CPT 36252
Global 000 ActiveIns cath ren art 1st bilat
CPT 36252 Billing & Documentation Guide
CPT code 36252 (Ins cath ren art 1st bilat) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.57, a non-facility practice expense RVU of 32.17, and a malpractice RVU of 1.48, a total non-facility RVU of 40.22 and facility RVU of 9.27. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1387.63, though rates vary from $1167.9 to $1819.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36252, 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 36252 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 36252 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 36252
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.57 | 6.57 |
| Practice Expense RVU | 32.17 | 1.22 |
| Malpractice RVU | 1.48 | 1.48 |
| Total RVU | 40.22 | 9.27 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36252
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 | $1525.55 | $302.33 | $1427.33 - $1819.52 | 29 |
| Florida | $1393.76 | $356.56 | $1320.97 - $1463.02 | 3 |
| Georgia | $1304 | $317.8 | $1236.83 - $1371.17 | 2 |
| Illinois | $1352.92 | $354.05 | $1277.73 - $1414.31 | 4 |
| Michigan | $1297.99 | $327.28 | $1256.28 - $1339.69 | 2 |
| North Carolina | $1253.55 | $289.05 | $1253.55 - $1253.55 | 1 |
| New York | $1495.78 | $342.52 | $1274.98 - $1602.87 | 5 |
| Ohio | $1250.3 | $306.48 | $1250.3 - $1250.3 | 1 |
| Pennsylvania | $1326.75 | $314.18 | $1252.56 - $1400.93 | 2 |
| Texas | $1324.42 | $306.68 | $1243.17 - $1400.51 | 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 36252
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36252 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 | 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 | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 |
Frequently Asked Questions, CPT 36252
What does CPT code 36252 mean? +
CPT code 36252 represents: Ins cath ren art 1st bilat. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36252? +
The 2026 Medicare national average non-facility payment for CPT 36252 is $1387.63. Rates range from $1167.9 to $1819.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36252? +
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 36252? +
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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