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CPT code 37242: Arterial embolization, nonhemorrhagic, nontumor2026 Medicare rate & RVUs in Puerto Rico

Report this service for arterial embolization to treat conditions such as arteriovenous malformations, fistulas, aneurysms, or pseudoaneurysms, excluding hemorrhage and tumors.

CMS RVU26DEffective Oct 1, 2026One payment locality14.7K Medicare services in 2024

In Puerto Rico, Medicare pays $6,743.80 for 37242 in the office and $413.25 when it’s performed in a hospital or facility.

$6,743.80Office (non-facility)
$413.25Hospital or facility
+1.0%vs the national office rate ($6,675.17)

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.

We’ll open 37242 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 37242 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Puerto Rico 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. Puerto Rico pays $6,743.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

37242 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$6,743.80
  2. Los Angeles, CA · California$7,825.73+$1,081.93
  3. Washington, DC area · District of Columbia$7,820.54+$1,076.74
  4. Miami, FL · Florida$7,009.32+$265.52
  5. Chicago, IL · Illinois$6,772.95+$29.15
  6. Manhattan, NY · New York$7,746.21+$1,002.41
  7. Alaska · Alaska$7,222.55+$478.75

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

37242 in every other Medicare payment locality
Payment localityOfficeFacility
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

37242 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
37242 office rate range by state
State / territoryOffice rate rangeLocalities
AK$7,222.551
AL$5,865.411
AR$5,761.991
AZ$6,472.551
CA$7,263.08–$9,474.8029
CO$7,071.791
CT$7,177.531
DC$7,820.541
DE$6,596.101
FL$6,422.55–$7,009.323
GA$6,003.57–$6,786.972
GU$7,518.341
HI$7,518.341
IA$6,109.321
ID$6,144.601
IL$6,154.34–$6,885.844
IN$6,189.391
KS$6,045.231
KY$5,970.951
LA$5,947.85–$6,309.812
MA$7,004.48–$7,906.272
MD$6,749.99–$7,820.543
ME$6,151.97–$6,600.172
MI$6,132.89–$6,488.362
MN$6,823.261
MO$5,803.60–$6,372.563
MS$5,785.671
MT$6,675.071
NC$6,234.791
ND$6,645.811
NE$6,158.831
NH$6,927.551
NJ$7,272.93–$7,707.682
NM$6,161.671
NV$6,673.221
NY$6,345.17–$7,929.885
OH$6,126.911
OK$5,989.361
OR$6,635.26–$7,367.642
PA$6,155.32–$6,949.022
PR$6,743.801
RI$6,884.011
SC$6,188.471
SD$6,642.351
TN$6,078.401
TX$6,104.08–$7,035.958
UT$6,291.741
VA$6,553.43–$7,820.542
VI$6,743.801
VT$6,587.691
WA$7,001.75–$8,113.652
WI$6,376.091
WV$5,870.331
WY$6,662.321

See 37242 in every payment locality

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

Office or facility?

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 37242 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work9.56× 1.0009.5600
Practice expense188.81× 1.011190.8869
Malpractice1.48× 0.9851.4578
Total RVUs201.9047
Conversion factor× 33.4009

Office rate, Puerto Rico$6743.80

Office: (9.56 × 1 + 188.81 × 1.011 + 1.48 × 0.985) × $33.4009 = $6743.80

Facility: (9.56 × 1 + 1.34 × 1.011 + 1.48 × 0.985) × $33.4009 = $413.25

Open 37242 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

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%).

When to use modifier 51

Codes related to 37242

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

Codes related to 37242
CodeHow it relatesOffice range, Puerto Rico
Same family
37241Venous embolization, nonhemorrhagic venous targetSibling code for embolization of a venous target outside the hemorrhage and tumor indications.$4,437.31
37243Embolization, tumor or organ ischemiaSibling code for embolization directed at a tumor or organ ischemia or infarction.$8,077.78
37244Vascular embolization, hemorrhage or lymphatic leakSibling code for embolization to manage arterial or venous hemorrhage or a lymphatic leak.$6,167.94
Used instead
37236Arterial stent, first treated arteryMay be considered for arterial stent treatment rather than embolization when the clinical plan is to preserve the vessel.$2,623.01

How 37242 has changed in Puerto Rico

37242 · Office / nonfacility

$6743.80

Effective 2026-10-01

The base rate is $235.58 higher than on 2025-10-01, moving from $6508.22 to $6743.80 (3.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $6508.22changed to$6743.80

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $6946.91changed to$6508.22

    • 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.

