Billing code 37242: Arterial embolizationMedicare rate & RVUs

Medicare pays $6,675.17 for 37242 nationally in the office and $413.50 in a hospital or facility. Local office rates run $5,761.99–$9,474.80.

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

What 37242 covers

An interventional radiologist, vascular surgeon, or neurointerventional specialist uses catheter-based techniques to occlude an artery or arterial lesion. Typical indications include congenital or acquired arteriovenous malformations, arteriovenous fistulas, aneurysms, and pseudoaneurysms when the treatment is embolization rather than management of hemorrhage or a tumor. The code covers the embolization intervention and the radiological supervision and interpretation, roadmapping, and imaging guidance needed to complete it.

Choose this code by the treatment target and indication: arterial embolization for a nonhemorrhagic, nontumor condition. The operative report should identify the lesion, target artery or arterial territory, embolization performed, and clinical reason. Report the code once per operative session, even when multiple vessels are treated. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is not appropriate. 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 37242 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

37242 rates by state

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

How the 37242 rate is calculated

Each of 37242’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 37242

The CMS indicators that decide how 37242 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

37242 compared with similar codes

How to choose

37241Venous embolization

Choose 37241 when the embolized target is venous; 37242 applies to an arterial target for a nonhemorrhagic, nontumor condition.

37243Embolization

Choose 37243 when embolization treats a tumor or organ ischemia or infarction. Use 37242 for other arterial indications such as an AVM, fistula, aneurysm, or pseudoaneurysm.

37244Vascular embolization

Choose 37244 when the indication is arterial or venous hemorrhage or a lymphatic leak; 37242 is for nonhemorrhagic arterial embolization.

37236Arterial stent

37236 describes arterial stent placement, which maintains or supports vessel patency. 37242 describes embolization intended to occlude an arterial target.

Codes related to 37242

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