Find policies, billing codes, payers, states, and providers

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

CPT code 36222 designates imaging supervision and interpretation for catheter angiography when a catheter is advanced into the thoracic aorta and into the common carotid artery or cervicocerebral arch for contrast injection and X‑ray imaging. This diagnostic interventional radiology procedure is used to identify carotid and cervicocerebral vascular disease and informs decisions on medical, endovascular, or surgical management. Nationally, accurate coding for this service affects procedural tracking, quality reporting, and appropriate reimbursement for complex vascular imaging.

Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, how it is typically delivered (hospital radiology or catheterization laboratory), and what to expect in coding and billing workflows. The publication also covers common modifiers used with angiographic services, relevant service-line placement, and benchmarking considerations where available. Data not available in the input will be clearly identified.

Customize your policy alerts

Sign up for cpt 36222 policy alerts

Get alerted when payer policies referencing 36222 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 36222 represents imaging supervision and interpretation for catheter angiography in which a catheter is inserted through a distal artery into the thoracic aorta and advanced into the common carotid artery or cervicocerebral arch for contrast injection and X‑ray imaging. The procedure is performed to detect vascular disease affecting the carotid or cervicocerebral circulation.

Service type: Diagnostic angiographic imaging with catheter-based contrast injection and real-time fluoroscopic guidance for vascular evaluation
Typical site of service: Hospital radiology or catheterization laboratory (inpatient or outpatient) and specialized vascular/interventional suites

Explore openpayer tools

View all tools

Find policies, billing codes, payers, states, and providers

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

Customize your policy alerts

Sign up for cpt 36222 policy alerts

Get alerted when payer policies referencing 36222 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Diagnostic angiographic imaging with catheter-based contrast injection and real-time fluoroscopic guidance for vascular evaluation
Typical site of service: Hospital radiology or catheterization laboratory (inpatient or outpatient) and specialized vascular/interventional suites

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with a history of hypertension, hyperlipidemia, and transient ischemic attack presents with new onset left-sided weakness and carotid bruits on exam. Noninvasive duplex ultrasound suggests high-grade right internal carotid artery stenosis. The vascular surgery and interventional radiology teams schedule diagnostic and planning angiography. Under conscious sedation in an angiography suite, vascular access is obtained via a distal arterial approach (commonly femoral or radial). A catheter is advanced into the thoracic aorta and selectively into the common carotid artery or cervicocerebral arch. Contrast is injected while the supervising physician provides imaging supervision and interpretation, acquiring X‑ray angiographic images to define lesion location, degree of stenosis, and anatomy for possible subsequent intervention (stenting or endarterectomy). The workflow includes pre-procedure informed consent, anticoagulation review, sterile arterial access, real-time fluoroscopic imaging with contrast injections, intraprocedural interpretation by the supervising physician, documentation of findings and interpretation in the procedure note, and post-procedure monitoring in a recovery unit prior to discharge or admission.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or benchmark service	When the procedure represents a routine, uncomplicated imaging interpretation by the primary clinician performing the service
`22`	Increased procedural services	When substantially greater work is required for imaging supervision/interpretation due to complexity or complications documented in the record
`52`	Reduced services	When the angiographic study is partially reduced or abbreviated and that reduction is documented
`59`	Distinct procedural service	When a separate and distinct angiographic procedure is performed at a different site or on a different vascular territory the same day
`62`	Two surgeons	When two surgeons with distinct, documented roles jointly perform services during the case (rare for interpretation codes)
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period
`80`	Assistant surgeon	If an assistant surgeon is documented as participating in the interventional procedure
`RT`	Right side	To indicate laterality when required by payer reporting for right-sided vascular access or procedures
`LT`	Left side	To indicate laterality when required by payer reporting for left-sided vascular access or procedures
`QX`	Ordering/Referring physician certification	When a certified non-physician practitioner performs a component under a physician’s order applicable to supervision/interpretation reporting

Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Commonly performs diagnostic and therapeutic carotid and aortic angiography
207RP2900X	Interventional Radiology	Frequently provides imaging supervision and interpretation for catheter-based angiography
207SG0101X	Diagnostic Radiology	Interprets vascular imaging and provides supervision for angiographic procedures
2086S0123X	Neurology (Vascular/Endovascular)	Endovascular neurologists may perform or interpret cervicocerebral angiography

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I65.21`	Occlusion and stenosis of right carotid artery	Common indication for diagnostic carotid angiography to define degree and location of stenosis
`I65.22`	Occlusion and stenosis of left carotid artery	Indicates left-sided carotid disease requiring angiographic evaluation
`I63.9`	Cerebral infarction, unspecified	Acute ischemic stroke where angiography may be performed to evaluate vascular etiology or plan intervention
`G45.9`	Transient cerebral ischemic attack, unspecified	TIA prompting vascular imaging to assess carotid or cervicocerebral disease
`I74.3`	Embolism and thrombosis of arteries of the lower extremity	While not cervicocerebral, angiography may be used when embolic source evaluation includes aortic arch imaging

