36245
RadiologyCMS status: ASelective catheter placement, arterial system, abdominal, pelvic, or lower extremity, first order arterial branch. CMS 2026 global wRVU 4.67, total RVU approximately 6.68, Medicare global allowable approximately $223. The foundational selective catheter code for abdominal and pelvic vascular procedures.
Drop 36245 into a scenario to see how unit volume rolls up to annual wRVUs, gross collections, and bonus.
Open in calculator →When to use it
Use 36245 when a first-order branch is selectively catheterized in the abdominal aorta or its branches (renal artery, celiac, SMA, IMA, common iliac, external iliac) for diagnostic angiography or to deliver therapy (embolization, chemoembolization, stenting). 36246 is the second-order branch (e.g., right renal segmental, hepatic proper from celiac), 36247 is the third or further order (e.g., dorsal pancreatic from celiac, intrarenal segmental). Each catheter selection in a NEW vascular family is separately billable; multiple selections in the same family stack with order codes.
Documentation checklist
- ✓Procedure note including: arterial access site (femoral, radial), introducer sheath, wire and catheter selections, each vascular territory engaged, fluoroscopy time, contrast type and volume.
- ✓Imaging guidance documentation. If non-vascular imaging guidance is also used for the procedure (e.g., 76942 for needle placement at a separate site), bill separately.
- ✓Indication for selective catheterization.
- ✓Outcomes / findings documented.
- ✓Setting modifier; signed report.
Common pitfalls
- !Confusion among 36245 / 36246 / 36247. Order matters: first-order = direct from the aorta, second-order = a branch beyond first, third-or-further = beyond second. Document each catheter movement and label.
- !Billing 36245 for non-selective aortogram (which is 36200 or 75630-series). Non-selective is when only the aorta itself is engaged, no branch selectivity.
- !Stacking 36245 multiple times for selections in the same vascular family. The correct code progresses with order (36245 -> 36246 -> 36247), not multiple 36245.
- !Forgetting the imaging guidance and supervision codes (75710 LE arteriogram unilateral, 75716 bilateral, 75726 visceral selective, 75774 each additional selective vessel) when angiography is the purpose.
- !Performing a procedure that includes selective catheterization as part of a bundled service code (e.g., uterine artery embolization 37243 bundles the selective catheter codes for the uterine arteries) and double-billing.
Payer notes
Medicare covers 36245 with appropriate indication and procedural documentation. Outpatient prior authorization is rare for ED or inpatient cases; outpatient elective IR procedures may require auth. The 26 modifier applies for the professional component when the imaging facility owns the equipment.