CPT code 37242: Arterial embolization, nonhemorrhagic, nontumor2026 Medicare rate & RVUs in Montana
Report this service for arterial embolization to treat conditions such as arteriovenous malformations, fistulas, aneurysms, or pseudoaneurysms, excluding hemorrhage and tumors.
In Montana, Medicare pays $6,675.07 for 37242 in the office and $413.40 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 37242 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 37242 covers
An interventional radiologist, vascular surgeon, or neurointerventional specialist uses catheter-based techniques to occlude an artery or arterial lesion. Typical indications include congenital or acquired arteriovenous malformations, arteriovenous fistulas, aneurysms, and pseudoaneurysms when the treatment is embolization rather than management of hemorrhage or a tumor. The code covers the embolization intervention and the radiological supervision and interpretation, roadmapping, and imaging guidance needed to complete it.
Choose this code by the treatment target and indication: arterial embolization for a nonhemorrhagic, nontumor condition. The operative report should identify the lesion, target artery or arterial territory, embolization performed, and clinical reason. Report the code once per operative session, even when multiple vessels are treated. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is not appropriate. 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.
How Montana compares for 37242
Across 109 of 109 payment localities, the office rate for 37242 runs from $5,761.99 in Arkansas to $9,474.80 in San Benito County, CA. Montana pays $6,675.07. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$6,675.07
- Los Angeles, CA · California$7,825.73+$1,150.66
- Washington, DC area · District of Columbia$7,820.54+$1,145.47
- Miami, FL · Florida$7,009.32+$334.25
- Chicago, IL · Illinois$6,772.95+$97.88
- Manhattan, NY · New York$7,746.21+$1,071.14
- Alaska · Alaska$7,222.55+$547.48
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $5,865.41 | $386.45 |
| ArkansasArkansas | $5,761.99 | $383.22 |
| ArizonaArizona | $6,472.55 | $405.00 |
| Bakersfield, CACalifornia | $7,267.33 | $404.54 |
| Chico, CACalifornia | $7,263.08 | $400.29 |
| El Centro, CACalifornia | $7,263.32 | $400.54 |
| Fresno, CACalifornia | $7,263.08 | $400.29 |
| Hanford, CACalifornia | $7,263.08 | $400.29 |
| Madera, CACalifornia | $7,263.08 | $400.29 |
| Merced, CACalifornia | $7,263.08 | $400.29 |
| Modesto, CACalifornia | $7,263.08 | $400.29 |
| Napa, CACalifornia | $8,676.41 | $423.53 |
| Oxnard, CACalifornia | $7,813.24 | $411.95 |
| Redding, CACalifornia | $7,263.08 | $400.29 |
| Rest of CaliforniaCalifornia | $7,263.08 | $400.29 |
| Riverside, CACalifornia | $7,279.07 | $416.28 |
| Sacramento, CACalifornia | $7,691.68 | $409.36 |
| Salinas, CACalifornia | $7,664.85 | $407.58 |
| San Diego, CACalifornia | $7,898.17 | $409.21 |
| Marin County, CACalifornia | $9,264.39 | $435.44 |
| San Francisco, CACalifornia | $9,262.71 | $433.76 |
| San Benito County, CACalifornia | $9,474.80 | $445.47 |
| Santa Clara County, CACalifornia | $9,467.93 | $438.60 |
| San Luis Obispo, CACalifornia | $7,534.25 | $402.22 |
