CPT code 37263: Leg angioplasty, simple lesion, first vessel2026 Medicare rate & RVUs in New York
Endovascular balloon angioplasty of a simple femoral-popliteal lesion is reported for the first treated vessel during lower-extremity revascularization.
Medicare pays $5,156.01–$6,464.33 for 37263 in the office in New York, from Rest of New York to NYC suburbs and Long Island, NY. Which amount applies depends on the service address.
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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On this page 9 sections
What 37263 covers
Code 37263 represents endovascular balloon angioplasty to restore flow through a femoral or popliteal artery when the treated lesion meets CPT’s simple-lesion criteria and this is the first treated vessel. Vascular surgeons, interventional radiologists, and interventional cardiologists commonly perform the procedure in a hospital catheterization laboratory or angiography suite for peripheral arterial disease. Stent placement or atherectomy changes the applicable treatment code family.
Report the code for the first qualifying vessel, not for each balloon inflation. For another treated vessel, use the additional-vessel code when appropriate; choose a complex-lesion code when the lesion meets that category’s criteria. Document the target artery, laterality, lesion characteristics supporting the simple classification, treatment performed, and vessels treated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for bilateral treatment 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 37263 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
5 payment localities
$5156.01 to $6464.33
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | $6,309.80 | $414.28 |
| NYC suburbs and Long Island, NY | $6,464.33 | $431.82 |
| Poughkeepsie and northern NYC suburbs, NY | $5,939.55 | $383.97 |
| Queens, NY | $6,403.19 | $406.20 |
| Rest of New York | $5,156.01 | $336.10 |
How the 37263 rate is calculated
Each of 37263’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 · 37263
RVUs × geographic indexes × conversion factor
Work7.75
7.75 RVUs× 1.000 GPCI
Practice expense152.98
152.98 RVUs× 1.000 GPCI
Malpractice1.83
1.83 RVUs× 1.000 GPCI
Adjusted RVUs
162.5600
Conversion factor
$33.4009
Medicare rate
$5,429.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37263
The CMS indicators that decide how 37263 is paid alongside other services.
CMS payment indicators · 37263
Leg angioplasty, simple lesion, first vessel
| 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) | 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
37263 without 50 · national office
$5,429.65
Leg angioplasty, simple lesion, first vessel
37263-50 · Bilateral: 150%
$8,144.48
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).
37263 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 37264Peripheral angioplastyAdditional vessel, simple category
- 37263 describes the first treated vessel in the simple-lesion category; 37264 describes each additional qualifying vessel.
- 37265Vessel angioplastyComplex, initial vessel
- Both concern femoral-popliteal angioplasty, but 37265 is for a complex lesion in the first vessel rather than a simple lesion.
- 37267Arterial stentingSimple lesion, initial vessel
- 37263 is the angioplasty treatment code for a simple lesion; 37267 is used when the treatment includes stent placement for a simple lesion.
- 37271AtherectomyStraightforward, initial vessel
- 37263 represents angioplasty for a simple lesion, while 37271 is the simple-lesion code when atherectomy is performed.
37263 billing questions
How does 37263 differ from 37264?
37263 is for the first treated vessel in the simple-lesion category. 37264 is the related code for each additional vessel when its criteria are met.
When should a complex-lesion code be considered instead?
Use the complex-lesion code when the treated lesion meets CPT’s complex classification rather than its simple classification. The medical record should support the selected lesion category.
Does 37263 apply when a stent or atherectomy is performed?
Stent placement or atherectomy changes the applicable treatment code family. Select the code that reflects the treatment performed and the lesion category.
Is the code reported for each lesion or balloon inflation?
No. It represents the first treated vessel, not each balloon inflation. Use an additional-vessel code when another qualifying vessel is treated.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document treatment on both sides.
What documentation supports reporting 37263?
Document the femoral or popliteal target, laterality, lesion characteristics supporting the simple category, angioplasty performed, and whether this was the first treated vessel.
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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