Billing code 34490: Vein thrombectomyMedicare rate & RVUs in Delaware
Reports surgical removal of thrombus from an upper-extremity vein, using direct access or a catheter, when operative venous thrombectomy is performed.
CMS doesn’t publish an office rate for 34490 in Delaware.
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 34490 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $519.36 |
How the 34490 rate is calculated
Each of 34490’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 · 34490
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.64Practice expense 2.44Malpractice 2.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 34490
34490 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 34490
Vein thrombectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 34490
Vein thrombectomy
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
34490 without 50 · national facility
$527.73
Vein thrombectomy
34490-50 · Bilateral: 150%
$791.60
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).
34490 compared with similar codes
Compare codes
34490 vs 34401 vs 34421 vs 37187: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 34401Vein thrombectomy
- Use 34401 for thrombectomy at its specified central or pelvic venous sites, rather than an upper-extremity vein.
- 34421Venous thrombectomy
- Use 34421 for thrombectomy of its specified lower-extremity venous region; 34490 is for an upper-extremity vein.
- 37187Venous thrombectomy
- 37187 describes percutaneous transluminal mechanical venous thrombectomy. 34490 describes operative thrombectomy by direct access or catheter assistance.
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 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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