| Santa Cruz, CACalifornia | $8,014.82 | $406.89 |
| Santa Maria, CACalifornia | $7,708.04 | $406.94 |
| Santa Rosa, CACalifornia | $8,099.68 | $410.35 |
| Stockton, CACalifornia | $7,263.08 | $400.29 |
| Vallejo, CACalifornia | $8,673.99 | $421.11 |
| Visalia, CACalifornia | $7,263.08 | $400.29 |
| Yuba City, CACalifornia | $7,263.08 | $400.29 |
| ColoradoColorado | $7,071.79 | $409.37 |
| ConnecticutConnecticut | $7,177.53 | $433.72 |
| DelawareDelaware | $6,596.10 | $409.57 |
| Fort Lauderdale, FLFlorida | $6,797.10 | $454.03 |
| Rest of FloridaFlorida | $6,422.55 | $436.40 |
| Atlanta, GAGeorgia | $6,786.97 | $425.11 |
| Rest of GeorgiaGeorgia | $6,003.57 | $418.16 |
| Hawaii, Guam, HIHawaii | $7,518.34 | $398.82 |
| IowaIowa | $6,109.32 | $379.89 |
| IdahoIdaho | $6,144.60 | $383.87 |
| East St. Louis, ILIllinois | $6,220.78 | $460.05 |
| Rest of IllinoisIllinois | $6,154.34 | $437.44 |
| Suburban Chicago, ILIllinois | $6,885.84 | $455.11 |
| IndianaIndiana | $6,189.39 | $384.83 |
| KansasKansas | $6,045.23 | $384.69 |
| KentuckyKentucky | $5,970.95 | $404.33 |
| New Orleans, LALouisiana | $6,309.81 | $417.59 |
| Rest of LouisianaLouisiana | $5,947.85 | $406.28 |
| Metropolitan Boston, MAMassachusetts | $7,906.27 | $429.84 |
| Rest of MassachusettsMassachusetts | $7,004.48 | $410.95 |
| Baltimore area, MDMaryland | $7,152.36 | $433.60 |
| Rest of MarylandMaryland | $6,749.99 | $413.18 |
| Rest of MaineMaine | $6,151.97 | $391.24 |
| Southern Maine, MEMaine | $6,600.17 | $394.86 |
| Detroit, MIMichigan | $6,488.36 | $445.85 |
| Rest of MichiganMichigan | $6,132.89 | $415.99 |
| MinnesotaMinnesota | $6,823.26 | $380.00 |
| Metropolitan Kansas City, MOMissouri | $6,289.34 | $409.64 |
| Metropolitan St. Louis, MOMissouri | $6,372.56 | $411.45 |
| Rest of MissouriMissouri | $5,803.60 | $406.04 |
| MississippiMississippi | $5,785.67 | $394.38 |
| North CarolinaNorth Carolina | $6,234.79 | $392.66 |
| North DakotaNorth Dakota | $6,645.81 | $384.14 |
| NebraskaNebraska | $6,158.83 | $379.31 |
| New HampshireNew Hampshire | $6,927.55 | $409.16 |
| Northern New JerseyNew Jersey | $7,707.68 | $444.14 |
| Rest of New JerseyNew Jersey | $7,272.93 | $435.19 |
| New MexicoNew Mexico | $6,161.67 | $419.72 |
| NevadaNevada | $6,673.22 | $405.29 |
| NYC suburbs and Long Island, NYNew York | $7,929.88 | $484.76 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $7,299.03 | $442.51 |
| Queens, NYNew York | $7,865.22 | $463.93 |
| Rest of New YorkNew York | $6,345.17 | $396.58 |
| OhioOhio | $6,126.91 | $410.00 |
| OklahomaOklahoma | $5,989.36 | $397.69 |
| Portland, OROregon | $7,367.64 | $410.93 |
| Rest of OregonOregon | $6,635.26 | $398.64 |
| Metropolitan Philadelphia, PAPennsylvania | $6,949.02 | $430.63 |
| Rest of PennsylvaniaPennsylvania | $6,155.32 | $407.11 |
| Puerto RicoPuerto Rico | $6,743.80 | $413.25 |
| Rhode IslandRhode Island | $6,884.01 | $415.71 |
| South CarolinaSouth Carolina | $6,188.47 | $402.69 |
| South DakotaSouth Dakota | $6,642.35 | $380.68 |
| TennesseeTennessee | $6,078.40 | $386.54 |
| Austin, TXTexas | $7,035.95 | $411.10 |
| Beaumont, TXTexas | $6,104.08 | $405.97 |
| Brazoria, TXTexas | $6,610.09 | $404.78 |
