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CPT code 37243: Embolization, tumor or organ ischemia2026 Medicare rate & RVUs in Virginia

Reports catheter-directed embolization to treat a tumor or cause organ ischemia or infarction, including uterine fibroid and prostate artery embolization.

CMS RVU26DEffective Oct 1, 2026One payment locality18.8K Medicare services in 2024

In Virginia, Medicare pays $7,853.73 for 37243 in the office and $468.58 when it’s performed in a hospital or facility.

$7,853.73Office (non-facility)
$468.58Hospital or facility
−1.8%vs the national office rate ($7,995.17)

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.

We’ll open 37243 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 37243 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 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 Virginia 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. Virginia pays $7,853.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

37243 in Virginia vs other payment areas
  1. Virginia · this page$7,853.73
  2. Los Angeles, CA · California$9,381.45+$1,527.72
  3. Washington, DC area · District of Columbia$9,368.07+$1,514.34
  4. Miami, FL · Florida$8,371.91+$518.18
  5. Chicago, IL · Illinois$8,091.93+$238.20
  6. Manhattan, NY · New York$9,271.32+$1,417.59
  7. Alaska · Alaska$8,658.90+$805.17

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

Every other payment area

37243 in every other Medicare payment locality
Payment localityOfficeFacility
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

37243 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.

$6,906.84

$10,035.46

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
37243 office rate range by state
State / territoryOffice rate rangeLocalities
AK$8,658.901
AL$7,030.161
AR$6,906.841
AZ$7,754.271
CA$8,708.18–$11,362.7329
CO$8,474.691
CT$8,594.781
DC$9,368.071
DE$7,901.871
FL$7,683.96–$8,371.913
GA$7,186.02–$8,126.162
GU$9,013.891
HI$9,013.891
IA$7,325.601
ID$7,366.751
IL$7,361.09–$8,235.744
IN$7,420.301
KS$7,246.981
KY$7,151.291
LA$7,122.88–$7,554.492
MA$8,393.65–$9,474.522
MD$8,086.27–$9,368.073
ME$7,373.22–$7,911.032
MI$7,342.24–$7,760.032
MN$8,184.111
MO$6,949.48–$7,631.933
MS$6,931.711
MT$7,995.091
NC$7,472.351
ND$7,969.381
NE$7,385.331
NH$8,300.091
NJ$8,711.06–$9,233.312
NM$7,375.651
NV$7,995.491
NY$7,603.81–$9,487.465
OH$7,336.991
OK$7,175.571
OR$7,952.00–$8,830.372
PA$7,372.10–$8,320.782
PR$8,077.781
RI$8,247.541
SC$7,413.391
SD$7,966.341
TN$7,286.261
TX$7,310.85–$8,430.018
UT$7,536.591
VA$7,853.73–$9,368.072
VI$8,077.781
VT$7,898.031
WA$8,390.94–$9,724.582
WI$7,647.211
WV$7,022.311
WY$7,983.881

See 37243 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 37243 in Virginia
ComponentRVULocality factorAdjusted
Physician work11.45× 1.00011.4500
Practice expense226.62× 0.983222.7675
Malpractice1.30× 0.7060.9178
Total RVUs235.1353
Conversion factor× 33.4009

Office rate, Virginia$7853.73

Office: (11.45 × 1 + 226.62 × 0.983 + 1.3 × 0.706) × $33.4009 = $7853.73

Facility: (11.45 × 1 + 1.69 × 0.983 + 1.3 × 0.706) × $33.4009 = $468.58

Open 37243 in the RVU calculator

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

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)1Not paid (statutory restriction).
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

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%).

When to use modifier 51

Codes related to 37243

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

Codes related to 37243
CodeHow it relatesOffice range, Virginia
Same family
37241Venous embolization, nonhemorrhagic venous targetVenous embolization for indications other than hemorrhage or tumor.$4,311.63
37242Arterial embolization, nonhemorrhagic, nontumorArterial embolization for indications other than hemorrhage or tumor.$6,553.43
37244Vascular embolization, hemorrhage or lymphatic leakEmbolization performed to treat hemorrhage.$5,996.66

How 37243 has changed in Virginia

37243 · Office / nonfacility

$7853.73

Effective 2026-10-01

The base rate is $140.42 higher than on 2025-10-01, moving from $7713.31 to $7853.73 (1.8%).

