CPT 36247
Global 000 ActiveIns cath abd/l-ext art 3rd
CPT 36247 Billing & Documentation Guide
CPT code 36247 (Ins cath abd/l-ext art 3rd) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.89, a non-facility practice expense RVU of 33.72, and a malpractice RVU of 0.99, a total non-facility RVU of 40.6 and facility RVU of 7.75. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1404.48, though rates vary from $1181.23 to $1860.19 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36247, 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 36247 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 3 units of 36247 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 36247
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.89 | 5.89 |
| Practice Expense RVU | 33.72 | 0.87 |
| Malpractice RVU | 0.99 | 0.99 |
| Total RVU | 40.6 | 7.75 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36247
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 | $1554.41 | $256.1 | $1452.2 - $1860.19 | 29 |
| Florida | $1391.13 | $290.26 | $1323.15 - $1452.81 | 3 |
| Georgia | $1311.06 | $264.32 | $1240.79 - $1381.33 | 2 |
| Illinois | $1348.88 | $288.69 | $1276.71 - $1413.39 | 4 |
| Michigan | $1300.85 | $270.55 | $1262.36 - $1339.34 | 2 |
| North Carolina | $1268.68 | $244.97 | $1268.68 - $1268.68 | 1 |
| New York | $1507.49 | $283.43 | $1289.94 - $1609.87 | 5 |
| Ohio | $1258.35 | $256.59 | $1258.35 - $1258.35 | 1 |
| Pennsylvania | $1337.04 | $262.32 | $1261.9 - $1412.18 | 2 |
| Texas | $1337.35 | $257.14 | $1252.36 - $1418.02 | 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 36247
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36247 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 |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36247
What does CPT code 36247 mean? +
CPT code 36247 represents: Ins cath abd/l-ext art 3rd. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36247? +
The 2026 Medicare national average non-facility payment for CPT 36247 is $1404.48. Rates range from $1181.23 to $1860.19 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36247? +
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 36247? +
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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