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36221`	Selective catheter placement, carotid artery, with angiography of the head and neck; initial vessel catheterization	Performed when individual selective catheterization of a carotid vessel is required before or during diagnostic angiography of cervicocerebral circulation
`36223`	Catheter placement, thoracic aorta, plus catheter placement in carotid or vertebral artery, with angiography; for additional vessel catheterization	Used for additional selective catheterizations beyond the initial catheterization covered by primary code
`36224`	Catheter placement, thoracic aorta, into innominate/subclavian with angiography	Related when imaging requires evaluation of proximal arch or great vessel anatomy during planning
`75635`	Angiography, thoracic aorta and branches, with contrast (CTA or catheter)	Cross-sectional or catheter angiography of the thoracic aorta may be performed adjunctively for surgical planning
`37184`	Transcatheter placement of intravascular stent(s), open or percutaneous; carotid artery	Therapeutic intervention that may follow diagnostic angiography if clinically indicated

CPT 36200: Aortic Catheterization via Distal Arterial Access

CPT-36215-SELECTIVE-CATHETERIZATION-THORACIC-BRACHIOCEPHALIC-BRANCH

CPT 36215: Selective Catheterization of Thoracic/Brachiocephalic Branches

CPT-36216-SELECTIVE-SECOND-ORDER-THORACIC-BRACHIOCEPHALIC-ANGIOGRAPHY

CPT 36216: Selective Catheterization of Second-Order Thoracic/Brachiocephalic Branch

CPT-36217-SELECTIVE-THIRD-ORDER-THORACIC-BRACHIOCEPHALIC-ANGIOGRAPHY

CPT 36217: Selective Angiography of Third-Order Thoracic/Brachiocephalic Branches

CPT-36218-SELECTIVE-CATHETERIZATION-THORACIC-BRACHIOCEPHALIC-BRANCH-ANGIOGRAPHY

CPT 36218: Selective Catheterization of Thoracic/Brachiocephalic Branches

CPT-36221-THORACIC-AORTIC-ANGIOGRAPHY-IMAGING-SUPERVISION-INTERPRETATION

CPT 36221: Imaging Supervision and Interpretation for Thoracic Aortic Angiography

CPT-36223-CAROTID-CERVICOCEREBRAL-ANGIOGRAPHY-IMAGING-INTERPRETATION

CPT 36223: Imaging Supervision and Interpretation for Carotid/Cervicocerebral Angiography

CPT-36224-INTERNAL-CAROTID-ARTERY-ANGIOGRAPHY-IMAGING

CPT 36224: Internal Carotid Artery Angiography, Imaging Supervision and Interpretation

CPT-36225-SUBCLAVIAN-INNOMINATE-ARTERY-ANGIOGRAPHY-INTERPRETATION

CPT 36225: Selective Subclavian/Innominate Artery Angiography, Imaging Interpretation

CPT-36226-THORACIC-AORTIC-ARCH-ANGIOGRAPHY-IMAGING-INTERPRETATION

CPT 36226: Thoracic Aorta and Aortic Arch Angiography, Imaging Supervision and Interpretation

Showing 1–10 of 12

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or benchmark service	When the procedure represents a routine, uncomplicated imaging interpretation by the primary clinician performing the service
`22`	Increased procedural services	When substantially greater work is required for imaging supervision/interpretation due to complexity or complications documented in the record
`52`	Reduced services	When the angiographic study is partially reduced or abbreviated and that reduction is documented
`59`	Distinct procedural service	When a separate and distinct angiographic procedure is performed at a different site or on a different vascular territory the same day
`62`	Two surgeons	When two surgeons with distinct, documented roles jointly perform services during the case (rare for interpretation codes)
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period
`80`	Assistant surgeon	If an assistant surgeon is documented as participating in the interventional procedure
`RT`	Right side	To indicate laterality when required by payer reporting for right-sided vascular access or procedures
`LT`	Left side	To indicate laterality when required by payer reporting for left-sided vascular access or procedures
`QX`	Ordering/Referring physician certification	When a certified non-physician practitioner performs a component under a physician’s order applicable to supervision/interpretation reporting

Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Commonly performs diagnostic and therapeutic carotid and aortic angiography
207RP2900X	Interventional Radiology	Frequently provides imaging supervision and interpretation for catheter-based angiography
207SG0101X	Diagnostic Radiology	Interprets vascular imaging and provides supervision for angiographic procedures
2086S0123X	Neurology (Vascular/Endovascular)	Endovascular neurologists may perform or interpret cervicocerebral angiography

