How much does Medicare pay for CPT 36226?

Medicare allowed an average of $286.02 per service and paid $227.45 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5235.40, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36226?

Insertion of tube into brain artery for diagnosis or treatment with review by radiologist. It was billed 17,224 times to 15,820 Medicare beneficiaries by 645 providers in 2024.

Does 36226 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1435.70 in an office setting and $260.72 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 36226 most?

Neurosurgery, with 8,289 services from 305 clinicians. Next are Neurology, Diagnostic Radiology, Interventional Radiology.

CPT 36226

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

$286.02Medicare-allowed amount per service, averaged across 17,224 services

Providers submitted

$5235.40

Asking price, not received

Medicare allowed

$286.02

The fee schedule figure

Medicare paid

$227.45

Balance is patient coinsurance

Providers submitted an average of $5235.40 for this code and Medicare allowed $286.02 — 18.3× 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 $227.45 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1435.70
Hospital / facility: $260.72

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. 371 services were billed in an office setting and 16,853 in a facility.

Services: 17,224
Beneficiaries: 15,820
Providers billing it: 645
Total allowed: $4,926,408

What Medicare pays for CPT 36226

Across 17,224 services billed by 645 providers to 15,820 beneficiaries, Medicare allowed an average of $286.02 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 36226

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	8,289	7,558	$276.32	305
Neurology	3,761	3,486	$258.27	143
Diagnostic Radiology	2,721	2,514	$289.52	110
Interventional Radiology	1,941	1,802	$332.01	65
Neuropsychiatry	185	154	$227.11	4
Cardiology	65	64	$892.61	4
Vascular Surgery	55	53	$260.53	3
Undefined Physician type	42	40	$1020.20	3
Internal Medicine	38	35	$240.00	2
Critical Care (Intensivists)	36	34	$153.69	1
Pediatric Medicine	24	21	$238.34	1
General Surgery	22	17	$247.63	1
Psychiatry	16	14	$253.96	1
Thoracic Surgery	16	15	$2710.01	1
Peripheral Vascular Disease	13	13	$158.24	1

36226 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
California	2,007	$298.29	$227.47	75
Florida	1,571	$292.49	$207.47	57
New York	1,216	$288.90	$194.97	44
Texas	1,176	$276.01	$215.14	51
Pennsylvania	922	$274.14	$216.09	31
Illinois	881	$279.61	$203.30	27
Ohio	812	$268.13	$217.39	28
Virginia	592	$249.22	$197.97	18
Massachusetts	586	$373.95	$261.66	16
Washington	500	$486.41	$382.95	14
North Carolina	451	$364.25	$311.94	20
New Jersey	449	$278.10	$204.62	19
Georgia	444	$324.31	$261.42	15
Tennessee	409	$347.88	$321.21	20
Maryland	378	$248.34	$191.38	13
Missouri	337	$237.87	$193.27	16
South Carolina	327	$246.52	$204.12	10
Arizona	299	$390.91	$330.79	11
Michigan	287	$272.52	$194.90	14
Kentucky	273	$248.41	$203.14	11
Indiana	271	$208.59	$177.46	9
Alabama	204	$208.72	$189.64	9
Colorado	204	$263.22	$200.86	8
Oklahoma	199	$214.28	$182.91	8
South Dakota	195	$206.50	$187.45	5
Connecticut	186	$269.62	$196.44	7
Kansas	185	$223.88	$193.97	8
Arkansas	182	$215.11	$199.16	8
Louisiana	158	$272.77	$220.55	7
Minnesota	155	$219.67	$195.73	9
Mississippi	150	$301.98	$267.69	7
Wisconsin	147	$218.43	$188.55	7
Oregon	143	$232.77	$183.62	7
Utah	140	$225.49	$180.47	5
Nevada	136	$229.46	$188.82	6
Hawaii	128	$262.04	$217.57	3
Iowa	106	$212.86	$178.02	3
District of Columbia	101	$247.85	$175.85	4
North Dakota	69	$172.47	$148.53	2
Maine	48	$230.05	$194.27	3
Montana	31	$226.31	$192.96	2
Vermont	31	$205.20	$187.20	1
New Hampshire	29	$369.91	$285.55	2
Idaho	28	$195.94	$176.69	1
Delaware	24	$211.60	$175.42	1
Alaska	23	$371.45	$252.11	1
West Virginia	19	$314.96	$233.96	1
Nebraska	15	$162.13	$155.42	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
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
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.