Billing code 37188: Venous thrombectomyMedicare rate & RVUs
Reports repeat catheter-based mechanical removal of venous thrombus during the same session as primary venous thrombectomy when further treatment is performed.
Medicare pays $1,377.45 for 37188 nationally in the office and $250.51 in a hospital or facility. Local office rates run $1,196.11–$1,895.22.
Medicare rate · 37188
Venous thrombectomy
Swap in your local Medicare rate.
- Work RVUs
- 5.32
- Total RVUs
- 41.24
- Global days
- 000
National rate · 2026
$1,377.45
Office setting, before claim adjustments.
See every locality for 37188 → · 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
What 37188 covers
This code describes repeat catheter-based mechanical removal of thrombus from a vein during the same session as the primary venous thrombectomy. It is used in endovascular treatment of venous clot, such as deep vein thrombosis, when the physician performs repeat thrombectomy after the primary treatment. Interventional radiologists, vascular surgeons, and other physicians with appropriate endovascular training commonly perform the service in a hospital or other procedural facility. Fluoroscopic guidance and intraprocedural thrombolytic injections are part of the service.
Report 37188 as an add-on to 37187, not as the primary venous thrombectomy code. The procedure report should identify the treated vein or veins, the primary thrombectomy, and the repeat treatment performed during that same session. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery is not paid; co-surgeons are permitted, while team surgery is 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 37188 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$1196.11 to $1895.22
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,216.54 | $230.46 |
| Alaska* | $1,526.09 | $325.89 |
| Arizona | $1,336.26 | $244.25 |
| Arkansas | $1,196.11 | $228.06 |
| Atlanta | $1,403.73 | $258.75 |
| Austin | $1,441.30 | $249.00 |
| Bakersfield | $1,478.76 | $243.63 |
| Baltimore/Surr. Cntys | $1,473.69 | $264.47 |
| Beaumont | $1,270.15 | $244.63 |
| Brazoria | $1,360.61 | $243.80 |
| Chicago | $1,430.37 | $297.79 |
| Chico | $1,475.82 | $240.69 |
| Colorado | $1,446.35 | $247.28 |
| Connecticut | $1,478.10 | $264.38 |
| Dallas | $1,369.37 | $246.93 |
| Dc + Md/Va Suburbs | $1,598.30 | $270.76 |
| Delaware | $1,360.79 | $247.37 |
| Detroit | $1,360.99 | $273.49 |
| East St. Louis | $1,320.21 | $283.41 |
| El Centro | $1,476.00 | $240.87 |
| Fort Lauderdale | $1,421.20 | $279.60 |
| Fort Worth | $1,358.18 | $247.02 |
| Fresno | $1,475.82 | $240.69 |
| Galveston | $1,364.63 | $245.58 |
| Hanford-Corcoran | $1,475.82 | $240.69 |
| Hawaii, Guam | $1,522.06 | $240.73 |
| Houston | $1,384.04 | $264.98 |
| Idaho | $1,265.65 | $228.86 |
| Indiana | $1,274.26 | $229.58 |
| Iowa | $1,257.13 | $225.98 |
| Kansas | $1,248.11 | $229.35 |
| Kentucky | $1,245.20 | $243.34 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,585.92 | $252.74 |
| Madera | $1,475.82 | $240.69 |
| Manhattan | $1,598.20 | $288.69 |
| Merced | $1,475.82 | $240.69 |
| Metropolitan Boston | $1,606.73 | $261.15 |
| Metropolitan Kansas City | $1,305.61 | $247.41 |
| Metropolitan Philadelphia | $1,435.22 | $262.07 |
| Metropolitan St. Louis | $1,321.63 | $248.78 |
| Miami | $1,479.33 | $306.17 |
| Minnesota | $1,386.29 | $226.67 |
