How much does Medicare pay for CPT 36227?

Medicare allowed an average of $157.57 per service and paid $125.90 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1257.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 36227?

Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist. It was billed 9,000 times to 8,427 Medicare beneficiaries by 403 providers in 2024.

Does 36227 pay differently in an office than a hospital?

Yes. The allowed amount averaged $350.29 in an office setting and $152.92 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 36227 most?

Neurosurgery, with 4,951 services from 206 clinicians. Next are Neurology, Diagnostic Radiology, Interventional Radiology.

CPT 36227

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

$157.57Medicare-allowed amount per service, averaged across 9,000 services

Providers submitted

$1257.47

Asking price, not received

Medicare allowed

$157.57

The fee schedule figure

Medicare paid

$125.90

Balance is patient coinsurance

Providers submitted an average of $1257.47 for this code and Medicare allowed $157.57 — 8.0× 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 $125.90 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $350.29
Hospital / facility: $152.92

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. 212 services were billed in an office setting and 8,788 in a facility.

Services: 9,000
Beneficiaries: 8,427
Providers billing it: 403
Total allowed: $1,418,130

What Medicare pays for CPT 36227

Across 9,000 services billed by 403 providers to 8,427 beneficiaries, Medicare allowed an average of $157.57 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 36227

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	4,951	4,590	$154.43	206
Neurology	1,567	1,474	$153.59	77
Diagnostic Radiology	1,251	1,198	$158.49	62
Interventional Radiology	1,013	961	$168.47	49
Neuropsychiatry	89	83	$156.13	2
Undefined Physician type	34	30	$305.40	2
Pediatric Medicine	25	23	$143.32	1
Cardiology	21	21	$397.09	1
Internal Medicine	21	21	$142.99	1
Vascular Surgery	15	15	$187.99	1
General Surgery	13	11	$149.29	1

36227 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	1,119	$164.52	$127.18	52
Florida	915	$167.23	$117.99	41
New York	641	$174.86	$117.14	31
Illinois	625	$162.47	$119.30	23
Texas	614	$151.79	$118.76	32
Pennsylvania	509	$146.97	$117.98	22
Virginia	408	$153.36	$123.58	13
Ohio	313	$142.61	$116.45	14
Washington	304	$215.90	$172.25	10
New Jersey	283	$167.33	$123.55	13
Georgia	268	$181.53	$145.36	9
North Carolina	230	$163.24	$135.14	10
Massachusetts	208	$159.33	$121.72	7
South Carolina	189	$142.09	$120.39	8
Arizona	178	$132.30	$109.53	9
Connecticut	161	$162.23	$119.58	6
Tennessee	161	$132.64	$119.27	10
Maryland	153	$152.35	$116.04	7
Kansas	148	$139.60	$120.46	8
Indiana	144	$133.86	$114.92	8
Missouri	137	$133.60	$105.00	5
Hawaii	131	$149.01	$126.49	3
Alabama	116	$141.15	$126.88	6
Iowa	100	$125.46	$108.45	5
Minnesota	97	$115.08	$101.27	5
Utah	77	$141.65	$115.51	4
Kentucky	74	$132.35	$99.98	4
Oklahoma	73	$132.18	$114.06	3
Nevada	70	$151.49	$125.11	3
South Dakota	66	$137.07	$122.66	2
Michigan	54	$154.32	$112.13	3
Colorado	53	$171.72	$130.06	3
Louisiana	51	$148.76	$123.08	2
District of Columbia	46	$156.44	$112.39	2
Arkansas	43	$123.53	$111.64	3
Wisconsin	41	$133.00	$121.43	3
Oregon	31	$156.70	$124.68	2
Maine	31	$138.76	$117.32	2
Montana	29	$130.81	$113.60	2
Mississippi	23	$127.96	$115.57	2
North Dakota	20	$131.50	$114.03	1
Idaho	15	$125.18	$112.11	1
Delaware	14	$153.88	$123.29	1
Rhode Island	13	$121.16	$105.77	1
West Virginia	12	$175.13	$135.87	1
Vermont	12	$136.34	$124.57	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
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.