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I65.21`	Occlusion and stenosis of right carotid artery	Common indication for diagnostic carotid angiography to define degree and location of stenosis
`I65.22`	Occlusion and stenosis of left carotid artery	Indicates left-sided carotid disease requiring angiographic evaluation
`I63.9`	Cerebral infarction, unspecified	Acute ischemic stroke where angiography may be performed to evaluate vascular etiology or plan intervention
`G45.9`	Transient cerebral ischemic attack, unspecified	TIA prompting vascular imaging to assess carotid or cervicocerebral disease
`I74.3`	Embolism and thrombosis of arteries of the lower extremity	While not cervicocerebral, angiography may be used when embolic source evaluation includes aortic arch imaging

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36221`	Selective catheter placement, carotid artery, with angiography of the head and neck; initial vessel catheterization	Performed when individual selective catheterization of a carotid vessel is required before or during diagnostic angiography of cervicocerebral circulation
`36223`	Catheter placement, thoracic aorta, plus catheter placement in carotid or vertebral artery, with angiography; for additional vessel catheterization	Used for additional selective catheterizations beyond the initial catheterization covered by primary code
`36224`	Catheter placement, thoracic aorta, into innominate/subclavian with angiography	Related when imaging requires evaluation of proximal arch or great vessel anatomy during planning
`75635`	Angiography, thoracic aorta and branches, with contrast (CTA or catheter)	Cross-sectional or catheter angiography of the thoracic aorta may be performed adjunctively for surgical planning
`37184`	Transcatheter placement of intravascular stent(s), open or percutaneous; carotid artery	Therapeutic intervention that may follow diagnostic angiography if clinically indicated

CPT 36200: Aortic Catheterization via Distal Arterial Access

CPT-36215-SELECTIVE-CATHETERIZATION-THORACIC-BRACHIOCEPHALIC-BRANCH

CPT 36215: Selective Catheterization of Thoracic/Brachiocephalic Branches

CPT-36216-SELECTIVE-SECOND-ORDER-THORACIC-BRACHIOCEPHALIC-ANGIOGRAPHY

CPT 36216: Selective Catheterization of Second-Order Thoracic/Brachiocephalic Branch

CPT-36217-SELECTIVE-THIRD-ORDER-THORACIC-BRACHIOCEPHALIC-ANGIOGRAPHY

CPT 36217: Selective Angiography of Third-Order Thoracic/Brachiocephalic Branches

CPT-36218-SELECTIVE-CATHETERIZATION-THORACIC-BRACHIOCEPHALIC-BRANCH-ANGIOGRAPHY

CPT 36218: Selective Catheterization of Thoracic/Brachiocephalic Branches

CPT-36221-THORACIC-AORTIC-ANGIOGRAPHY-IMAGING-SUPERVISION-INTERPRETATION

CPT 36221: Imaging Supervision and Interpretation for Thoracic Aortic Angiography

CPT-36223-CAROTID-CERVICOCEREBRAL-ANGIOGRAPHY-IMAGING-INTERPRETATION

CPT 36223: Imaging Supervision and Interpretation for Carotid/Cervicocerebral Angiography

CPT-36224-INTERNAL-CAROTID-ARTERY-ANGIOGRAPHY-IMAGING

CPT 36224: Internal Carotid Artery Angiography, Imaging Supervision and Interpretation

CPT-36225-SUBCLAVIAN-INNOMINATE-ARTERY-ANGIOGRAPHY-INTERPRETATION

CPT 36225: Selective Subclavian/Innominate Artery Angiography, Imaging Interpretation

CPT-36226-THORACIC-AORTIC-ARCH-ANGIOGRAPHY-IMAGING-INTERPRETATION

CPT 36226: Thoracic Aorta and Aortic Arch Angiography, Imaging Supervision and Interpretation

Showing 1–10 of 12

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

Sign up for cpt 36222 policy alerts

Billing Code Overview

OpenPayer

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

Sign up for cpt 36222 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

Sign up for cpt 36222 policy alerts

Billing Code Overview

CPT 36222: Catheter Angiography of Carotid/Cervicocerebral Circulation

Sign up for cpt 36222 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 36222 describe?

Which modifiers are commonly used with CPT 36222 and when are they applied?

What other CPT codes are related to or commonly billed with this angiography procedure?

Where and how is the procedure described for CPT 36222 typically performed?

Which diagnoses in the provided documentation commonly justify performing CPT 36222?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 36222 describe?

Which modifiers are commonly used with CPT 36222 and when are they applied?

What other CPT codes are related to or commonly billed with this angiography procedure?

Where and how is the procedure described for CPT 36222 typically performed?

Which diagnoses in the provided documentation commonly justify performing CPT 36222?

References