CPT code 37243: Embolization, tumor or organ ischemia2026 Medicare rate & RVUs in South Carolina
Reports catheter-directed embolization to treat a tumor or cause organ ischemia or infarction, including uterine fibroid and prostate artery embolization.
In South Carolina, Medicare pays $7,413.39 for 37243 in the office and $471.51 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 37243 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 37243 covers
An interventional radiologist or other qualified physician delivers embolic material through a catheter to reduce or stop blood flow to a tumor or targeted organ. Common settings include hospital interventional radiology suites, where procedures may address liver tumors, uterine fibroids, or benign prostatic hyperplasia. The embolic agent and catheter approach depend on the target vessels and treatment plan.
Choose this code when the embolization is performed for a tumor or to produce organ ischemia or infarction; embolization for bleeding or other arterial and venous indications belongs to different codes in the family. The report should identify the clinical indication, target organ or tumor, vessels treated, embolic technique, and imaging guidance. The code includes same-day preoperative and postoperative care under its 0-day global period. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and reduces the others by 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery payment.
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 South Carolina compares for 37243
Across 109 of 109 payment localities, the office rate for 37243 runs from $6,906.84 in Arkansas to $11,362.73 in San Benito County, CA. South Carolina pays $7,413.39. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$7,413.39
- Los Angeles, CA · California$9,381.45+$1,968.06
- Washington, DC area · District of Columbia$9,368.07+$1,954.68
- Miami, FL · Florida$8,371.91+$958.52
- Chicago, IL · Illinois$8,091.93+$678.54
- Manhattan, NY · New York$9,271.32+$1,857.93
- Alaska · Alaska$8,658.90+$1,245.51
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $7,030.16 | $456.41 |
| ArkansasArkansas | $6,906.84 | $453.29 |
| ArizonaArizona | $7,754.27 | $474.31 |
| Bakersfield, CACalifornia | $8,712.12 | $478.02 |
| Chico, CACalifornia | $8,708.18 | $474.08 |
| El Centro, CACalifornia | $8,708.40 | $474.30 |
| Fresno, CACalifornia | $8,708.18 | $474.08 |
| Hanford, CACalifornia | $8,708.18 | $474.08 |
| Madera, CACalifornia | $8,708.18 | $474.08 |
| Merced, CACalifornia | $8,708.18 | $474.08 |
| Modesto, CACalifornia | $8,708.18 | $474.08 |
| Napa, CACalifornia | $10,404.95 | $502.99 |
| Oxnard, CACalifornia | $9,367.13 | $486.92 |
| Redding, CACalifornia | $8,708.18 | $474.08 |
| Rest of CaliforniaCalifornia | $8,708.18 | $474.08 |
| Riverside, CACalifornia | $8,722.33 | $488.23 |
| Sacramento, CACalifornia | $9,222.59 | $485.13 |
| Salinas, CACalifornia | $9,190.40 | $482.99 |
| San Diego, CACalifornia | $9,470.34 | $484.96 |
| Marin County, CACalifornia | $11,111.43 | $518.29 |
| San Francisco, CACalifornia | $11,109.96 | $516.82 |
| San Benito County, CACalifornia | $11,362.73 | $529.18 |
| Santa Clara County, CACalifornia | $11,356.69 | $523.14 |
| San Luis Obispo, CACalifornia | $9,033.66 | $476.51 |
| Santa Cruz, CACalifornia | $9,610.46 | $482.33 |
| Santa Maria, CACalifornia | $9,242.24 | $482.24 |
| Santa Rosa, CACalifornia | $9,712.30 | $486.50 |
| Stockton, CACalifornia | $8,708.18 | $474.08 |
| Vallejo, CACalifornia | $10,402.82 | $500.86 |
| Visalia, CACalifornia | $8,708.18 | $474.08 |
