Extracranail Embolization

Billed together on one claim

61626 36223 36224 36225 36226 36227 75898-26 ×3

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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

$17,287.72

Total the claim is paid on

Medicare pays

$13,553.58

80%, less 2% sequestration

Patient owes

$3,457.54

20% coinsurance, once the Part B deductible is met

Billing rules changed it by

−$8,667.86

from $25,955.58 at full fee schedule

Bundled into 36224 36223

NCCI denies 36223 billed with 36224. If it was a distinct service (different site, session or encounter), document that and add 59 or XE/XS/XP/XU.
Bundled into 36226 36225

NCCI denies 36225 billed with 36226. If it was a distinct service (different site, session or encounter), document that and add 59 or XE/XS/XP/XU.
Units over the daily MUE 75898-26

Medicare denies every unit of 75898 when more than 2 are billed for one day. Bill at most 2 units, or document why more were needed and appeal (clinical edit).

Highest-paid first, the order Medicare ranks multiple procedures

Code	Description	Units	Fee schedule	× Units	Adjustments	Allowed
61626	Tcat perm occls/embol noncns	1	$13,730.99	$13,730.99	—	$13,730.99
36224	Place cath carotd art	1	$3,253.36	$3,253.36	−$1,626.68	$1,626.68
	Multiple procedure Multiple procedure (50%)				−$1,626.68
36226	Place cath vertebral art	1	$3,161.80	$3,161.80	−$1,580.90	$1,580.90
	Multiple procedure Multiple procedure (50%)				−$1,580.90
36223	Place cath carotid/inom art Bundled into 36224	1	$2,640.32	$2,640.32	−$2,640.32	$0.00
	NCCI bundling Bundled into 36224 (NCCI)				−$2,640.32
36225	Place cath subclavian art Bundled into 36226	1	$2,463.29	$2,463.29	−$2,463.29	$0.00
	NCCI bundling Bundled into 36226 (NCCI)				−$2,463.29
36227	Place cath xtrnl carotid	1	$349.15	$349.15	—	$349.15
75898-26	Follow-up angiography Units over the daily MUE	3	$118.89	$356.67	−$356.67	$0.00
	Unit limit Over MUE of 2 per day				−$356.67
Total				$25,955.58	−$8,667.86	$17,287.72

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)
61626	14.93 × 1.11	272.48 × 1.442 non-facility	4.05 × 0.397	411.0963	33.4009	$13,730.99	0-day global	Standard (2nd+ at 50%)	No bilateral adjustment	Not paid	Not permitted
36224	6.09 × 1.11	62.32 × 1.442 non-facility	1.96 × 0.397	97.4035	33.4009	$3,253.36	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
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
36225	5.61 × 1.11	46.36 × 1.442 non-facility	1.69 × 0.397	73.7492	33.4009	$2,463.29	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36227	2.04 × 1.11	5.5 × 1.442 non-facility	0.65 × 0.397	10.4535	33.4009	$349.15	Add-on code	No reduction	150% with 50	Not paid	Not permitted
75898-26	1.8 × 1.11	0.97 × 1.442 non-facility	0.41 × 0.397	3.5595	33.4009	$118.89	No global period	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.