CPT Code 36248Complete Billing & Coding Guide (2026)Ins cath abd/l-ext art addl
About CPT 36248
CPT 36248 is a Current Procedural Terminology code in the Surgery (Respiratory/Cardiovascular) category maintained by the American Medical Association. The CMS short descriptor reads "Ins cath abd/l-ext art addl". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Add-on codes cannot be billed alone and inherit their global period from the primary procedure. Payer scrubbers will reject add-on codes submitted without a valid base code on the same claim.
36248 has 6 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
Medicare Payment by State
Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.
Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.
NCCI Bundling Edits
6 pairsThese codes trigger National Correct Coding Initiative edits when billed with 36248. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
36248 + 36002: bundled, modifier may bypass (indicator 1)
The most-asked bundling question on this code. Verdict pulled from the current NCCI quarterly file.
Modifier indicator 1 means a modifier may bypass the edit when the clinical scenario supports a distinct, separately identifiable service. Most billers default to modifier 59, but payers prefer the more specific X-modifiers (XE, XS, XP, XU) and pay them with less audit scrutiny. Documentation must establish the separation factor.
CPT Manual or CMS manual coding instruction
Billing 36248 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
CPT Manual or CMS manual coding instruction
More extensive procedure
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
Multi-procedure NCCI edits hit surgical specialties harder than any other category. CO-97 denials on 36248 are frequently recoverable when the operative note documents distinct anatomic sites or staged steps. Our coders read the op note against the edit pair and pick the right modifier (XS preferred over modifier 59 for distinct structures).
Denied on 36248 + 36002 with the wrong modifier? Send us the EOB.
Most bundling denials on 36248 are recoverable when an X-modifier replaces a generic mod 59 and the chart supports a distinct service. A coder will read the EOB and the operative or procedure note for you.
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Applicable Modifiers
Modifiers commonly paired with 36248 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Modifier 24, 79, 78, and 58 on global-period claims are the highest-recovery surgical billing levers. 36248 carries a ZZZ global indicator. Our team flags every encounter inside an active global period for the right modifier decision.
Supporting ICD-10 Diagnoses
These diagnosis codes commonly support medical necessity for CPT 36248. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.
Surgical CO-50 denials usually trace to ICD-10 specificity gaps (E11.9 instead of E11.65, M17.11 instead of M17.0, etc.). Our coders map every diagnosis to the highest-specificity code the chart supports, eliminating the common medical-necessity denial pattern.
Find the revenue leakage in your 36248 claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Surgery (Respiratory/Cardiovascular) claims. Our AAPC-certified team audits your last 90 days of 36248 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
Losing revenue on CPT 36248? We’ll find it.
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Specialty billing guides
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Everything about CPT 36248
What does CPT code 36248 cover?
CPT 36248 is a Current Procedural Terminology code in the Surgery (Respiratory/Cardiovascular) category maintained by the American Medical Association. The CMS short descriptor reads "Ins cath abd/l-ext art addl". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 36248?
The national average Medicare payment for CPT 36248 is approximately $112.23 in a non-facility setting and $41.42 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 3.36 with a conversion factor of $33.4009.
What is the global period for CPT 36248?
CPT 36248 is an add-on code (indicator ZZZ). Its global period matches the base procedure it's billed with. Cannot be billed alone. Must be paired with a primary code per CPT guidelines.
What codes bundle with CPT 36248?
CPT 36248 has NCCI Procedure-to-Procedure edits with 6+ codes including 36002, 36200, 36591. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
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We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.