Billing code 37256: Iliac angioplastyMedicare rate & RVUs in Alaska
Reports endovascular balloon angioplasty of the initial iliac-territory vessel treated for a complex lesion, such as peripheral arterial disease causing impaired limb blood flow.
Medicare pays $2,701.31 for 37256 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 37256 covers
This code covers endovascular angioplasty of the initial vessel treated in the iliac vascular territory for a complex lesion. The procedure uses a catheter-based approach to widen a diseased iliac artery, commonly to improve blood flow in a patient with symptomatic peripheral arterial disease. Vascular surgeons, interventional radiologists, and interventional cardiologists may perform it in a hospital angiography or endovascular suite. The code identifies angioplasty treatment; it is not the code for a stent-based treatment pathway.
Choose the complex-lesion code using the applicable billing code lesion criteria, not simply because the procedure used specialized equipment. Document the target vessel, laterality, lesion characteristics supporting complexity, and angioplasty performed. The code includes same-day preoperative and postoperative care under its 0-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 identifies bilateral treatment and 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.
37256 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $2,701.31 | $637.07 |
How the 37256 rate is calculated
Each of 37256’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 · 37256
RVUs × geographic indexes × conversion factor
Work10.75
10.75 RVUs× 1.000 GPCI
Practice expense59.50
59.50 RVUs× 1.000 GPCI
Malpractice2.51
2.51 RVUs× 1.000 GPCI
Adjusted RVUs
72.7600
Conversion factor
$33.4009
Medicare rate
$2,430.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37256
The CMS indicators that decide how 37256 is paid alongside other services.
CMS payment indicators · 37256
Iliac angioplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
37256 without 50 · national office
$2,430.25
Iliac angioplasty
37256-50 · Bilateral: 150%
$3,645.38
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).
37256 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 37254Iliac angioplasty
- Both cover angioplasty of the initial iliac-territory vessel. Choose 37254 for a straightforward lesion and 37256 when the lesion meets the complex criteria.
- 37257Iliac angioplasty
- 37256 covers the initial vessel; 37257 is the add-on for each qualifying additional vessel treated for a complex lesion in the iliac territory.
- 37260Arterial stenting
- Both address a complex iliac lesion, but 37256 represents angioplasty treatment and 37260 represents treatment using the stent pathway.
- 37265Vessel angioplasty
- 37265 is complex-lesion angioplasty in the femoral/popliteal territory. Use 37256 for the iliac territory.
37256 billing questions
How do I distinguish 37256 from 37254?
Both report iliac-territory angioplasty of an initial vessel. Use 37256 when the lesion meets the applicable billing code criteria for complex rather than straightforward treatment.
When is 37257 reported with 37256?
37257 is the add-on code for angioplasty of each additional vessel in the iliac territory when the applicable complex-lesion criteria are met. Report it with the appropriate initial-vessel code.
Should routine procedural imaging be billed separately?
Routine imaging and radiological supervision and interpretation associated with the endovascular angioplasty are included. A diagnostic angiogram requires a distinct diagnostic purpose and must meet the applicable reporting criteria.
What documentation supports reporting 37256?
Record the treated iliac vessel, laterality, lesion findings that support the complex classification, and the angioplasty performed. The record should make clear which vessel was treated first in the territory.
How is bilateral treatment handled?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%. The standard multiple-procedure reduction applies when other procedures are performed in the same session.
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
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