| Yuba City, CACalifornia | $8,708.18 | $474.08 |
| ColoradoColorado | $8,474.69 | $481.00 |
| ConnecticutConnecticut | $8,594.78 | $503.42 |
| DelawareDelaware | $7,901.87 | $479.16 |
| Fort Lauderdale, FLFlorida | $8,128.66 | $518.13 |
| Rest of FloridaFlorida | $7,683.96 | $501.67 |
| Atlanta, GAGeorgia | $8,126.16 | $493.09 |
| Rest of GeorgiaGeorgia | $7,186.02 | $484.55 |
| Hawaii, Guam, HIHawaii | $9,013.89 | $471.76 |
| IowaIowa | $7,325.60 | $451.33 |
| IdahoIdaho | $7,366.75 | $454.91 |
| East St. Louis, ILIllinois | $7,433.66 | $521.82 |
| Rest of IllinoisIllinois | $7,361.09 | $501.84 |
| Suburban Chicago, ILIllinois | $8,235.74 | $520.03 |
| IndianaIndiana | $7,420.30 | $455.87 |
| KansasKansas | $7,246.98 | $455.35 |
| KentuckyKentucky | $7,151.29 | $472.35 |
| New Orleans, LALouisiana | $7,554.49 | $484.88 |
| Rest of LouisianaLouisiana | $7,122.88 | $473.99 |
| Metropolitan Boston, MAMassachusetts | $9,474.52 | $504.16 |
| Rest of MassachusettsMassachusetts | $8,393.65 | $482.61 |
| Baltimore area, MDMaryland | $8,564.14 | $502.84 |
| Rest of MarylandMaryland | $8,086.27 | $483.25 |
| Rest of MaineMaine | $7,373.22 | $461.38 |
| Southern Maine, MEMaine | $7,911.03 | $465.78 |
| Detroit, MIMichigan | $7,760.03 | $510.12 |
| Rest of MichiganMichigan | $7,342.24 | $483.00 |
| MinnesotaMinnesota | $8,184.11 | $453.38 |
| Metropolitan Kansas City, MOMissouri | $7,532.45 | $477.87 |
| Metropolitan St. Louis, MOMissouri | $7,631.93 | $479.69 |
| Rest of MissouriMissouri | $6,949.48 | $473.39 |
| MississippiMississippi | $6,931.71 | $463.13 |
| MontanaMontana | $7,995.09 | $482.22 |
| North CarolinaNorth Carolina | $7,472.35 | $462.85 |
| North DakotaNorth Dakota | $7,969.38 | $456.52 |
| NebraskaNebraska | $7,385.33 | $450.95 |
| New HampshireNew Hampshire | $8,300.09 | $479.20 |
| Northern New JerseyNew Jersey | $9,233.31 | $518.39 |
| Rest of New JerseyNew Jersey | $8,711.06 | $507.01 |
| New MexicoNew Mexico | $7,375.65 | $486.35 |
| NevadaNevada | $7,995.49 | $475.11 |
| NYC suburbs and Long Island, NYNew York | $9,487.46 | $554.67 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $8,740.59 | $514.00 |
| Queens, NYNew York | $9,416.46 | $536.25 |
| Rest of New YorkNew York | $7,603.81 | $466.59 |
| OhioOhio | $7,336.99 | $477.75 |
| OklahomaOklahoma | $7,175.57 | $466.59 |
| Portland, OROregon | $8,830.37 | $483.58 |
| Rest of OregonOregon | $7,952.00 | $469.19 |
| Metropolitan Philadelphia, PAPennsylvania | $8,320.78 | $499.89 |
| Rest of PennsylvaniaPennsylvania | $7,372.10 | $475.29 |
| Puerto RicoPuerto Rico | $8,077.78 | $482.28 |
| Rhode IslandRhode Island | $8,247.54 | $486.75 |
| South DakotaSouth Dakota | $7,966.34 | $453.48 |
| TennesseeTennessee | $7,286.26 | $457.07 |
| Austin, TXTexas | $8,430.01 | $481.40 |
| Beaumont, TXTexas | $7,310.85 | $474.15 |
| Brazoria, TXTexas | $7,920.56 | $475.31 |
| Dallas, TXTexas | $7,962.17 | $479.36 |
| Fort Worth, TXTexas | $7,887.04 | $479.36 |
| Galveston, TXTexas | $7,937.78 | $477.50 |
| Houston, TXTexas | $7,961.57 | $501.30 |
| Rest of TexasTexas | $7,604.93 | $475.22 |
| UtahUtah | $7,536.59 | $474.49 |
| VirginiaVirginia | $7,853.73 | $468.58 |
| Virgin Islands, VIUnited States Virgin Islands | $8,077.78 | $482.28 |
| VermontVermont | $7,898.03 | $460.29 |
| Rest of WashingtonWashington | $8,390.94 | $479.89 |
| King County, WAWashington | $9,724.58 | $506.30 |
| WisconsinWisconsin | $7,647.21 | $449.89 |
| West VirginiaWest Virginia | $7,022.31 | $493.63 |
| WyomingWyoming | $7,983.88 | $471.02 |
37243 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.
