Billing code 37254: Iliac angioplastyMedicare rate & RVUs

Reports endovascular angioplasty for a simple lesion in the first treated iliac artery during revascularization for iliac arterial disease.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,072.53 for 37254 nationally in the office and $335.68 in a hospital or facility. Local office rates run $1,795.03–$2,855.89.

Medicare rate · 37254

Iliac angioplasty

Swap in your local Medicare rate.

Work RVUs
7.3
Total RVUs
62.05
Global days
000

National rate · 2026

$2,072.53

Office setting, before claim adjustments.

See every locality for 37254 → · 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 37254 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 37254 covers

This service treats an iliac artery narrowing or blockage by advancing an endovascular device to the affected site and expanding a balloon to improve blood flow. Vascular surgeons, interventional radiologists, and other physicians with appropriate endovascular training commonly perform it in an angiography suite or hospital procedure room. The code identifies treatment in the iliac territory and the simple category, not angioplasty elsewhere in the leg.

Select it when the documented intervention meets the billing code criteria for simple treatment and is the first treated artery in the iliac territory. The procedure report should identify the treated artery, lesion, approach, and intervention. CMS assigns 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 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 37254 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

$1795.03 to $2855.89

$1795.03$2325.46$2855.89
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

37254 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$1,826.29$306.55
Alaska*$2,283.95$434.21
Arizona$2,009.38$326.38
Arkansas$1,795.03$303.08
Atlanta$2,113.08$348.45
Austin$2,169.25$331.67
Bakersfield$2,224.90$321.31
Baltimore/Surr. Cntys$2,219.29$355.65
Beaumont$1,909.03$328.50
Brazoria$2,045.97$324.75

37254 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.

$1,795.03

$2,538.06

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
37254 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,283.951
AL$1,826.291
AR$1,795.031
AZ$2,009.381
CA$2,220.24–$2,855.8929
CO$2,176.321
CT$2,225.811
DC$2,407.491
DE$2,046.721
FL$2,023.31–$2,232.493
GA$1,892.16–$2,113.082
GU$2,291.191
HI$2,291.191
IA$1,887.501
ID$1,900.701
IL$1,950.55–$2,166.164
IN$1,913.841
KS$1,874.121
KY$1,871.031
LA$1,866.39–$1,975.772
MA$2,158.73–$2,419.932
MD$2,091.54–$2,407.493
ME$1,909.21–$2,035.512
MI$1,925.77–$2,049.702
MN$2,083.691
MO$1,826.56–$1,987.603
MS$1,811.371
MT$2,072.411
NC$1,933.211
ND$2,038.601
NE$1,900.591
NH$2,138.021
NJ$2,250.80–$2,375.222
NM$1,936.961
NV$2,064.761
NY$1,966.98–$2,471.915
OH$1,918.851
OK$1,870.231
OR$2,048.48–$2,258.452
PA$1,924.11–$2,160.572
PR$2,091.161
RI$2,129.451
SC$1,929.321
SD$2,034.601
TN$1,884.871
TX$1,909.03–$2,169.258
UT$1,960.411
VA$2,025.62–$2,407.492
VI$2,091.161
VT$2,026.591
WA$2,155.94–$2,476.412
WI$1,958.601
WV$1,865.071
WY$2,057.681

How the 37254 rate is calculated

Each of 37254’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 · 37254

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.30Practice expense 53.04Malpractice 1.71

62.0500 adjusted RVUs×$33.4009 conversion factor=$2,072.53

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

Payment rules and modifiers for 37254

The CMS indicators that decide how 37254 is paid alongside other services.

CMS payment indicators · 37254

Iliac angioplasty

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

37254 without 50 · national office

$2,072.53

Iliac angioplasty

37254-50 · Bilateral: 150%

$3,108.80

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).

When to use modifier 50

37254 compared with similar codes

Compare codes

37254 vs 37256 vs 37258 vs 37263: national Medicare rates

Swap in your local Medicare rate.

  • 37254
    Iliac angioplasty · 7.3 wRVU
    $2,072.53
  • 37256
    Iliac angioplasty · 10.75 wRVU
    $2,430.25+$357.72
  • 37258
    Arterial stenting · 8.75 wRVU
    $3,562.21+$1,489.68
  • 37263
    Leg angioplasty · 7.75 wRVU
    $5,429.65+$3,357.12

How to choose

37256Iliac angioplasty
Both are iliac-territory angioplasty codes. Choose 37254 for treatment meeting the simple-category criteria and 37256 for treatment meeting the complex-category criteria.
37258Arterial stenting
This code represents simple-category iliac angioplasty; 37258 is the related simple-category code when the iliac intervention involves stent placement.
37263Leg angioplasty
Both cover simple-category angioplasty, but 37254 is for the iliac territory and 37263 is for the femoropopliteal territory.

37254 billing questions

How is this code distinguished from 37256?

Both describe iliac-territory angioplasty, but 37254 is for treatment meeting the simple-category criteria. Use 37256 when the documented treatment meets the complex-category criteria.

When is 37255 relevant?

37255 is the related simple-category code for an additional treated iliac artery. Identify the arteries treated and their order in the procedure documentation.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How does CMS handle bilateral reporting and multiple procedures?

Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment is allowed 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
RVUs for 37254PPRRVU2026_Oct_nonQPP.csv, line 4,613 (RVU26D)

Open CMS sourceHow we calculate rates

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