CPT code 37218: Carotid stenting, antegrade intrathoracic approach2026 Medicare rate & RVUs in Illinois
Reports antegrade stent placement in the intrathoracic common carotid or innominate artery, including angioplasty when performed during treatment.
CMS doesn’t publish an office rate for 37218 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $900.76 |
| East St. Louis, IL | Unavailable | $851.73 |
| Rest of Illinois | Unavailable | $796.80 |
| Suburban Chicago, IL | Unavailable | $841.34 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share 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.
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).
37218 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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