| Mississippi | $1,206.37 | $236.07 |
| Modesto | $1,475.82 | $240.69 |
| Montana** | $1,377.38 | $250.44 |
| Napa | $1,741.49 | $256.18 |
| Nebraska | $1,265.78 | $225.60 |
| Nevada** | $1,372.70 | $244.63 |
| New Hampshire | $1,420.77 | $247.61 |
| New Mexico | $1,287.93 | $254.52 |
| New Orleans | $1,313.57 | $253.11 |
| North Carolina | $1,286.66 | $235.22 |
| North Dakota** | $1,356.42 | $229.48 |
| Northern Nj | $1,577.35 | $270.09 |
| Nyc Suburbs/Long Island | $1,639.23 | $299.29 |
| Ohio | $1,276.44 | $247.54 |
| Oklahoma | $1,244.97 | $238.61 |
| Oxnard-Thousand Oaks-Ventura | $1,580.99 | $248.94 |
| Portland | $1,500.48 | $248.44 |
| Poughkpsie/N Nyc Suburbs | $1,503.50 | $269.49 |
| Puerto Rico | $1,389.73 | $250.39 |
| Queens | $1,616.39 | $284.34 |
| Redding | $1,475.82 | $240.69 |
| Rest Of California | $1,475.82 | $240.69 |
| Rest Of Florida | $1,344.03 | $266.67 |
| Rest Of Georgia | $1,258.50 | $253.26 |
| Rest Of Illinois | $1,296.09 | $267.19 |
| Rest Of Louisiana | $1,242.07 | $244.72 |
| Rest Of Maine | $1,270.92 | $234.13 |
| Rest Of Maryland | $1,390.30 | $249.83 |
| Rest Of Massachusetts | $1,434.82 | $248.15 |
| Rest Of Michigan | $1,280.72 | $251.82 |
| Rest Of Missouri | $1,215.85 | $244.42 |
| Rest Of New Jersey | $1,495.12 | $264.49 |
| Rest Of New York | $1,308.72 | $238.12 |
| Rest Of Oregon | $1,362.28 | $239.84 |
| Rest Of Pennsylvania | $1,280.03 | $245.49 |
| Rest Of Texas | $1,314.64 | $245.16 |
| Rest Of Washington | $1,433.01 | $246.34 |
| Rhode Island | $1,415.43 | $251.29 |
| Riverside-San Bernardino-Ontario | $1,487.23 | $252.09 |
| Sacramento-Roseville-Folsom | $1,557.21 | $246.57 |
| Salinas | $1,551.67 | $245.54 |
| San Diego-Chula Vista-Carlsbad | $1,594.78 | $246.95 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,852.57 | $263.57 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,851.36 | $262.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,895.22 | $270.16 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,890.30 | $265.24 |
| San Luis Obispo-Paso Robles | $1,525.89 | $242.30 |
| Santa Cruz-Watsonville | $1,615.09 | $245.85 |
| Santa Maria-Santa Barbara | $1,559.28 | $245.26 |
| Santa Rosa-Petaluma | $1,631.83 | $247.94 |
| Seattle (King Cnty) | $1,644.17 | $261.40 |
| South Carolina | $1,283.65 | $242.35 |
| South Dakota** | $1,353.94 | $227.00 |
| Southern Maine | $1,353.91 | $237.11 |
| Stockton | $1,475.82 | $240.69 |
| Suburban Chicago | $1,437.47 | $280.09 |
| Tennessee | $1,255.10 | $230.71 |
| Utah | $1,303.98 | $244.65 |
| Vallejo | $1,739.76 | $254.44 |
| Vermont | $1,348.32 | $232.64 |
| Virgin Islands | $1,389.73 | $250.39 |
| Virginia | $1,347.25 | $239.46 |
| Visalia | $1,475.82 | $240.69 |
| West Virginia | $1,240.18 | $260.87 |
| Wisconsin | $1,304.05 | $224.44 |
| Wyoming** | $1,368.25 | $241.30 |
| Yuba City | $1,475.82 | $240.69 |
37188 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$1,196.11
$1,685.52
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,526.09 | 1 |
| AL | $1,216.54 | 1 |
| AR | $1,196.11 | 1 |
| AZ | $1,336.26 | 1 |
| CA | $1,475.82–$1,895.22 | 29 |
| CO | $1,446.35 | 1 |
| CT | $1,478.10 | 1 |
| DC | $1,598.30 | 1 |
| DE | $1,360.79 | 1 |
| FL | $1,344.03–$1,479.33 | 3 |
| GA | $1,258.50–$1,403.73 | 2 |
| GU | $1,522.06 | 1 |
| HI | $1,522.06 | 1 |
| IA | $1,257.13 | 1 |
| ID | $1,265.65 | 1 |
