice RVU | 0.65 | 0.65 |
| Total RVU | 8.19 | 3.24 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36227
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 | $299.73 | $104.09 | $282.27 - $352.17 | 29 |
| Florida | $294.72 | $128.83 | $276.39 - $314.28 | 3 |
| Georgia | $269.47 | $111.74 | $257.88 - $281.06 | 2 |
| Illinois | $287.37 | $127.61 | $269.79 - $303.06 | 4 |
| Michigan | $271.2 | $115.95 | $260.37 - $282.02 | 2 |
| North Carolina | $253.41 | $99.15 | $253.41 - $253.41 | 1 |
| New York | $305.83 | $121.38 | $257.92 - $331.24 | 5 |
| Ohio | $257.74 | $106.79 | $257.74 - $257.74 | 1 |
| Pennsylvania | $271.9 | $109.96 | $257.3 - $286.5 | 2 |
| Texas | $269.54 | $106.76 | $255.48 - $281.87 | 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 36227
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36227 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 35201 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35206 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35226 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35231 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35236 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35256 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35261 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35266 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 35286 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36160 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 36227
What does CPT code 36227 mean? +
CPT code 36227 represents: Place cath xtrnl carotid. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 36227? +
The 2026 Medicare national average non-facility payment for CPT 36227 is $279.83. Rates range from $237.12 to $352.17 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36227? +
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 36227? +
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 1, 2026.
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