CPT code 37294: Arterial revascularization, complex first vessel2026 Medicare rate & RVUs in Maryland
Reports complex endovascular treatment of an initial tibial or peroneal artery vessel using atherectomy and stent placement during peripheral arterial revascularization.
Medicare pays $15,368.47–$17,821.65 for 37294 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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 37294 covers
This code describes catheter-based treatment of a complex lesion in an initial tibial or peroneal artery vessel, combining atherectomy with stent placement. It is typically performed by an interventional radiologist, vascular surgeon, or interventional cardiologist in a hospital or other procedural setting. Angioplasty within the treated vessel is part of this revascularization service. The code is specific to the tibial/peroneal vascular territory; femoral or popliteal interventions belong to a different territory family.
Select the complex first-vessel code when the documented intervention meets the CPT criteria for complex treatment and includes both atherectomy and stenting. The operative report should identify the treated vessel, the intervention performed, and the basis for classifying the work as complex. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and other procedures 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 37294 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$15368.47 to $17821.65
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $16,293.98 | $859.12 |
| Rest of Maryland | $15,368.47 | $811.09 |
| Washington, DC area | $17,821.65 | $876.39 |
How the 37294 rate is calculated
Each of 37294’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 · 37294
RVUs × geographic indexes × conversion factor
Work18.00
18.00 RVUs× 1.000 GPCI
Practice expense433.39
433.39 RVUs× 1.000 GPCI
Malpractice3.65
3.65 RVUs× 1.000 GPCI
Adjusted RVUs
455.0400
Conversion factor
$33.4009
Medicare rate
$15,198.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37294
The CMS indicators that decide how 37294 is paid alongside other services.
CMS payment indicators · 37294
Arterial revascularization, complex 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
37294 without 50 · national office
$15,198.75
Arterial revascularization, complex first vessel
37294-50 · Bilateral: 150%
$22,798.13
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).
37294 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 37292Arterial revascularizationSimple, initial vessel
- Both codes combine stenting and atherectomy in an initial tibial/peroneal vessel; 37292 is for the simple category, while 37294 is for the complex category.
- 37295Tibial revascularizationComplex additional vessel
- 37294 reports the initial complex vessel. Use 37295 for an additional complex vessel rather than treating it as another initial-vessel service.
- 37290Peripheral atherectomyComplex, initial vessel
- 37290 describes complex atherectomy without the combined stent service. Use 37294 when both atherectomy and stenting are performed in the vessel.
- 37286Venous stentingComplex, initial vein
- 37286 describes complex stenting without the combined atherectomy service. Use 37294 when atherectomy and stenting are both performed.
37294 billing questions
How does 37294 differ from 37292?
Both describe tibial/peroneal treatment using stenting and atherectomy in an initial vessel. Use 37294 for a lesion meeting the CPT complex criteria and 37292 for the simple category.
Does 37294 include both atherectomy and stent placement?
Yes. It represents the combined treatment in the same complex tibial/peroneal vessel, including angioplasty within that vessel.
Which code reports another complex vessel?
Use 37295 for each additional complex tibial/peroneal vessel treated with stenting and atherectomy, subject to the applicable CPT instructions.
What documentation supports 37294?
Document the tibial or peroneal vessel treated, the atherectomy and stent work performed, and the facts supporting complex rather than simple classification.
How does CMS handle other procedures in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant surgeon be paid with 37294?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
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
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