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CPT code 37218: Carotid stenting, antegrade intrathoracic approach2026 Medicare rate & RVUs

Reports antegrade stent placement in the intrathoracic common carotid or innominate artery, including angioplasty when performed during treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities169 Medicare services in 2024

Medicare pays $741.83 for 37218 nationally in a facility.

Medicare rate · 37218

Carotid stenting, antegrade intrathoracic approach

Office or facility?

Work RVUs
14.38
Total RVUs
22.21
Global days
090

National rate · 2026

$741.83

Facility setting, before claim adjustments.

See every locality for 37218 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 37218 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 37218 covers

This service treats a lesion in the intrathoracic common carotid or innominate artery by placing an intravascular stent in an antegrade direction. Angioplasty of the treated vessel is included when performed. Vascular surgeons and interventional specialists typically perform the procedure in a hospital setting, using catheter-based imaging to guide treatment of a proximal supra-aortic vessel lesion.

Select this code when the treated vessel and antegrade approach meet its scope; distinguish it from retrograde treatment and stenting of the cervical carotid artery. The operative report should identify the target vessel, approach, lesion, stent placement, and any angioplasty performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 37218 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

37218 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$672.19
AlaskaUnavailable$937.52
ArizonaUnavailable$720.21
ArkansasUnavailable$663.82
Atlanta, GAUnavailable$769.58
Austin, TXUnavailable$737.40
Bakersfield, CAUnavailable$717.83
Baltimore area, MDUnavailable$788.22
Beaumont, TXUnavailable$720.57
Brazoria, TXUnavailable$718.09

37218 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
37218 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 37218 rate is calculated

Each of 37218’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 37218

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.38

14.38 RVUs× 1.000 GPCI

Practice expense4.25

4.25 RVUs× 1.000 GPCI

Malpractice3.58

3.58 RVUs× 1.000 GPCI

Adjusted RVUs

22.2100

Conversion factor

$33.4009

Medicare rate

$741.83

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 37218

37218 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 37218

Carotid stenting, antegrade intrathoracic approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 37218

Carotid stenting, antegrade intrathoracic approach

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

37218 without 50 · national facility

$741.83

Carotid stenting, antegrade intrathoracic approach

37218-50 · Bilateral: 150%

$1,112.75

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

37218 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 37218

    Carotid stenting, antegrade intrathoracic approach14.38 wRVU

    Not priced

  • 37217

    Carotid stenting, retrograde approach19.87 wRVU

    Not priced

  • 37215

    Carotid stenting, with distal embolic protection17.31 wRVU

    Not priced

  • 37216

    Carotid stent, without embolic protection17.53 wRVU

    Not priced

How to choose

37217Carotid stentingRetrograde approach
Both address stenting in the intrathoracic common carotid or innominate artery. The approach is antegrade for 37218 and retrograde for 37217.
37215Carotid stentingWith distal embolic protection
37215 is for cervical carotid stenting with distal embolic protection; 37218 is for antegrade stenting in the intrathoracic common carotid or innominate artery.
37216Carotid stentWithout embolic protection
37216 is for cervical carotid stenting without distal embolic protection. Choose 37218 for the specified intrathoracic vessel and antegrade approach.

Codes related to 37218

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 37218
CodeHow it relatesNational office range
Same family
37217Carotid stenting, retrograde approachRelated proximal-vessel stenting code for the retrograde approach.No office rate
Used instead
37215Carotid stenting, with distal embolic protectionFor stenting in the cervical carotid artery with distal embolic protection.No office rate
37216Carotid stent, without embolic protectionFor stenting in the cervical carotid artery without distal embolic protection.No office rate

37218 billing questions

How does 37218 differ from 37217?

The distinction is the direction of treatment: 37218 is for an antegrade approach, while 37217 is for a retrograde approach to the specified proximal vessel.

Is angioplasty of the treated vessel reported separately?

Angioplasty performed as part of the stent treatment is included in 37218.

When should 37215 or 37216 be considered instead?

Those codes describe stenting in the cervical carotid artery. Use 37218 for antegrade treatment of the intrathoracic common carotid or innominate artery.

What documentation supports reporting 37218?

Document the treated vessel and lesion, the antegrade approach, and the stent placement; also describe angioplasty if performed.

Can an assistant-at-surgery be paid for this procedure?

CMS assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 37218PPRRVU2026_Oct_nonQPP.csv, line 4,598 (RVU26D)

Open CMS sourceHow we calculate rates

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