CPT code 37278: Stent and atherectomy, complex, each additional artery2026 Medicare rate & RVUs in Texas
Reports stent placement with atherectomy in each additional complex femoral or popliteal artery treated during endovascular revascularization.
Medicare pays $3,544.39–$4,079.89 for 37278 in the office in Texas, from Beaumont, TX to Austin, TX. 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 37278 covers
This add-on represents treatment of an additional femoral or popliteal artery with both atherectomy and stent placement when the intervention meets the complex classification. The service is typically performed by an interventional radiologist, vascular surgeon, or other physician qualified to perform endovascular lower-extremity revascularization in an angiography suite or operating room. Code selection follows the treated arterial territory, the intervention performed, whether the artery is classified as complex, and whether it is the first or an additional artery treated.
Report this code with the applicable primary revascularization code; 37277 represents the first complex femoral-popliteal artery treated with stenting and atherectomy. The operative report should identify each treated artery, the intervention performed, and the basis for complex classification. CMS treats this as an add-on paid within the primary procedure’s global period. When the procedure is bilateral and modifier 50 is reported, CMS pays 150% of the applicable amount.
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 37278 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$3544.39 to $4079.89
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $4,079.89 | $267.61 |
| Beaumont, TX | $3,544.39 | $265.40 |
| Brazoria, TX | $3,833.20 | $262.34 |
| Dallas, TX | $3,855.06 | $266.18 |
| Fort Worth, TX | $3,819.36 | $266.51 |
| Galveston, TX | $3,842.62 | $264.55 |
| Houston, TX | $3,867.33 | $289.26 |
| Rest of Texas | $3,684.73 | $265.21 |
How the 37278 rate is calculated
Each of 37278’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 · 37278
RVUs × geographic indexes × conversion factor
Work6.00
6.00 RVUs× 1.000 GPCI
Practice expense108.64
108.64 RVUs× 1.000 GPCI
Malpractice1.35
1.35 RVUs× 1.000 GPCI
Adjusted RVUs
115.9900
Conversion factor
$33.4009
Medicare rate
$3,874.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37278
The CMS indicators that decide how 37278 is paid alongside other services.
CMS payment indicators · 37278
Stent and atherectomy, complex, each additional artery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
37278 without 50 · national office
$3,874.17
Stent and atherectomy, complex, each additional artery
37278-50 · Bilateral: 150%
$5,811.26
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).
37278 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 37277Peripheral revascularizationComplex, initial vessel
- 37277 reports the first complex femoral-popliteal artery treated with stenting and atherectomy; 37278 reports each additional artery treated with that combination.
- 37276Peripheral revascularizationSimple, each additional vessel
- Both codes address additional arteries treated with stenting and atherectomy, but 37276 is for straightforward interventions and 37278 is for complex interventions.
- 37274AtherectomyComplex, additional vessel
- 37274 is for complex atherectomy in an additional femoral-popliteal artery without the stent-and-atherectomy combination represented by 37278.
- 37270Arterial stentingComplex, each additional vessel
- 37270 is for complex stenting in an additional femoral-popliteal artery without the stent-and-atherectomy combination represented by 37278.
37278 billing questions
When is 37278 reported instead of 37277?
Use 37277 for the first complex femoral-popliteal artery treated with stenting and atherectomy. Report 37278 for each additional artery treated with that same combination and classification.
Can 37278 be billed by itself?
No. It is an add-on code and must accompany an applicable primary revascularization procedure.
What documentation supports 37278?
Document the femoral or popliteal artery treated, the use of both atherectomy and a stent, and the findings that support classifying the intervention as complex.
How does CMS handle bilateral reporting?
For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
Is payment for 37278 outside the primary procedure's global period?
No. CMS identifies 37278 as an add-on code paid within the primary procedure's global period.
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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