How much does Medicare pay for CPT 36225?

Medicare allowed an average of $253.70 per service and paid $202.20 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5444.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36225?

Insertion of tube into chest artery for diagnosis or treatment with review by radiologist. It was billed 3,822 times to 3,643 Medicare beneficiaries by 157 providers in 2024.

Does 36225 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1524.34 in an office setting and $200.71 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 36225 most?

Neurosurgery, with 1,771 services from 68 clinicians. Next are Neurology, Interventional Radiology, Diagnostic Radiology.

CPT 36225

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

$253.70Medicare-allowed amount per service, averaged across 3,822 services

Providers submitted

$5444.13

Asking price, not received

Medicare allowed

$253.70

The fee schedule figure

Medicare paid

$202.20

Balance is patient coinsurance

Providers submitted an average of $5444.13 for this code and Medicare allowed $253.70 — 21.5× 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 $202.20 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1524.34
Hospital / facility: $200.71

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. 153 services were billed in an office setting and 3,669 in a facility.

Services: 3,822
Beneficiaries: 3,643
Providers billing it: 157
Total allowed: $969,641

What Medicare pays for CPT 36225

Across 3,822 services billed by 157 providers to 3,643 beneficiaries, Medicare allowed an average of $253.70 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 36225

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	1,771	1,668	$196.47	68
Neurology	852	826	$187.96	37
Interventional Radiology	507	472	$292.85	15
Diagnostic Radiology	244	236	$225.15	14
Interventional Cardiology	172	172	$208.79	9
Vascular Surgery	81	81	$1846.12	4
Cardiology	65	64	$757.15	4
Neuropsychiatry	36	35	$189.60	2
Internal Medicine	36	35	$192.58	2
Critical Care (Intensivists)	29	27	$172.53	1
Peripheral Vascular Disease	29	27	$163.07	1

36225 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
Florida	427	$221.54	$161.48	19
Texas	349	$232.16	$189.96	17
California	329	$620.50	$440.55	14
New York	325	$247.35	$173.47	11
Massachusetts	233	$277.21	$183.29	2
Ohio	191	$191.43	$148.15	9
Arizona	191	$190.70	$154.80	4
Pennsylvania	183	$193.28	$153.69	9
Illinois	175	$195.38	$147.85	7
Maryland	151	$200.12	$157.91	5
Washington	148	$386.06	$310.44	4
Virginia	111	$187.29	$151.06	5
New Jersey	105	$196.87	$146.37	4
South Dakota	98	$162.90	$146.72	4
South Carolina	87	$173.62	$147.55	4
Utah	85	$188.28	$151.20	4
Louisiana	62	$176.44	$143.89	3
Iowa	58	$198.43	$169.91	3
Colorado	47	$186.93	$145.82	2
Georgia	44	$180.89	$144.05	3
Kentucky	41	$184.16	$144.68	2
Indiana	41	$174.54	$150.04	2
Alabama	33	$177.43	$163.01	2
Tennessee	33	$149.76	$131.08	2
Mississippi	33	$154.97	$135.08	2
North Dakota	30	$223.36	$198.62	1
Connecticut	27	$198.38	$146.37	1
Oklahoma	25	$179.48	$145.37	1
Kansas	25	$175.48	$150.90	2
Arkansas	22	$162.13	$145.86	1
Missouri	20	$173.47	$141.04	1
Idaho	16	$205.19	$184.24	1
Montana	15	$167.53	$133.97	1
Hawaii	14	$156.56	$134.61	1
Michigan	14	$288.36	$224.12	1
Nevada	12	$173.46	$141.65	1
Nebraska	11	$211.03	$188.51	1
Guam	11	$1114.46	$786.88	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
36223Insertion of tube into intracranial artery for diagnosis or treatment$304.28
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
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.