How much does Medicare pay for CPT 36223?

Medicare allowed an average of $304.28 per service and paid $241.80 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5189.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36223?

Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist. It was billed 12,200 times to 11,632 Medicare beneficiaries by 504 providers in 2024.

Does 36223 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1672.47 in an office setting and $284.94 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 36223 most?

Neurosurgery, with 5,508 services from 220 clinicians. Next are Neurology, Diagnostic Radiology, Interventional Radiology.

CPT 36223

Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist

$304.28Medicare-allowed amount per service, averaged across 12,200 services

Providers submitted

$5189.79

Asking price, not received

Medicare allowed

$304.28

The fee schedule figure

Medicare paid

$241.80

Balance is patient coinsurance

Providers submitted an average of $5189.79 for this code and Medicare allowed $304.28 — 17.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $241.80 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1672.47
Hospital / facility: $284.94

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 170 services were billed in an office setting and 12,030 in a facility.

Services: 12,200
Beneficiaries: 11,632
Providers billing it: 504
Total allowed: $3,712,216

What Medicare pays for CPT 36223

Across 12,200 services billed by 504 providers to 11,632 beneficiaries, Medicare allowed an average of $304.28 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 36223

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	5,508	5,211	$289.06	220
Neurology	2,677	2,569	$278.72	111
Diagnostic Radiology	1,716	1,641	$279.32	74
Interventional Radiology	1,314	1,254	$314.09	45
Interventional Cardiology	289	284	$305.61	16
Cardiology	254	251	$466.70	15
Vascular Surgery	127	121	$638.02	9
Neuropsychiatry	114	105	$258.15	4
Internal Medicine	62	62	$1089.94	3
Peripheral Vascular Disease	38	37	$291.19	1
General Surgery	31	31	$1795.15	2
Critical Care (Intensivists)	24	23	$207.33	1
Thoracic Surgery	16	15	$1126.38	1
Psychiatry	15	15	$275.36	1
Pediatric Medicine	15	13	$209.99	1

36223 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	1,309	$341.49	$232.22	46
Florida	1,120	$336.72	$246.78	45
Texas	952	$337.89	$270.51	45
California	871	$279.53	$217.04	40
Pennsylvania	832	$284.73	$223.09	30
Ohio	735	$289.45	$229.52	26
Illinois	557	$314.60	$229.68	23
Massachusetts	481	$295.10	$206.83	14
Arizona	416	$312.79	$254.93	11
North Carolina	345	$282.74	$235.40	21
Tennessee	341	$245.91	$215.13	16
Maryland	279	$310.51	$234.60	10
Virginia	274	$253.69	$198.00	11
Missouri	247	$299.38	$240.65	13
Michigan	245	$328.65	$236.72	13
Colorado	240	$231.70	$177.44	8
Kentucky	201	$282.99	$229.63	8
Minnesota	197	$226.72	$199.43	8
New Jersey	184	$291.72	$216.37	8
Indiana	170	$246.33	$210.90	9
Oregon	162	$529.76	$423.65	8
Iowa	160	$222.73	$185.06	6
Oklahoma	156	$421.61	$362.29	6
South Dakota	152	$277.61	$247.69	5
Washington	142	$381.98	$303.50	5
Georgia	140	$295.93	$222.38	7
Louisiana	139	$275.55	$220.36	7
Alabama	127	$259.21	$227.04	7
Utah	127	$273.70	$216.44	5
Mississippi	123	$243.44	$208.14	6
Nevada	117	$279.77	$231.32	5
South Carolina	113	$214.04	$178.01	4
Connecticut	80	$271.13	$200.01	4
North Dakota	62	$264.70	$228.85	3
Montana	57	$282.28	$216.57	2
Hawaii	48	$198.64	$159.88	2
District of Columbia	44	$219.29	$161.92	2
Vermont	35	$258.68	$226.17	2
Wisconsin	32	$259.49	$235.13	2
West Virginia	31	$315.89	$225.81	2
Kansas	28	$208.07	$169.52	1
Alaska	22	$353.95	$238.56	1
Idaho	18	$250.49	$207.44	1
New Hampshire	17	$260.89	$197.55	1
Rhode Island	17	$200.97	$169.66	1
Arkansas	16	$228.91	$206.06	1
Guam	15	$1872.61	$1510.60	1
New Mexico	12	$208.71	$163.47	1
Nebraska	12	$211.48	$234.98	1

Related codes

36247Insertion of tube into abdominal$508.22
36248Insertion of tube into abdominal$94.94
36224Insertion of tube into internal neck artery for diagnosis or treatment$416.64
36226Insertion of tube into brain artery for diagnosis or treatment$286.02
36215Insertion of tube into chest or arm artery$311.96
36227Insertion of tube into external neck artery for diagnosis or treatment$157.57
36245Insertion of tube into abdominal$406.16
36246Insertion of tube into abdominal$345.02
36225Insertion of tube into chest artery for diagnosis or treatment$253.70
36200Insertion of tube into aorta$221.32

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.