| Dallas, TXTexas | $6,645.80 | $409.18 |
| Fort Worth, TXTexas | $6,583.38 | $409.37 |
| Galveston, TXTexas | $6,625.08 | $407.24 |
| Houston, TXTexas | $6,652.17 | $434.33 |
| Rest of TexasTexas | $6,348.75 | $406.43 |
| UtahUtah | $6,291.74 | $405.78 |
| VirginiaVirginia | $6,553.43 | $398.21 |
| Virgin Islands, VIUnited States Virgin Islands | $6,743.80 | $413.25 |
| VermontVermont | $6,587.69 | $388.64 |
| Rest of WashingtonWashington | $7,001.75 | $408.21 |
| King County, WAWashington | $8,113.65 | $430.58 |
| WisconsinWisconsin | $6,376.09 | $377.42 |
| West VirginiaWest Virginia | $5,870.33 | $428.95 |
| WyomingWyoming | $6,662.32 | $400.65 |
37242 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$5,761.99
$8,368.94
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $7,222.55 | 1 |
| AL | $5,865.41 | 1 |
| AR | $5,761.99 | 1 |
| AZ | $6,472.55 | 1 |
| CA | $7,263.08–$9,474.80 | 29 |
| CO | $7,071.79 | 1 |
| CT | $7,177.53 | 1 |
| DC | $7,820.54 | 1 |
| DE | $6,596.10 | 1 |
| FL | $6,422.55–$7,009.32 | 3 |
| GA | $6,003.57–$6,786.97 | 2 |
| GU | $7,518.34 | 1 |
| HI | $7,518.34 | 1 |
| IA | $6,109.32 | 1 |
| ID | $6,144.60 | 1 |
| IL | $6,154.34–$6,885.84 | 4 |
| IN | $6,189.39 | 1 |
| KS | $6,045.23 | 1 |
| KY | $5,970.95 | 1 |
| LA | $5,947.85–$6,309.81 | 2 |
| MA | $7,004.48–$7,906.27 | 2 |
| MD | $6,749.99–$7,820.54 | 3 |
| ME | $6,151.97–$6,600.17 | 2 |
| MI | $6,132.89–$6,488.36 | 2 |
| MN | $6,823.26 | 1 |
| MO | $5,803.60–$6,372.56 | 3 |
| MS | $5,785.67 | 1 |
| MT | $6,675.07 | 1 |
| NC | $6,234.79 | 1 |
| ND | $6,645.81 | 1 |
| NE | $6,158.83 | 1 |
| NH | $6,927.55 | 1 |
| NJ | $7,272.93–$7,707.68 | 2 |
| NM | $6,161.67 | 1 |
| NV | $6,673.22 | 1 |
| NY | $6,345.17–$7,929.88 | 5 |
| OH | $6,126.91 | 1 |
| OK | $5,989.36 | 1 |
| OR | $6,635.26–$7,367.64 | 2 |
| PA | $6,155.32–$6,949.02 | 2 |
| PR | $6,743.80 | 1 |
| RI | $6,884.01 | 1 |
| SC | $6,188.47 | 1 |
| SD | $6,642.35 | 1 |
| TN | $6,078.40 | 1 |
| TX | $6,104.08–$7,035.95 | 8 |
| UT | $6,291.74 | 1 |
| VA | $6,553.43–$7,820.54 | 2 |
| VI | $6,743.80 | 1 |
| VT | $6,587.69 | 1 |
| WA | $7,001.75–$8,113.65 | 2 |
| WI | $6,376.09 | 1 |
| WV | $5,870.33 | 1 |
| WY | $6,662.32 | 1 |
How the 37242 rate is calculated
Each of 37242’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 · 37242
RVUs × geographic indexes × conversion factor
Work9.56
9.56 RVUs× 1.000 GPCI
Practice expense188.81
188.81 RVUs× 1.000 GPCI
Malpractice1.48
1.48 RVUs× 1.000 GPCI
Adjusted RVUs
199.8500
Conversion factor
$33.4009
Medicare rate
$6,675.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,604
- Code
- 37242
- Physician work
- 9.56
- Practice expense
- 188.81
- Malpractice
- 1.48
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.56 | × 1.000 | 9.5600 |
| Practice expense | 188.81 | × 1.000 | 188.8100 |
| Malpractice | 1.48 | × 0.998 | 1.4770 |
| Total RVUs | 199.8470 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$6675.07
Office: (9.56 × 1 + 188.81 × 1 + 1.48 × 0.998) × $33.4009 = $6675.07
Facility: (9.56 × 1 + 1.34 × 1 + 1.48 × 0.998) × $33.4009 = $413.40
Payment rules and modifiers for 37242
The CMS indicators that decide how 37242 is paid alongside other services.