$6,906.84
$10,035.46
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 | $8,658.90 | 1 |
| AL | $7,030.16 | 1 |
| AR | $6,906.84 | 1 |
| AZ | $7,754.27 | 1 |
| CA | $8,708.18–$11,362.73 | 29 |
| CO | $8,474.69 | 1 |
| CT | $8,594.78 | 1 |
| DC | $9,368.07 | 1 |
| DE | $7,901.87 | 1 |
| FL | $7,683.96–$8,371.91 | 3 |
| GA | $7,186.02–$8,126.16 | 2 |
| GU | $9,013.89 | 1 |
| HI | $9,013.89 | 1 |
| IA | $7,325.60 | 1 |
| ID | $7,366.75 | 1 |
| IL | $7,361.09–$8,235.74 | 4 |
| IN | $7,420.30 | 1 |
| KS | $7,246.98 | 1 |
| KY | $7,151.29 | 1 |
| LA | $7,122.88–$7,554.49 | 2 |
| MA | $8,393.65–$9,474.52 | 2 |
| MD | $8,086.27–$9,368.07 | 3 |
| ME | $7,373.22–$7,911.03 | 2 |
| MI | $7,342.24–$7,760.03 | 2 |
| MN | $8,184.11 | 1 |
| MO | $6,949.48–$7,631.93 | 3 |
| MS | $6,931.71 | 1 |
| MT | $7,995.09 | 1 |
| NC | $7,472.35 | 1 |
| ND | $7,969.38 | 1 |
| NE | $7,385.33 | 1 |
| NH | $8,300.09 | 1 |
| NJ | $8,711.06–$9,233.31 | 2 |
| NM | $7,375.65 | 1 |
| NV | $7,995.49 | 1 |
| NY | $7,603.81–$9,487.46 | 5 |
| OH | $7,336.99 | 1 |
| OK | $7,175.57 | 1 |
| OR | $7,952.00–$8,830.37 | 2 |
| PA | $7,372.10–$8,320.78 | 2 |
| PR | $8,077.78 | 1 |
| RI | $8,247.54 | 1 |
| SC | $7,413.39 | 1 |
| SD | $7,966.34 | 1 |
| TN | $7,286.26 | 1 |
| TX | $7,310.85–$8,430.01 | 8 |
| UT | $7,536.59 | 1 |
| VA | $7,853.73–$9,368.07 | 2 |
| VI | $8,077.78 | 1 |
| VT | $7,898.03 | 1 |
| WA | $8,390.94–$9,724.58 | 2 |
| WI | $7,647.21 | 1 |
| WV | $7,022.31 | 1 |
| WY | $7,983.88 | 1 |
How the 37243 rate is calculated
Each of 37243’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 · 37243
RVUs × geographic indexes × conversion factor
Work11.45
11.45 RVUs× 1.000 GPCI
Practice expense226.62
226.62 RVUs× 1.000 GPCI
Malpractice1.30
1.30 RVUs× 1.000 GPCI
Adjusted RVUs
239.3700
Conversion factor
$33.4009
Medicare rate
$7,995.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,605
- Code
- 37243
- Physician work
- 11.45
- Practice expense
- 226.62
- Malpractice
- 1.30
GPCI2026.csv
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.45 | × 1.000 | 11.4500 |
| Practice expense | 226.62 | × 0.924 | 209.3969 |
| Malpractice | 1.30 | × 0.850 | 1.1050 |
| Total RVUs | 221.9519 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$7413.39
Office: (11.45 × 1 + 226.62 × 0.924 + 1.3 × 0.85) × $33.4009 = $7413.39
Facility: (11.45 × 1 + 1.69 × 0.924 + 1.3 × 0.85) × $33.4009 = $471.51
Payment rules and modifiers for 37243
The CMS indicators that decide how 37243 is paid alongside other services.
