CPT code 37290: Peripheral atherectomy, complex, initial vessel2026 Medicare rate & RVUs

Medicare pays $10,646.20 for 37290 nationally in the office and $766.88 in a hospital or facility. Local office rates run $9,184.02–$15,054.97.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 37290 covers

This code identifies catheter-based atherectomy to restore flow through a complex peripheral arterial lesion in the initial vessel treated. The operator advances endovascular devices to remove or modify obstructive plaque. Vascular surgeons, interventional radiologists, and interventional cardiologists may perform this treatment in a hospital or outpatient procedural setting for symptomatic peripheral arterial disease. The code’s complex designation and vessel order distinguish it from the simple-lesion and additional-vessel entries in the atherectomy family.

Select the code using the documented lesion classification and treated vessel sequence under the applicable CPT rules; do not infer complexity from the device alone. The procedure report should identify the treated vessel and lesion, describe the atherectomy performed, and support the complex classification. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 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 37290 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

37290 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 37290 rate is calculated

Each of 37290’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.

Payment rules and modifiers for 37290

The CMS indicators that decide how 37290 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

37290 compared with similar codes

How to choose

37288Tibial atherectomySimple, initial vessel

Use 37288 for an initial vessel with a simple lesion; 37290 identifies the complex-lesion initial-vessel service.

37291AtherectomyComplex, each additional vessel

37291 is the additional-vessel entry for complex-lesion atherectomy. This code is the initial-vessel entry.

37294Arterial revascularizationComplex first vessel

37294 describes complex initial-vessel treatment that combines stenting and atherectomy; 37290 is the complex initial-vessel atherectomy entry.

Codes related to 37290

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

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

Open CMS sourceHow we calculate rates