No office rate
Use 34401 for thrombectomy at its specified central or pelvic venous sites, rather than an upper-extremity vein.
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CMS RVU26D · Effective 2026-10-01
34490 Vein thrombectomy Medicare reimbursement rates in Alabama
Reports surgical removal of thrombus from an upper-extremity vein, using direct access or a catheter, when operative venous thrombectomy is performed. Compare 34490 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 34490 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
$478.12
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.
Vascular surgery
About 34490: Open upper-extremity venous thrombectomy
Reports surgical removal of thrombus from an upper-extremity vein, using direct access or a catheter, when operative venous thrombectomy is performed.
This code describes operative removal of clot from an upper-extremity vein, by direct exposure or with catheter assistance. Vascular surgeons typically perform the procedure in a hospital operating room for selected patients with significant venous obstruction, such as extensive upper-extremity deep vein thrombosis. The operative report should identify the treated vein and side, the approach, and the thrombectomy performed.
Report the code for the upper-extremity venous thrombectomy itself, distinguishing it from open thrombectomy of lower-extremity or central veins and from percutaneous mechanical thrombectomy. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. 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% multiple-procedure reduction. Bilateral reporting with modifier 50 is priced at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 34490
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.64 · 67%
- Practice expense (office) RVU2.44 · 15%
- Malpractice RVU2.72 · 17%
64
Medicare services in 2024 · #5198 by national volume
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.
34490 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Use 34421 for thrombectomy of its specified lower-extremity venous region; 34490 is for an upper-extremity vein.
$1,418.38
37187 describes percutaneous transluminal mechanical venous thrombectomy. 34490 describes operative thrombectomy by direct access or catheter assistance.
Compare 34490 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
Alabama →
Office / nonfacility
Unavailable
Facility
$478.12
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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 34490 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
4,192
- Code
- 34490
- Physician work
- 10.64
- Practice expense
- 2.44
- Malpractice
- 2.72
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.64 | × 1.000 | 10.6400 |
| Practice expense | 2.44 | × 0.875 | 2.1350 |
| Malpractice | 2.72 | × 0.566 | 1.5395 |
| Total RVUs | 14.3145 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$478.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.64 | 1 |
| Practice expense | 2.44 | 0.875 |
| Malpractice | 2.72 | 0.566 |
(10.64 × 1 + 2.44 × 0.875 + 2.72 × 0.566) × $33.4009 = $478.12
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.
34490 billing questions
How is 34490 distinguished from 34401 or 34421?
34490 is for thrombectomy of an upper-extremity vein. Codes 34401 and 34421 describe thrombectomy at specified central or lower-extremity venous sites.
Can 34490 be reported for percutaneous mechanical thrombectomy?
Use 34490 for operative thrombectomy by direct access or catheter assistance. Code 37187 describes percutaneous transluminal mechanical venous thrombectomy.
What documentation supports reporting 34490?
Document the treated upper-extremity vein, laterality, surgical approach, and the clot-removal work performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is 34490 priced when bilateral procedures are performed?
CMS prices bilateral reporting with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 34490. 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 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.
4,18934421,,Removal of vein clot,A,,13.04,2.66,NA,2.66,,3.32,19.02,19.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19034451,,Removal of vein clot,A,,27.81,4.19,NA,4.19,,7.11,39.11,39.11,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19134471,,Removal of vein clot,A,,20.58,3.62,NA,3.62,,5.25,29.45,29.45,0,090,0.09,0.84,0.07,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19234490,,Removal of vein clot,A,,10.64,2.44,NA,2.44,,2.72,15.80,15.80,0,090,0.09,0.84,0.07,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19334501,,Repair valve femoral vein,A,,16.43,3.95,NA,3.95,,4.19,24.57,24.57,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19434502,,Reconstruct vena cava,A,,27.37,8.62,NA,8.62,,6.42,42.41,42.41,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,1953450F,,Dyspnea scrnd no-mild dysp,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515