CMS payment indicators · 37242
Arterial embolization, nonhemorrhagic, nontumor
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
37242 without 51 · national office
$6,675.17
Arterial embolization, nonhemorrhagic, nontumor
37242-51 · Second procedure: 50%
$3,337.59
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 37242 has changed in Montana
37242 · Office / nonfacility
$6675.07
Effective 2026-10-01
The base rate is $209.75 higher than on 2025-10-01, moving from $6465.32 to $6675.07 (3.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$6465.32changed to$6675.07
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 9.80 changed to 9.56
- Practice expense RVU 188.61 changed to 188.81
- Malpractice RVU 1.50 changed to 1.48
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$6901.04changed to$6465.32
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 196.01 changed to 188.61
- Malpractice RVU 1.54 changed to 1.50
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$6788.40changed to$6901.04
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$7284.96changed to$6788.40
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 203.70 changed to 196.01
- Malpractice RVU 1.51 changed to 1.54
January 1, 2023
RVU23A
$7726.07changed to$7284.96
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 212.05 changed to 203.70
- Malpractice RVU 1.44 changed to 1.51
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$8068.60changed to$7726.07
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 220.06 changed to 212.05
- Malpractice RVU 1.41 changed to 1.44
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$7838.42changed to$8068.60
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 205.62 changed to 220.06
- Malpractice RVU 1.36 changed to 1.41
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$7652.74changed to$7838.42
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 200.36 changed to 205.62
- Malpractice RVU 1.34 changed to 1.36
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$7505.81changed to$7652.74
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 196.43 changed to 200.36
- Malpractice RVU 1.39 changed to 1.34
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$7574.38changed to$7505.81
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 199.38 changed to 196.43
- Malpractice RVU 1.31 changed to 1.39
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$7839.36changed to$7574.38
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 10.05 changed to 9.80
- Practice expense RVU 207.38 changed to 199.38
- Malpractice RVU 1.24 changed to 1.31
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$7926.63changed to$7839.36
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 208.96 changed to 207.38
- Malpractice RVU 1.29 changed to 1.24
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$7887.18changed to$7926.63
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$7812.40changed to$7887.18
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 206.66 changed to 208.96
- Malpractice RVU 1.18 changed to 1.29
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$7812.40
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $6,675.07 | $413.40 | RVU26D |
| 2026-07-01 | $6,675.07 | $413.40 | RVU26C |
| 2026-04-01 | $6,675.07 | $413.40 | RVU26B |
| 2026-01-01 | $6,675.07 | $413.40 | RVU26A |
| 2025-10-01 | $6,465.32 | $448.23 | RVU25D |
| 2025-07-01 | $6,465.32 | $448.23 | RVU25C |
| 2025-04-01 | $6,465.32 | $448.23 | RVU25B |
| 2025-01-01 | $6,465.32 | $448.23 | RVU25A |
| 2024-10-01 | $6,901.04 | $459.57 | RVU24D |
| 2024-07-01 | $6,901.04 | $459.57 | RVU24C |
| 2024-04-01 | $6,901.04 | $459.57 | RVU24B |
| 2024-03-09 | $6,901.04 | $459.57 | RVU24AR |
| 2024-01-01 | $6,788.40 | $452.07 | RVU24A |
| 2023-10-01 | $7,284.96 | $468.89 | RVU23D |
| 2023-07-01 | $7,284.96 | $468.89 | RVU23C |
| 2023-04-01 | $7,284.96 | $468.89 | RVU23B |
| 2023-01-01 | $7,284.96 | $468.89 | RVU23A |
| 2022-10-01 | $7,726.07 | $476.07 | RVU22D |
| 2022-07-01 | $7,726.07 | $476.07 | RVU22C |
| 2022-04-01 | $7,726.07 | $476.07 | RVU22B |
| 2022-01-01 | $7,726.07 | $476.07 | RVU22A |
| 2021-10-01 | $8,068.60 | $480.04 | RVU21D |
| 2021-07-01 | $8,068.60 | $480.04 | RVU21C |
| 2021-04-01 | $8,068.60 | $480.04 | RVU21B |
| 2021-01-01 | $8,068.60 | $480.04 | RVU21A |
| 2020-10-01 | $7,838.42 | $514.76 | RVU20D |
| 2020-07-01 | $7,838.42 | $514.76 | RVU20C |
| 2020-04-01 | $7,838.42 | $514.76 | RVU20B |
| 2020-01-01 | $7,838.42 | $514.76 | RVU20A |
| 2019-10-01 | $7,652.74 | $529.97 | RVU19D |
| 2019-07-01 | $7,652.74 | $529.97 | RVU19C |
| 2019-04-01 | $7,652.74 | $529.97 | RVU19B |
| 2019-01-01 | $7,652.74 | $529.97 | RVU19A |
| 2018-10-01 | $7,505.81 | $533.77 | RVU18D |
| 2018-07-01 | $7,505.81 | $533.77 | RVU18C |
| 2018-04-01 | $7,505.81 | $533.77 | RVU18B |
| 2018-01-01 | $7,505.81 | $533.77 | RVU18AR1 |
| 2017-10-01 | $7,574.38 | $524.41 | RVU17D |
| 2017-07-01 | $7,574.38 | $524.41 | RVU17C |
| 2017-04-01 | $7,574.38 | $524.41 | RVU17B |
| 2017-01-01 | $7,574.38 | $524.41 | RVU17A |
| 2016-10-01 | $7,839.36 | $527.05 | RVU16D |
| 2016-07-01 | $7,839.36 | $527.05 | RVU16C |
| 2016-04-01 | $7,839.36 | $527.05 | RVU16B |
| 2016-01-01 | $7,839.36 | $527.05 | RVU16A |
| 2015-10-01 | $7,926.63 | $530.43 | RVU15D |
| 2015-07-01 | $7,926.63 | $530.43 | RVU15C |
| 2015-04-01 | $7,887.18 | $527.79 | RVU15B |
| 2015-01-01 | $7,887.18 | $527.79 | RVU15A |
| 2014-10-01 | $7,812.40 | $524.97 | RVU14D |
| 2014-07-01 | $7,812.40 | $524.97 | RVU14C |
| 2014-04-01 | $7,812.40 | $524.97 | RVU14B |
| 2014-01-01 | $7,812.40 | $524.97 | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
37242 billing questions
How does this differ from 37241?
37242 is for an arterial target; 37241 is for a venous target. Select based on the vessel being embolized, not simply the diagnosis.
When should 37243 or 37244 be used instead?
Use 37243 for embolization directed at a tumor or organ ischemia or infarction. Use 37244 for arterial or venous hemorrhage or a lymphatic leak.
Are roadmapping and procedural imaging separately reported?
No. The code includes the radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance needed to complete the embolization.
How many units are reported when several arteries are embolized?
Report 37242 once per operative session, even if multiple vessels are treated. Document the treated lesion and vessels in the procedure report.
Can modifier 50 be used for bilateral embolization?
No. The bilateral adjustment is not appropriate for this code. If multiple procedures are performed in the same session, the standard multiple-procedure reduction applies.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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
Fee sheets · Coming soon
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Your codes at your locality, with payer contracts beside Medicare.
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