CMS payment indicators · 37243
Embolization, tumor or organ ischemia
| 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) | 1 | Not paid (statutory restriction). |
| 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
37243 without 51 · national office
$7,995.17
Embolization, tumor or organ ischemia
37243-51 · Second procedure: 50%
$3,997.59
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 37243 has changed in South Carolina
37243 · Office / nonfacility
$7413.39
Effective 2026-10-01
The base rate is $225.26 higher than on 2025-10-01, moving from $7188.13 to $7413.39 (3.1%).
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
$7188.13changed to$7413.39
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 11.74 changed to 11.45
- Practice expense RVU 229.43 changed to 226.62
- Malpractice RVU 1.24 changed to 1.30
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$7666.54changed to$7188.13
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 238.30 changed to 229.43
- Malpractice RVU 1.23 changed to 1.24
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$7541.41changed to$7666.54
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$8065.59changed to$7541.41
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 248.20 changed to 238.30
- Malpractice RVU 1.20 changed to 1.23
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$8448.90changed to$8065.59
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 256.53 changed to 248.20
- Malpractice RVU 1.09 changed to 1.20
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$9002.02changed to$8448.90
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 271.90 changed to 256.53
- Malpractice RVU 1.04 changed to 1.09
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$8983.95changed to$9002.02
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 260.80 changed to 271.90
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$9017.28changed to$8983.95
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 260.86 changed to 260.80
- Malpractice RVU 1.02 changed to 1.04
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$9053.04changed to$9017.28
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 262.25 changed to 260.86
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$8978.48changed to$9053.04
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 260.65 changed to 262.25
- Malpractice RVU 1.14 changed to 1.02
- Malpractice GPCI 0.634 changed to 0.553
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$9097.52changed to$8978.48
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 11.99 changed to 11.74
- Practice expense RVU 264.52 changed to 260.65
- Malpractice RVU 1.20 changed to 1.14
- Malpractice GPCI 0.715 changed to 0.634
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$9140.80changed to$9097.52
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 264.58 changed to 264.52
- Malpractice RVU 1.53 changed to 1.20
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$9095.31changed to$9140.80
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$8999.89changed to$9095.31
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 261.66 changed to 264.58
- Malpractice RVU 1.41 changed to 1.53
- Practice expense GPCI 0.911 changed to 0.912
- Malpractice GPCI 0.618 changed to 0.715
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$8999.89
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 | $7,413.39 | $471.51 | RVU26D |
| 2026-07-01 | $7,413.39 | $471.51 | RVU26C |
| 2026-04-01 | $7,413.39 | $471.51 | RVU26B |
| 2026-01-01 | $7,413.39 | $471.51 | RVU26A |
| 2025-10-01 | $7,188.13 | $513.52 | RVU25D |
| 2025-07-01 | $7,188.13 | $513.52 | RVU25C |
