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Billing code 37600: Carotid ligationMedicare rate & RVUs

Reports operative ligation of the external carotid artery when a surgeon needs to interrupt its blood flow, such as for control of head-and-neck bleeding.

CMS RVU26DEffective Oct 1, 2026109 payment localities424 Medicare services in 2024

Medicare pays $662.34 for 37600 nationally in a facility.

Medicare rate · 37600

Carotid ligation

Swap in your local Medicare rate.

Work RVUs
12.11
Total RVUs
19.83
Global days
090

National rate · 2026

$662.34

Facility setting, before claim adjustments.

See every locality for 37600 → · 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 37600 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 37600 covers

The surgeon exposes and ties off the external carotid artery in the neck to interrupt blood flow to its branches. The operation may be performed to control severe bleeding in the head or neck or when operative management requires control of external-carotid inflow. Vascular, otolaryngology, and head-and-neck surgeons typically perform it in a hospital operating room.

Choose this code when the artery ligated is the external carotid, rather than the internal or common carotid. The operative report should identify the artery and document the ligation and clinical purpose. The 90-day global period includes 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%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and 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 37600 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

37600 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$608.12
Alaska*Unavailable$844.77
ArizonaUnavailable$646.31
ArkansasUnavailable$601.51
AtlantaUnavailable$680.84
AustinUnavailable$665.87
BakersfieldUnavailable$660.13
Baltimore/Surr. CntysUnavailable$699.30
BeaumontUnavailable$640.48
BrazoriaUnavailable$648.24

37600 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
37600 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 37600 rate is calculated

Each of 37600’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 · 37600

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.11Practice expense 5.59Malpractice 2.13

19.8300 adjusted RVUs×$33.4009 conversion factor=$662.34

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

Payment rules and modifiers for 37600

37600 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 37600

Carotid 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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
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 · 37600

Carotid 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 51 · payment effect

With and without the modifier

37600 without 51 · national facility

$662.34

Carotid ligation

37600-51 · Second procedure: 50%

$331.17

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

37600 compared with similar codes

Compare codes

37600 vs 37605 vs 37606 vs 37615: national Medicare rates

Swap in your local Medicare rate.

  • 37600
    Carotid ligation · 12.11 wRVU
    —
  • 37605
    Carotid ligation · 13.92 wRVU
    —
  • 37606
    Carotid ligation · 8.59 wRVU
    —
  • 37615
    Arterial ligation · 7.61 wRVU
    —

How to choose

37605Carotid ligation
Use 37605 for ligation of the internal or common carotid artery; 37600 is specific to the external carotid.
37606Carotid ligation
This code covers ligation or occlusion involving the internal or common carotid artery, not the external carotid.
37615Arterial ligation
This code applies to ligation of a major artery in the neck when the procedure is not the specific external carotid service reported with 37600.

Codes related to 37600

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

Codes related to 37600
CodeHow it relatesNational office range
Same family
37605Carotid ligationLigation of the internal or common carotid artery rather than the external carotid.No office rate
37606Carotid ligationAddresses ligation or occlusion of the internal or common carotid artery.No office rate
Used instead
37615Arterial ligationFor ligation of a major neck artery when the procedure is not specifically external carotid ligation.No office rate

37600 billing questions

How does 37600 differ from ligation of the internal or common carotid?

Use 37600 when the external carotid artery is ligated. Codes 37605 and 37606 address the internal or common carotid instead.

What documentation supports reporting 37600?

The operative report should identify the external carotid artery, describe its exposure and ligation, and state the clinical reason for interrupting its blood flow.

Can modifier 50 be used for bilateral ligation?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Is related postoperative care included?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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 37600PPRRVU2026_Oct_nonQPP.csv, line 4,672 (RVU26D)

Open CMS sourceHow we calculate rates

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