Understanding Billing for Catheterization of the Carotid Artery

Published 07/09/2025

Understanding Current Procedural Terminology® (CPT®) Code 36224

CPT® code 36244 specifically pertains to the catheterization of the carotid artery for the purpose of diagnostic imaging. This code is crucial for accurate billing and documentation of the procedure in the healthcare revenue cycle.

Providers Who Can Bill

Medicare regulations state the provider listed on the claim must be someone who can, and did in fact, perform the test or procedure. Often the person performing CPT® code 36244 will be an interventional radiologist or neurointerventionalist. These specialists are trained in image-guided procedures and are qualified to perform the necessary angiography. The ordering physician should not be listed in the claim.

Medicare Reimbursement

The CPT® code 36224 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service.

Applicable Modifiers

Table 1. Applicable Modifiers.
Modifier Circumstance Description
26 Professional Component Only the professional component of the service is being billed, typically by the physician who interprets the results.
TC Technical Component Only the technical component of the service is being billed, usually by the facility providing the equipment and technical support.
50 Bilateral Procedure Procedure is performed on both sides of the body during the same session.
51 Multiple Procedures Multiple procedures are performed during the same session by the same provider, indicating that the procedure is one of several.
52 Reduced Services Service or procedure is partially reduced or eliminated at the physician's discretion.
59 Distinct Procedural Service Procedure or service was distinct or independent from other services performed on the same day.
76 Repeat Procedure by Same Physician Same procedure is repeated by the same physician on the same day.
77 Repeat Procedure by Another Physician Same procedure is repeated by a different physician on the same day.
78 Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period Related procedure is performed during the postoperative period.
79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period Procedure is unrelated to the original procedure performed during the postoperative period.
80 Assistant Surgeon Assistant surgeon is required for the procedure.
81 Minimum Assistant Surgeon Minimum assistant surgeon is required for the procedure.
82 Assistant Surgeon (when qualified resident surgeon not available) Assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.


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