CPT code 37265: Vessel angioplasty, complex, initial vessel2026 Medicare rate & RVUs in Missouri
Reports endovascular balloon angioplasty for a complex lesion in an initial femoral or popliteal vessel during lower-extremity revascularization.
Medicare pays $5,943.54–$6,521.37 for 37265 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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 37265 covers
This code represents endovascular transluminal angioplasty of a complex lesion in an initial vessel in the femoral/popliteal vascular territory. A vascular surgeon, interventional radiologist, or other qualified endovascular specialist typically performs the intervention in a hospital or ambulatory procedure setting to improve blood flow through a diseased lower-extremity artery. The code distinguishes complex angioplasty from simple angioplasty and from treatment that includes stent placement.
Select the code based on the treated territory, the documented lesion characteristics supporting complex classification under CPT guidelines, the intervention performed, and whether this is the initial or an additional vessel. The operative or procedure report should identify the vessel and side, describe the lesion and treatment, and support the complexity designation. The service has a 0-day global period, so same-day preoperative and postoperative care is included. In a same-session multiple-procedure setting, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant is paid only when medical necessity is documented; 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 37265 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$5943.54 to $6521.37
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $6,436.17 | $476.80 |
| Metropolitan St. Louis, MO | $6,521.37 | $479.50 |
| Rest of Missouri | $5,943.54 | $472.85 |
How the 37265 rate is calculated
Each of 37265’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 · 37265
RVUs × geographic indexes × conversion factor
Work10.50
10.50 RVUs× 1.000 GPCI
Practice expense191.45
191.45 RVUs× 1.000 GPCI
Malpractice2.48
2.48 RVUs× 1.000 GPCI
Adjusted RVUs
204.4300
Conversion factor
$33.4009
Medicare rate
$6,828.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37265
The CMS indicators that decide how 37265 is paid alongside other services.
CMS payment indicators · 37265
Vessel angioplasty, complex, initial 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
37265 without 50 · national office
$6,828.15
Vessel angioplasty, complex, initial vessel
37265-50 · Bilateral: 150%
$10,242.23
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).
37265 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37263Leg angioplastySimple lesion, first vessel
- Both describe angioplasty of an initial femoral/popliteal vessel. Choose 37265 when the lesion meets CPT's complex criteria; choose 37263 for a simple lesion.
- 37266AngioplastyComplex, each additional vessel
- 37265 is for the initial complex angioplasty vessel; 37266 identifies an additional qualifying vessel treated in the same territory.
- 37269Arterial stentingComplex lesion, initial vessel
- 37265 describes complex angioplasty without stent placement as the coded intervention. 37269 is the initial-vessel complex code when stent placement is part of the treatment.
37265 billing questions
How is complex angioplasty different from simple angioplasty?
Use the complex code only when the lesion meets the applicable CPT complexity criteria. The procedure report should document the lesion details supporting that classification rather than relying on a general statement that treatment was difficult.
When is 37265 used instead of an additional-vessel code?
37265 represents the initial treated vessel for complex angioplasty in this territory. For another qualifying complex angioplasty vessel, 37266 is the related additional-vessel code.
How does this code differ from a stent code?
37265 describes angioplasty without stent placement as the coded intervention. When treatment includes stent placement, select the applicable stent code based on the lesion classification and vessel sequence.
Can diagnostic angiography be reported with this intervention?
The intervention code describes angioplasty, not a diagnostic angiographic study. Report a separate diagnostic study only when it independently meets CPT reporting criteria and is supported by the record.
How should bilateral treatment be reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
What documentation supports the complex classification?
Document the treated vessel and side, lesion characteristics relevant to CPT's complex criteria, and the angioplasty performed. The record should also make clear which vessel is the initial 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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