$4,668.05–$7,683.51
Use 37180 for open surgical revision of a portosystemic shunt. Use 37183 for endovascular revision of a TIPS.
On this page
CMS RVU26D · Effective 2026-10-01
37180 Shunt revision Medicare reimbursement rates
Reports open surgical revision of an existing portosystemic shunt, such as when a surgically created shunt requires correction for dysfunction. Compare 37180 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 37180?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 37180 pays more and less
Vascular surgery
About 37180: Open portosystemic shunt revision
Reports open surgical revision of an existing portosystemic shunt, such as when a surgically created shunt requires correction for dysfunction.
This code describes an open operation to revise an existing portosystemic shunt. It is distinct from creating a new shunt and from revising a TIPS through an endovascular approach. Surgeons may perform it when a surgically created shunt needs correction; the operative record should identify the existing shunt, the reason for revision, and the work performed on it.
Report the code for the revision service, not for shunt creation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 37180
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU35.59 · 61%
- Practice expense (office) RVU13.59 · 23%
- Malpractice RVU9.54 · 16%
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.
37180 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
37182 describes placement of a TIPS; 37180 describes revision of an existing surgically created portosystemic shunt.
No office rate
37140 is a shunt procedure, not revision of an existing shunt. Choose 37180 when the documented service is revision.
See how rates vary across the country
37180 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 37180 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1766.27 |
| Alaska* | Office Unavailable | Facility $2442.10 |
| Arizona | Office Unavailable | Facility $1901.34 |
| Arkansas | Office Unavailable | Facility $1742.76 |
| Atlanta | Office Unavailable | Facility $2036.18 |
| Austin | Office Unavailable | Facility $1953.68 |
| Bakersfield | Office Unavailable | Facility $1902.87 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $2088.98 |
| Beaumont | Office Unavailable | Facility $1897.82 |
| Brazoria | Office Unavailable | Facility $1896.62 |
| Chicago | Office Unavailable | Facility $2384.54 |
| Chico | Office Unavailable | Facility $1877.23 |
| Colorado | Office Unavailable | Facility $1934.83 |
| Connecticut | Office Unavailable | Facility $2086.94 |
| Dallas | Office Unavailable | Facility $1924.94 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2142.30 |
| Delaware | Office Unavailable | Facility $1929.61 |
| Detroit | Office Unavailable | Facility $2164.00 |
| East St. Louis | Office Unavailable | Facility $2248.09 |
| El Centro | Office Unavailable | Facility $1878.83 |
| Fort Lauderdale | Office Unavailable | Facility $2224.67 |
| Fort Worth | Office Unavailable | Facility $1924.54 |
| Fresno | Office Unavailable | Facility $1877.23 |
| Galveston | Office Unavailable | Facility $1912.83 |
| Hanford-Corcoran | Office Unavailable | Facility $1877.23 |
| Hawaii, Guam | Office Unavailable | Facility $1889.34 |
| Houston | Office Unavailable | Facility $2087.44 |
| Idaho | Office Unavailable | Facility $1757.06 |
| Indiana | Office Unavailable | Facility $1764.38 |
| Iowa | Office Unavailable | Facility $1730.58 |
| Kansas | Office Unavailable | Facility $1759.68 |
| Kentucky | Office Unavailable | Facility $1883.83 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1986.04 |
| Madera | Office Unavailable | Facility $1877.23 |
| Manhattan | Office Unavailable | Facility $2297.64 |
| Merced | Office Unavailable | Facility $1877.23 |
| Metropolitan Boston | Office Unavailable | Facility $2063.05 |
| Metropolitan Kansas City | Office Unavailable | Facility $1926.28 |
| Metropolitan Philadelphia | Office Unavailable | Facility $2062.81 |
| Metropolitan St. Louis | Office Unavailable | Facility $1940.15 |
| Miami | Office Unavailable | Facility $2467.12 |
| Minnesota | Office Unavailable | Facility $1750.14 |
| Mississippi | Office Unavailable | Facility $1815.04 |
| Modesto | Office Unavailable | Facility $1877.23 |
| Montana** | Office Unavailable | Facility $1960.66 |
| Napa | Office Unavailable | Facility $2023.76 |
| Nebraska | Office Unavailable | Facility $1728.15 |
| Nevada** | Office Unavailable | Facility $1908.54 |
| New Hampshire | Office Unavailable | Facility $1940.08 |
| New Mexico | Office Unavailable | Facility $1987.67 |
| New Orleans | Office Unavailable | Facility $1977.86 |
| North Carolina | Office Unavailable | Facility $1815.86 |
| North Dakota** | Office Unavailable | Facility $1772.03 |
| Northern Nj | Office Unavailable | Facility $2130.49 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2396.25 |
