CPT 36253
Global 000 ActiveIns cath ren art 2nd+ unilat
CPT 36253 Billing & Documentation Guide
CPT code 36253 (Ins cath ren art 2nd+ unilat) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 7.12, a non-facility practice expense RVU of 48.81, and a malpractice RVU of 0.88, a total non-facility RVU of 56.81 and facility RVU of 9.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1969.27, though rates vary from $1653.38 to $2630.62 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36253, 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 36253 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 36253 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 36253
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.12 | 7.12 |
| Practice Expense RVU | 48.81 | 1.13 |
| Malpractice RVU | 0.88 | 0.88 |
| Total RVU | 56.81 | 9.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36253
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 | $2191.37 | $306.94 | $2044.42 - $2630.62 | 29 |
| Florida | $1930.77 | $332.9 | $1840.56 - $2009.29 | 3 |
| Georgia | $1828.65 | $309.35 | $1727.08 - $1930.21 | 2 |
| Illinois | $1870.09 | $331.29 | $1772.22 - $1965.88 | 4 |
| Michigan | $1810.03 | $314.63 | $1759.46 - $1860.61 | 2 |
| North Carolina | $1777.66 | $291.81 | $1777.66 - $1777.66 | 1 |
| New York | $2107.81 | $331.15 | $1807.26 - $2246.04 | 5 |
| Ohio | $1755.9 | $301.9 | $1755.9 - $1755.9 | 1 |
| Pennsylvania | $1868.25 | $308.35 | $1762.2 - $1974.3 | 2 |
| Texas | $1871.45 | $303.58 | $1748.69 - $1989.19 | 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 36253
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36253 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 36253
What does CPT code 36253 mean? +
CPT code 36253 represents: Ins cath ren art 2nd+ unilat. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36253? +
The 2026 Medicare national average non-facility payment for CPT 36253 is $1969.27. Rates range from $1653.38 to $2630.62 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36253? +
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 36253? +
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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