  3. March 9, 2024

    RVU24AR

    $6833.53changed to$6946.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $7340.49changed to$6833.53

    • 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
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $7286.09changed to$7340.49

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $7785.23changed to$7286.09

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $8130.47changed to$7785.23

    • 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.

  8. January 1, 2021

    RVU21A

    $7882.28changed to$8130.47

    • 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 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $7672.33changed to$7882.28

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $7523.24changed to$7672.33

    • 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.

  11. January 1, 2018

    RVU18AR1

    $6506.99changed to$7523.24

    • 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
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $5607.53changed to$6506.99

    • 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
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $5668.32changed to$5607.53

    • 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.

  14. July 1, 2015

    RVU15C

    $5640.12changed to$5668.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $5494.45changed to$5640.12

    • 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
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    No ratechanged to$5494.45

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$6,743.80$413.25RVU26D
2026-07-01$6,743.80$413.25RVU26C
2026-04-01$6,743.80$413.25RVU26B
2026-01-01$6,743.80$413.25RVU26A
2025-10-01$6,508.22$449.01RVU25D
2025-07-01$6,508.22$449.01RVU25C
2025-04-01$6,508.22$449.01RVU25B
2025-01-01$6,508.22$449.01RVU25A
2024-10-01$6,946.91$460.36RVU24D
2024-07-01$6,946.91$460.36RVU24C
2024-04-01$6,946.91$460.36RVU24B
2024-03-09$6,946.91$460.36RVU24AR
2024-01-01$6,833.53$452.85RVU24A
2023-10-01$7,340.49$469.89RVU23D
2023-07-01$7,286.09$470.02RVU23C
2023-04-01$7,286.09$470.02RVU23B
2023-01-01$7,286.09$470.02RVU23A
2022-10-01$7,785.23$477.23RVU22D
2022-07-01$7,785.23$477.23RVU22C
2022-04-01$7,785.23$477.23RVU22B
2022-01-01$7,785.23$477.23RVU22A
2021-10-01$8,130.47$481.21RVU21D
2021-07-01$8,130.47$481.21RVU21C
2021-04-01$8,130.47$481.21RVU21B
2021-01-01$8,130.47$481.21RVU21A
2020-10-01$7,882.28$500.03RVU20D
2020-07-01$7,882.28$500.03RVU20C
2020-04-01$7,882.28$500.03RVU20B
2020-01-01$7,882.28$500.03RVU20A
2019-10-01$7,672.33$499.71RVU19D
2019-07-01$7,672.33$499.71RVU19C
2019-04-01$7,672.33$499.71RVU19B
2019-01-01$7,672.33$499.71RVU19A
2018-10-01$7,523.24$502.39RVU18D
2018-07-01$7,523.24$502.39RVU18C
2018-04-01$7,523.24$502.39RVU18B
2018-01-01$7,523.24$502.39RVU18AR1
2017-10-01$6,506.99$472.21RVU17D
2017-07-01$6,506.99$472.21RVU17C
2017-04-01$6,506.99$472.21RVU17B
2017-01-01$6,506.99$472.21RVU17A
2016-10-01$5,607.53$452.35RVU16D
2016-07-01$5,607.53$452.35RVU16C
2016-04-01$5,607.53$452.35RVU16B
2016-01-01$5,607.53$452.35RVU16A
2015-10-01$5,668.32$454.01RVU15D
2015-07-01$5,668.32$454.01RVU15C
2015-04-01$5,640.12$451.75RVU15B
2015-01-01$5,640.12$451.75RVU15A
2014-10-01$5,494.45$451.54RVU14D
2014-07-01$5,494.45$451.54RVU14C
2014-04-01$5,494.45$451.54RVU14B
2014-01-01$5,494.45$451.54RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 37242 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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
RVUs for 37242PPRRVU2026_Oct_nonQPP.csv, line 4,604 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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