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

    $7713.31changed to$7853.73

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $8227.98changed to$7713.31

    • 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.

  3. March 9, 2024

    RVU24AR

    $8093.69changed to$8227.98

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $8758.12changed to$8093.69

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $9273.25changed to$8758.12

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $9882.19changed to$9273.25

    • 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.

  7. January 1, 2021

    RVU21A

    $9785.04changed to$9882.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 260.80 changed to 271.90
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $9726.02changed to$9785.04

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $9764.70changed to$9726.02

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 262.25 changed to 260.86

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $9670.84changed to$9764.70

    • 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
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $9774.64changed to$9670.84

    • 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
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $9821.81changed to$9774.64

    • 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.

  13. July 1, 2015

    RVU15C

    $9772.93changed to$9821.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $9654.74changed to$9772.93

    • 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 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$9654.74

    Held through RVU14B, RVU14C, RVU14D.

  16. 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$7,853.73$468.58RVU26D
2026-07-01$7,853.73$468.58RVU26C
2026-04-01$7,853.73$468.58RVU26B
2026-01-01$7,853.73$468.58RVU26A
2025-10-01$7,713.31$519.65RVU25D
2025-07-01$7,713.31$519.65RVU25C
2025-04-01$7,713.31$519.65RVU25B
2025-01-01$7,713.31$519.65RVU25A
2024-10-01$8,227.98$530.25RVU24D
2024-07-01$8,227.98$530.25RVU24C
2024-04-01$8,227.98$530.25RVU24B
2024-03-09$8,227.98$530.25RVU24AR
2024-01-01$8,093.69$521.60RVU24A
2023-10-01$8,758.12$544.48RVU23D
2023-07-01$8,758.12$544.48RVU23C
2023-04-01$8,758.12$544.48RVU23B
2023-01-01$8,758.12$544.48RVU23A
2022-10-01$9,273.25$554.77RVU22D
2022-07-01$9,273.25$554.77RVU22C
2022-04-01$9,273.25$554.77RVU22B
2022-01-01$9,273.25$554.77RVU22A
2021-10-01$9,882.19$558.85RVU21D
2021-07-01$9,882.19$558.85RVU21C
2021-04-01$9,882.19$558.85RVU21B
2021-01-01$9,882.19$558.85RVU21A
2020-10-01$9,785.04$583.48RVU20D
2020-07-01$9,785.04$583.48RVU20C
2020-04-01$9,785.04$583.48RVU20B
2020-01-01$9,785.04$583.48RVU20A
2019-10-01$9,726.02$583.34RVU19D
2019-07-01$9,726.02$583.34RVU19C
2019-04-01$9,726.02$583.34RVU19B
2019-01-01$9,726.02$583.34RVU19A
2018-10-01$9,764.70$584.47RVU18D
2018-07-01$9,764.70$584.47RVU18C
2018-04-01$9,764.70$584.47RVU18B
2018-01-01$9,764.70$584.47RVU18AR1
2017-10-01$9,670.84$587.56RVU17D
2017-07-01$9,670.84$587.56RVU17C
2017-04-01$9,670.84$587.56RVU17B
2017-01-01$9,670.84$587.56RVU17A
2016-10-01$9,774.64$600.20RVU16D
2016-07-01$9,774.64$600.20RVU16C
2016-04-01$9,774.64$600.20RVU16B
2016-01-01$9,774.64$600.20RVU16A
2015-10-01$9,821.81$607.54RVU15D
2015-07-01$9,821.81$607.54RVU15C
2015-04-01$9,772.93$604.52RVU15B
2015-01-01$9,772.93$604.52RVU15A
2014-10-01$9,654.74$603.62RVU14D
2014-07-01$9,654.74$603.62RVU14C
2014-04-01$9,654.74$603.62RVU14B
2014-01-01$9,654.74$603.62RVU14A
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 37243 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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

Show the CMS file lines behind this rate
RVUs for 37243PPRRVU2026_Oct_nonQPP.csv, line 4,605 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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