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Billing code 37182: TIPS placementMedicare rate & RVUs

Reports creation of a transjugular intrahepatic portosystemic shunt to decompress portal hypertension, commonly for complications such as recurrent variceal bleeding.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $701.08 for 37182 nationally in a facility.

Medicare rate · 37182

TIPS placement

Swap in your local Medicare rate.

Work RVUs
16.55
Total RVUs
20.99
Global days
000

National rate · 2026

$701.08

Facility setting, before claim adjustments.

See every locality for 37182 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 37182 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 37182 covers

A TIPS procedure creates a channel through the liver between the portal venous system and a hepatic vein, then keeps that channel open with a stent. Interventional radiologists and other qualified endovascular physicians perform it in a hospital setting, commonly for portal hypertension complications such as recurrent variceal bleeding or refractory ascites. The service involves vascular access and catheter work, imaging guidance, and the steps needed to establish the shunt.

Report 37182 for initial TIPS creation, not for revising an existing shunt. The record should support the clinical indication and document creation of the intrahepatic connection and its stent placement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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 37182 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

37182 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$663.45
Alaska*Unavailable$955.36
ArizonaUnavailable$689.51
ArkansasUnavailable$658.92
AtlantaUnavailable$716.55
AustinUnavailable$700.16
BakersfieldUnavailable$695.73
Baltimore/Surr. CntysUnavailable$730.89
BeaumontUnavailable$688.91
BrazoriaUnavailable$691.13

37182 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
37182 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 37182 rate is calculated

Each of 37182’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 · 37182

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.55Practice expense 2.59Malpractice 1.85

20.9900 adjusted RVUs×$33.4009 conversion factor=$701.08

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 37182

The CMS indicators that decide how 37182 is paid alongside other services.

CMS payment indicators · 37182

TIPS placement

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

37182 without 51 · national facility

$701.08

TIPS placement

37182-51 · Second procedure: 50%

$350.54

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

37182 compared with similar codes

Compare codes

37182 vs 37183 vs 37181 vs 37140: national Medicare rates

Swap in your local Medicare rate.

  • 37182
    TIPS placement · 16.55 wRVU
    —
  • 37183
    TIPS revision · 7.55 wRVU
    $5,404.27
  • 37181
    Splenorenal shunt · 39 wRVU
    —
  • 37140
    Portacaval shunt · 39 wRVU
    —

How to choose

37183TIPS revision
37182 creates a new TIPS; 37183 revises a TIPS that is already in place.
37181Splenorenal shunt
37181 concerns portal-vein stenting; 37182 creates a channel through the liver between the portal and hepatic venous systems.
37140Portacaval shunt
37140 is a surgical portosystemic shunt. Use 37182 for transjugular, endovascular creation of an intrahepatic shunt.

Codes related to 37182

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

Codes related to 37182
CodeHow it relatesNational office range
Same family
37183TIPS revisionRevision of an existing TIPS, rather than creation of a new intrahepatic shunt.$4,668.05–$7,683.51
Used instead
37140Portacaval shuntA surgical portosystemic shunt is a different approach to portal decompression.No office rate
37145Surgical shuntA distal splenorenal shunt is a surgical alternative for portal decompression.No office rate

37182 billing questions

How is initial TIPS placement different from code 37183?

Use 37182 to create a new intrahepatic shunt. Code 37183 is for revision of an existing TIPS.

Does 37182 include imaging guidance and catheter access?

Yes. The TIPS placement service includes the access, catheter work, imaging guidance, and related steps needed to create the shunt.

Can modifier 50 be reported for TIPS placement?

No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.

When is an assistant at surgery payable?

CMS allows assistant-at-surgery payment only when documentation establishes medical necessity.

How does the multiple-procedure reduction affect 37182?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50% under the standard reduction.

Can co-surgeons or a surgical team report this procedure?

CMS does not permit co-surgeons or team surgery for 37182.

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
RVUs for 37182PPRRVU2026_Oct_nonQPP.csv, line 4,577 (RVU26D)

Open CMS sourceHow we calculate rates

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