| IL | $1,296.09–$1,437.47 | 4 |
| IN | $1,274.26 | 1 |
| KS | $1,248.11 | 1 |
| KY | $1,245.20 | 1 |
| LA | $1,242.07–$1,313.57 | 2 |
| MA | $1,434.82–$1,606.73 | 2 |
| MD | $1,390.30–$1,598.30 | 3 |
| ME | $1,270.92–$1,353.91 | 2 |
| MI | $1,280.72–$1,360.99 | 2 |
| MN | $1,386.29 | 1 |
| MO | $1,215.85–$1,321.63 | 3 |
| MS | $1,206.37 | 1 |
| MT | $1,377.38 | 1 |
| NC | $1,286.66 | 1 |
| ND | $1,356.42 | 1 |
| NE | $1,265.78 | 1 |
| NH | $1,420.77 | 1 |
| NJ | $1,495.12–$1,577.35 | 2 |
| NM | $1,287.93 | 1 |
| NV | $1,372.70 | 1 |
| NY | $1,308.72–$1,639.23 | 5 |
| OH | $1,276.44 | 1 |
| OK | $1,244.97 | 1 |
| OR | $1,362.28–$1,500.48 | 2 |
| PA | $1,280.03–$1,435.22 | 2 |
| PR | $1,389.73 | 1 |
| RI | $1,415.43 | 1 |
| SC | $1,283.65 | 1 |
| SD | $1,353.94 | 1 |
| TN | $1,255.10 | 1 |
| TX | $1,270.15–$1,441.30 | 8 |
| UT | $1,303.98 | 1 |
| VA | $1,347.25–$1,598.30 | 2 |
| VI | $1,389.73 | 1 |
| VT | $1,348.32 | 1 |
| WA | $1,433.01–$1,644.17 | 2 |
| WI | $1,304.05 | 1 |
| WV | $1,240.18 | 1 |
| WY | $1,368.25 | 1 |
How the 37188 rate is calculated
Each of 37188’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 · 37188
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.32Practice expense 34.86Malpractice 1.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37188
The CMS indicators that decide how 37188 is paid alongside other services.
CMS payment indicators · 37188
Venous thrombectomy
| 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 | 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | 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
37188 without 50 · national office
$1,377.45
Venous thrombectomy
37188-50 · Bilateral: 150%
$2,066.18
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).
37188 compared with similar codes
Compare codes
37188 vs 37187 vs 37184 vs 37186: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37187Venous thrombectomy
- 37187 reports the primary venous mechanical thrombectomy. Use 37188 only for repeat thrombectomy during that same session, in addition to the primary service.
- 37184Arterial thrombectomy
- 37184 is for primary mechanical thrombectomy in an artery or arterial bypass graft; 37188 concerns repeat treatment of venous thrombus.
- 37186Arterial thrombectomy
- 37186 describes secondary mechanical thrombectomy in arterial treatment performed with another percutaneous intervention. It is not the repeat venous thrombectomy add-on.
37188 billing questions
When should 37188 be reported instead of 37187?
Use 37187 for the primary venous mechanical thrombectomy. Report 37188 as the add-on when repeat venous mechanical thrombectomy is performed during that same session.
Can 37188 be billed by itself?
No. It is reported with the primary venous thrombectomy code 37187.
Are fluoroscopy and thrombolytic injections separately reported?
Fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections are included in the thrombectomy service.
How is bilateral treatment reported?
Use modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
What documentation supports 37188?
Document the treated vein or veins, the primary thrombectomy, and the repeat mechanical treatment performed during the same session.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's payment.
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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