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

Facility rates · Physician

Payer

Traditional Medicare

Priced as of

November 13, 2026

Medicare allowed

$1,232.93

Total the claim is paid on

Medicare pays

$966.61

80%, less 2% sequestration

Patient owes

$246.59

20% coinsurance, once the Part B deductible is met

Billing rules changed it by

−$1,308.15

from $2,541.08 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	$780.62	$780.62	—	$780.62
36224	Place cath carotd art	1	$342.81	$342.81	−$171.41	$171.40
	Multiple procedure Multiple procedure (50%)				−$171.41
36226	Place cath vertebral art	1	$340.35	$340.35	−$170.18	$170.17
	Multiple procedure Multiple procedure (50%)				−$170.18
36223	Place cath carotid/inom art Bundled into 36224	1	$306.76	$306.76	−$306.76	$0.00
	NCCI bundling Bundled into 36224 (NCCI)				−$306.76
36225	Place cath subclavian art Bundled into 36226	1	$303.13	$303.13	−$303.13	$0.00
	NCCI bundling Bundled into 36226 (NCCI)				−$303.13
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
36227	Place cath xtrnl carotid	1	$110.74	$110.74	—	$110.74
Total				$2,541.08	−$1,308.15	$1,232.93

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	3.6 × 1.442 facility	4.05 × 0.397	23.3714	33.4009	$780.62	0-day global	Standard (2nd+ at 50%)	No bilateral adjustment	Not paid	Not permitted
36224	6.09 × 1.11	1.89 × 1.442 facility	1.96 × 0.397	10.2634	33.4009	$342.81	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36226	6.09 × 1.11	1.85 × 1.442 facility	1.92 × 0.397	10.1898	33.4009	$340.35	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36223	5.61 × 1.11	1.58 × 1.442 facility	1.71 × 0.397	9.1843	33.4009	$306.76	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
36225	5.61 × 1.11	1.51 × 1.442 facility	1.69 × 0.397	9.0755	33.4009	$303.13	0-day global	Standard (2nd+ at 50%)	150% with 50	Not paid	Not permitted
75898-26	1.8 × 1.11	0.97 × 1.442 facility	0.41 × 0.397	3.5595	33.4009	$118.89	No global period	No reduction	No bilateral adjustment	Needs documentation	Not permitted
36227	2.04 × 1.11	0.55 × 1.442 facility	0.65 × 0.397	3.3156	33.4009	$110.74	Add-on code	No reduction	150% with 50	Not paid	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.