Temp package (2026)

Billed together on one claim

76937-26 36222 ×2 36223 ×2 36226 61645

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Price for scenario

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Fee schedule

2026 Medicare PFS · RVU26D

Effective October 1, 2026 · CF $33.4009

Locality

San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09)

Setting · provider

Office (non-facility) rates · Physician

Payer

Traditional Medicare

Priced as of

November 13, 2026

Medicare allowed

$792.76

Total the claim is paid on

Medicare pays

$621.53

80%, less 2% sequestration

Patient owes

$158.55

20% coinsurance, once the Part B deductible is met

Billing rules changed it by

−$11,869.32

from $12,662.08 at full fee schedule

Units over the daily MUE 36222

Medicare denies every unit of 36222 when more than 1 are billed for one day. If it was done on both sides, bill one unit with modifier 50 (36222-50, paid at 150%). Otherwise bill at most 1 unit, or document why more were needed and appeal (clinical edit).
Units over the daily MUE 36223

Medicare denies every unit of 36223 when more than 1 are billed for one day. If it was done on both sides, bill one unit with modifier 50 (36223-50, paid at 150%). Otherwise bill at most 1 unit, or document why more were needed and appeal (clinical edit).
Bundled into 61645 36226

NCCI denies 36226 billed with 61645. If it was a distinct service (different site, session or encounter), document that and add 59 or XE/XS/XP/XU.

Highest-paid first, the order Medicare ranks multiple procedures

Code	Description	Units	Fee schedule	× Units	Adjustments	Allowed
36226	Place cath vertebral art Bundled into 61645	1	$3,161.80	$3,161.80	−$3,161.80	$0.00
	NCCI bundling Bundled into 61645 (NCCI)				−$3,161.80
36223	Place cath carotid/inom art Units over the daily MUE	2	$2,640.32	$5,280.64	−$5,280.64	$0.00
	Unit limit Over MUE of 1 per day				−$5,280.64
36222	Place cath carotid/inom art Units over the daily MUE	2	$1,713.44	$3,426.88	−$3,426.88	$0.00
	Unit limit Over MUE of 1 per day				−$3,426.88
61645	Perq art m-thrombect &/nfs No office rate	1	$777.28	$777.28	—	$777.28
76937-26	Us guide vascular access	1	$15.48	$15.48	—	$15.48
Total				$12,662.08	−$11,869.32	$792.76

No office rate 61645

CMS has no non-facility rate for 61645; it's normally done in a facility. If the MAC pays it in the office, it pays the facility rate (used here).

Before the Part B deductible

Until the patient meets the annual Part B deductible, they pay the full allowed amount instead of 20% coinsurance.

How each fee is calculated (Work RVU × GPCI + PE RVU × GPCI + MP RVU × GPCI) × conversion factor ▸

Code	Work	Practice expense	Malpractice	Adjusted RVU	× CF	Fee	Global	Multiple procedure	Bilateral (50)	Assistant	Co-surgeon (62)
36226	6.09 × 1.11	60.43 × 1.442 non-facility	1.92 × 0.397	94.6622	33.4009	$3,161.80	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36223	5.61 × 1.11	50.03 × 1.442 non-facility	1.71 × 0.397	79.0492	33.4009	$2,640.32	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36222	5.15 × 1.11	31.25 × 1.442 non-facility	1.31 × 0.397	51.2991	33.4009	$1,713.44	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
61645	14.63 × 1.11	3.69 × 1.442 facility	4.31 × 0.397	23.2714	33.4009	$777.28	0-day global	No reduction	150% with 50	Needs documentation	Not permitted
76937-26	0.29 × 1.11	0.09 × 1.442 non-facility	0.03 × 0.397	0.4636	33.4009	$15.48	Add-on code	No reduction	No bilateral adjustment	Needs documentation	Not permitted

GPCIs for San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09) in RVU26D. Imaging fees are capped at the OPPS amount when that's lower.