Head and Neck Angiography CPT codes

Head and neck diagnostic catheterization and angiography procedures were restructured in 2013:

• Codes are all-inclusive, describing both catheter placement and imaging in a single code.

• Codes are cumulative – all less selective catheter placement and imaging is bundled into more selective. The code descriptors “stair step,” and specific catheter location and extent of imaging (including distal runoff) are both identified.

• All codes include angiography of the cervicocerebral arch, when performed.

• All codes are unilateral – report bilateral with modifier -50. If left and right sides not to same level of selectivity,  report lesser code with modifier -59.


• Add-on codes exist for selective catheterizations of external carotid or additional intracranial branches of the internal carotid or vertebral circulatory systems.



Code Catheter Location Vessel(s) imaged

36221 Non-selective, thoracic aorta Extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral

36222 Common carotid or innominate Ipsilateral extracranial carotid

36223 Common carotid or innominate Ipsilateral intracranial carotid, includes extracranial carotid, when performed

36224 Internal carotid Ipsilateral intracranial carotid, includes extracranial carotid, when performed

36225 Subclavian or innominate Ipsilateral vertebral circulation

36226 Vertebral artery Ipsilateral vertebral circulation

+36227 External carotid Ipsilateral external carotid circulation

+36228 Each intracranial branch of the internal carotid or vertebral arteries (eg, middle cerebral artery, posterior inferior cerebellar artery) Selected vessel circulation

Note: Codes 33221 - 33226 include angiography of the cervicocerebral arch, when performed; add-on codes 36227 and 36228 do not, as it would have been captured in a base code.