| 2025-04-01 | $7,188.13 | $513.52 | RVU25B |
| 2025-01-01 | $7,188.13 | $513.52 | RVU25A |
| 2024-10-01 | $7,666.54 | $524.23 | RVU24D |
| 2024-07-01 | $7,666.54 | $524.23 | RVU24C |
| 2024-04-01 | $7,666.54 | $524.23 | RVU24B |
| 2024-03-09 | $7,666.54 | $524.23 | RVU24AR |
| 2024-01-01 | $7,541.41 | $515.68 | RVU24A |
| 2023-10-01 | $8,065.59 | $532.27 | RVU23D |
| 2023-07-01 | $8,065.59 | $532.27 | RVU23C |
| 2023-04-01 | $8,065.59 | $532.27 | RVU23B |
| 2023-01-01 | $8,065.59 | $532.27 | RVU23A |
| 2022-10-01 | $8,448.90 | $536.55 | RVU22D |
| 2022-07-01 | $8,448.90 | $536.55 | RVU22C |
| 2022-04-01 | $8,448.90 | $536.55 | RVU22B |
| 2022-01-01 | $8,448.90 | $536.55 | RVU22A |
| 2021-10-01 | $9,002.02 | $540.73 | RVU21D |
| 2021-07-01 | $9,002.02 | $540.73 | RVU21C |
| 2021-04-01 | $9,002.02 | $540.73 | RVU21B |
| 2021-01-01 | $9,002.02 | $540.73 | RVU21A |
| 2020-10-01 | $8,983.95 | $562.33 | RVU20D |
| 2020-07-01 | $8,983.95 | $562.33 | RVU20C |
| 2020-04-01 | $8,983.95 | $562.33 | RVU20B |
| 2020-01-01 | $8,983.95 | $562.33 | RVU20A |
| 2019-10-01 | $9,017.28 | $560.76 | RVU19D |
| 2019-07-01 | $9,017.28 | $560.76 | RVU19C |
| 2019-04-01 | $9,017.28 | $560.76 | RVU19B |
| 2019-01-01 | $9,017.28 | $560.76 | RVU19A |
| 2018-10-01 | $9,053.04 | $561.79 | RVU18D |
| 2018-07-01 | $9,053.04 | $561.79 | RVU18C |
| 2018-04-01 | $9,053.04 | $561.79 | RVU18B |
| 2018-01-01 | $9,053.04 | $561.79 | RVU18AR1 |
| 2017-10-01 | $8,978.48 | $568.38 | RVU17D |
| 2017-07-01 | $8,978.48 | $568.38 | RVU17C |
| 2017-04-01 | $8,978.48 | $568.38 | RVU17B |
| 2017-01-01 | $8,978.48 | $568.38 | RVU17A |
| 2016-10-01 | $9,097.52 | $585.73 | RVU16D |
| 2016-07-01 | $9,097.52 | $585.73 | RVU16C |
| 2016-04-01 | $9,097.52 | $585.73 | RVU16B |
| 2016-01-01 | $9,097.52 | $585.73 | RVU16A |
| 2015-10-01 | $9,140.80 | $592.06 | RVU15D |
| 2015-07-01 | $9,140.80 | $592.06 | RVU15C |
| 2015-04-01 | $9,095.31 | $589.12 | RVU15B |
| 2015-01-01 | $9,095.31 | $589.12 | RVU15A |
| 2014-10-01 | $8,999.89 | $586.05 | RVU14D |
| 2014-07-01 | $8,999.89 | $586.05 | RVU14C |
| 2014-04-01 | $8,999.89 | $586.05 | RVU14B |
| 2014-01-01 | $8,999.89 | $586.05 | 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 South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
37243 billing questions
When should this code be chosen instead of arterial embolization code 37242?
Use 37243 when the purpose is tumor treatment or organ ischemia or infarction. Code 37242 describes an arterial embolization for another indication, such as a vascular malformation or aneurysm.
How does this code differ from embolization for bleeding?
Use 37244 when the embolization treats hemorrhage. The indication for 37243 is a tumor or intended organ ischemia or infarction.
Can the imaging used to guide embolization be separately reported?
The code includes the imaging guidance, intraprocedural roadmapping, and radiological supervision and interpretation necessary to complete the intervention. Do not separately report those included services as though they were separate guidance for the same embolization.
Should modifier 50 be appended for embolization on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What happens when other procedures are performed in the same session?
CMS pays the highest-valued procedure in full and reduces the other procedures by 50% under the standard multiple procedure rule.
Does Medicare pay an assistant or co-surgeon for this procedure?
CMS lists a statutory restriction on assistant-at-surgery payment and does not permit co-surgeon or team-surgery payment for this code.
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
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