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CMS RVU26D · Effective 2026-10-01

34451 Venous thrombectomy Medicare reimbursement rates in Alabama

Open thrombectomy of the popliteal vein removes venous clot directly or with catheter assistance when treatment targets this specific vein. Compare 34451 office and facility rates across CMS payment localities in Alabama.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 34451 in Alabama?

Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1185.75

1 of 1 localities have a supported rate.

Payment area: Alabama

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 34451 in your payment locality →

Vascular surgery

About 34451: Open popliteal vein thrombectomy

Open thrombectomy of the popliteal vein removes venous clot directly or with catheter assistance when treatment targets this specific vein.

This service removes thrombus from the popliteal vein through open surgical access, using direct extraction or catheter assistance. Vascular surgeons typically perform it in an operating room for clinically significant venous thrombosis requiring surgical removal. The code is selected by the treated vein: the operative record should identify the popliteal vein and describe the access and clot-removal method.

Report the procedure once for the treated popliteal vein and support the site and work with the operative note. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same 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%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 34451

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU27.81 · 71%
  • Practice expense (office) RVU4.19 · 11%
  • Malpractice RVU7.11 · 18%

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.

34451 compared with similar codes

Office rates for Alabama, from the same CMS release.

34421

Venous thrombectomy

Vena cava, abdominal approach

No office rate

34421 applies when the treated vein is the femoral vein; 34451 applies to the popliteal vein. Follow the documented operative site.

34401

Vein thrombectomy

Iliac vein, leg incision

No office rate

34401 targets the iliac vein, whereas 34451 targets the popliteal vein.

37187

Venous thrombectomy

Initial treatment

$1,418.38

37187 describes endovascular mechanical thrombectomy. Use 34451 for open surgical clot removal from the popliteal vein.

Compare 34451 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

  • Alabama →

    Office / nonfacility

    Unavailable

    Facility

    $1185.75

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 34451 in Alabama.

PPRRVU2026_Oct_nonQPP.csv

4,190

Code
34451
Physician work
27.81
Practice expense
4.19
Malpractice
7.11

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Facility calculation for 34451 in Alabama
ComponentRVULocality factorAdjusted
Physician work27.81× 1.00027.8100
Practice expense4.19× 0.8753.6663
Malpractice7.11× 0.5664.0243
Total RVUs35.5005
Conversion factor× 33.4009

Facility rate, Alabama$1185.75

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work27.811
Practice expense4.190.875
Malpractice7.110.566

(27.81 × 1 + 4.19 × 0.875 + 7.11 × 0.566) × $33.4009 = $1185.75

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

34451 billing questions

How is this code distinguished from femoral vein thrombectomy?

Use this code when the treated thrombus is in the popliteal vein. The femoral vein is reported with 34421; document the operative site clearly.

When is 34401 more appropriate?

34401 is for thrombectomy targeting the iliac vein. Choose this code when the treated segment is the popliteal vein.

Can an endovascular thrombectomy code be used instead?

Code 37187 describes endovascular mechanical thrombectomy, while this code represents open surgical removal from the popliteal vein. The documented approach and treated anatomy determine the choice.

What documentation supports reporting this code?

The operative report should identify the popliteal vein as the treated site and describe the surgical access and direct or catheter-assisted clot removal.

How are bilateral procedures and other same-session procedures paid?

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

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 34451PPRRVU2026_Oct_nonQPP.csv, line 4,190 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet