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Billing code 37565: Vein ligationMedicare rate & RVUs

Reports surgical ligation of an internal jugular vein, such as for bleeding control or intentional vein sacrifice during a neck operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities99 Medicare services in 2024

Medicare pays $651.32 for 37565 nationally in a facility.

Medicare rate · 37565

Vein ligation

Swap in your local Medicare rate.

Work RVUs
11.75
Total RVUs
19.50
Global days
090

National rate · 2026

$651.32

Facility setting, before claim adjustments.

See every locality for 37565 → · 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 37565 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 37565 covers

The surgeon ties off an internal jugular vein in the neck. The service may be performed to control bleeding or to intentionally sacrifice the vein during neck surgery. It is an operative vascular procedure, generally performed by a surgeon in a hospital or other surgical setting; it is not a code for routine venous access or catheter management.

Select the code when the documented operation includes ligation of the internal jugular vein, and record the side, indication, and operative work. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery and co-surgeon payment require supporting documentation; 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 37565 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

37565 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$593.36
Alaska*Unavailable$821.80
ArizonaUnavailable$633.93
ArkansasUnavailable$586.32
AtlantaUnavailable$671.96
AustinUnavailable$652.87
BakersfieldUnavailable$643.28
Baltimore/Surr. CntysUnavailable$690.08
BeaumontUnavailable$629.59
BrazoriaUnavailable$634.65

37565 rates by state

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

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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
37565 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 37565 rate is calculated

Each of 37565’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 · 37565

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.75Practice expense 5.27Malpractice 2.48

19.5000 adjusted RVUs×$33.4009 conversion factor=$651.32

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

Payment rules and modifiers for 37565

37565 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 37565

Vein ligation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 37565

Vein ligation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

37565 without 50 · national facility

$651.32

Vein ligation

37565-50 · Bilateral: 150%

$976.98

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

37565 compared with similar codes

Compare codes

37565 vs 35201 vs 38720 vs 38724: national Medicare rates

Swap in your local Medicare rate.

  • 37565
    Vein ligation · 11.75 wRVU
    —
  • 35201
    Vessel repair · 16.51 wRVU
    —
  • 38720
    Neck node removal · 21.4 wRVU
    —
  • 38724
    Neck dissection · 23.35 wRVU
    —

How to choose

35201Vessel repair
Use 35201 for direct repair of a blood vessel in the neck; use 37565 when the internal jugular vein is surgically ligated.
38720Neck node removal
Use 38720 for a radical neck dissection when internal jugular vein removal is part of the broader procedure, rather than separately reporting an included ligation.
38724Neck dissection
Use 38724 for a modified radical neck dissection, a broader lymph-node operation; 37565 describes ligation of the internal jugular vein itself.

Codes related to 37565

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

Codes related to 37565
CodeHow it relatesNational office range
Used instead
35201Vessel repairDirect repair of a neck blood vessel may be selected when the vessel is repaired rather than ligated.No office rate
38720Neck node removalRadical neck dissection captures internal jugular vein removal when it is part of that broader operation.No office rate
38724Neck dissectionModified radical neck dissection may describe a broader neck operation involving lymph-node dissection.No office rate

37565 billing questions

When is this code appropriate instead of a neck dissection code?

Use it for a separately performed internal jugular vein ligation. If vein sacrifice is part of a radical neck dissection, report the dissection service rather than separately coding an included step.

Can the ligation be reported with a neck dissection?

Do not separately report ligation when it is integral to the documented neck dissection. The operative report should establish whether a distinct ligation service was performed.

How is bilateral ligation reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.

What documentation supports assistant or co-surgeon payment?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 37565PPRRVU2026_Oct_nonQPP.csv, line 4,667 (RVU26D)

Open CMS sourceHow we calculate rates

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