| Ohio | Office Unavailable | Facility $1924.36 |
| Oklahoma | Office Unavailable | Facility $1841.67 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1957.07 |
| Portland | Office Unavailable | Facility $1949.13 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2124.83 |
| Puerto Rico | Office Unavailable | Facility $1961.51 |
| Queens | Office Unavailable | Facility $2260.83 |
| Redding | Office Unavailable | Facility $1877.23 |
| Rest Of California | Office Unavailable | Facility $1877.23 |
| Rest Of Florida | Office Unavailable | Facility $2101.61 |
| Rest Of Georgia | Office Unavailable | Facility $1973.46 |
| Rest Of Illinois | Office Unavailable | Facility $2101.21 |
| Rest Of Louisiana | Office Unavailable | Facility $1895.72 |
| Rest Of Maine | Office Unavailable | Facility $1804.54 |
| Rest Of Maryland | Office Unavailable | Facility $1952.51 |
| Rest Of Massachusetts | Office Unavailable | Facility $1939.69 |
| Rest Of Michigan | Office Unavailable | Facility $1962.92 |
| Rest Of Missouri | Office Unavailable | Facility $1890.38 |
| Rest Of New Jersey | Office Unavailable | Facility $2081.52 |
| Rest Of New York | Office Unavailable | Facility $1843.97 |
| Rest Of Oregon | Office Unavailable | Facility $1864.85 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1906.55 |
| Rest Of Texas | Office Unavailable | Facility $1907.24 |
| Rest Of Washington | Office Unavailable | Facility $1924.66 |
| Rhode Island | Office Unavailable | Facility $1964.45 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1979.43 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1930.23 |
| Salinas | Office Unavailable | Facility $1922.47 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1939.99 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2087.95 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2077.12 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2144.84 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2100.55 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1896.75 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1936.01 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1922.08 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1952.61 |
| Seattle (King Cnty) | Office Unavailable | Facility $2065.47 |
| South Carolina | Office Unavailable | Facility $1879.01 |
| South Dakota** | Office Unavailable | Facility $1749.72 |
| Southern Maine | Office Unavailable | Facility $1839.64 |
| Stockton | Office Unavailable | Facility $1877.23 |
| Suburban Chicago | Office Unavailable | Facility $2227.87 |
| Tennessee | Office Unavailable | Facility $1772.46 |
| Utah | Office Unavailable | Facility $1901.56 |
| Vallejo | Office Unavailable | Facility $2008.15 |
| Vermont | Office Unavailable | Facility $1799.35 |
| Virgin Islands | Office Unavailable | Facility $1961.51 |
| Virginia | Office Unavailable | Facility $1859.90 |
| Visalia | Office Unavailable | Facility $1877.23 |
| West Virginia | Office Unavailable | Facility $2039.17 |
| Wisconsin | Office Unavailable | Facility $1721.73 |
| Wyoming** | Office Unavailable | Facility $1878.45 |
| Yuba City | Office Unavailable | Facility $1877.23 |
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37180 billing questions
How does this differ from 37183?
37180 is for open surgical revision of a portosystemic shunt. 37183 is used for endovascular revision of a TIPS.
Should 37180 be reported when creating a new shunt?
No. This code is for revising an existing shunt; codes such as 37140, 37145, or 37160 describe shunt procedures rather than this revision service.
Are related preoperative and postoperative visits separately reported?
The day-before preoperative visit and related postoperative care during the 90-day global period are included.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting 37180?
The operative report should establish that a portosystemic shunt already existed, explain why it required revision, and describe the revision 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,57237140,,Revision of circulation,A,,39.00,14.55,NA,14.55,,10.45,64.00,64.00,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57337145,,Revision of circulation,A,,36.08,13.70,NA,13.70,,9.67,59.45,59.45,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57437160,,Revision of circulation,A,,37.05,14.07,NA,14.07,,9.93,61.05,61.05,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57537180,,Revision of circulation,A,,35.59,13.59,NA,13.59,,9.54,58.72,58.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57637181,,Splice spleen/kidney veins,A,,39.00,14.55,NA,14.55,,10.45,64.00,64.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57737182,,Insert hepatic shunt (tips),A,,16.55,2.59,NA,2.59,,1.85,20.99,20.99,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57837183,,Revision tips,A,,7.55,153.40,,1.24,,0.85,161.80,9.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00