$4,235.66–$4,624.78
Choose 37241 when the embolized target is venous; 37242 applies to an arterial target for a nonhemorrhagic, nontumor condition.
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CMS RVU26D · Effective 2026-10-01
37242 Arterial embolization Medicare reimbursement rates in Florida
Report this service for arterial embolization to treat conditions such as arteriovenous malformations, fistulas, aneurysms, or pseudoaneurysms, excluding hemorrhage and tumors. Compare 37242 office and facility rates across CMS payment localities in Florida.
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 37242 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$6422.55–$7009.32
3 of 3 localities have a supported rate.
Facility setting
$436.40–$490.92
3 of 3 localities have a supported rate.
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.
Where 37242 pays more and less in Florida
3 payment localities
$6422.55 to $7009.32
Interventional radiology
About 37242: Arterial embolization for nonhemorrhagic conditions
Report this service for arterial embolization to treat conditions such as arteriovenous malformations, fistulas, aneurysms, or pseudoaneurysms, excluding hemorrhage and tumors.
An interventional radiologist, vascular surgeon, or neurointerventional specialist uses catheter-based techniques to occlude an artery or arterial lesion. Typical indications include congenital or acquired arteriovenous malformations, arteriovenous fistulas, aneurysms, and pseudoaneurysms when the treatment is embolization rather than management of hemorrhage or a tumor. The code covers the embolization intervention and the radiological supervision and interpretation, roadmapping, and imaging guidance needed to complete it.
Choose this code by the treatment target and indication: arterial embolization for a nonhemorrhagic, nontumor condition. The operative report should identify the lesion, target artery or arterial territory, embolization performed, and clinical reason. Report the code once per operative session, even when multiple vessels are treated. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is not appropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 37242
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.56 · 5%
- Practice expense (office) RVU188.81 · 94%
- Malpractice RVU1.48 · 1%
14.7K
Medicare services in 2024 · #1260 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.
37242 compared with similar codes
Office rates for Florida, from the same CMS release.
$7,683.96–$8,371.91
Choose 37243 when embolization treats a tumor or organ ischemia or infarction. Use 37242 for other arterial indications such as an AVM, fistula, aneurysm, or pseudoaneurysm.
$5,885.97–$6,415.09
Choose 37244 when the indication is arterial or venous hemorrhage or a lymphatic leak; 37242 is for nonhemorrhagic arterial embolization.
$2,533.42–$2,792.06
37236 describes arterial stent placement, which maintains or supports vessel patency. 37242 describes embolization intended to occlude an arterial target.
Compare 37242 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
$6797.10
Facility
$454.03
Miami →
Office / nonfacility
$7009.32
Facility
$490.92
Rest Of Florida →
Office / nonfacility
$6422.55
Facility
$436.40
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37242 billing questions
How does this differ from 37241?
37242 is for an arterial target; 37241 is for a venous target. Select based on the vessel being embolized, not simply the diagnosis.
When should 37243 or 37244 be used instead?
Use 37243 for embolization directed at a tumor or organ ischemia or infarction. Use 37244 for arterial or venous hemorrhage or a lymphatic leak.
Are roadmapping and procedural imaging separately reported?
No. The code includes the radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance needed to complete the embolization.
How many units are reported when several arteries are embolized?
Report 37242 once per operative session, even if multiple vessels are treated. Document the treated lesion and vessels in the procedure report.
Can modifier 50 be used for bilateral embolization?
No. The bilateral adjustment is not appropriate for this code. If multiple procedures are performed in the same session, the standard multiple-procedure reduction applies.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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.
4,60137238,,Open/perq place stent same,A,,5.89,90.91,,0.98,,1.24,98.04,8.11,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60237239,,Open/perq place stent ea add,A,,2.90,46.20,,0.45,,0.59,49.69,3.94,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60337241,,Vasc embolize/occlude venous,A,,8.53,121.73,,1.31,,1.27,131.53,11.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60437242,,Vasc embolize/occlude artery,A,,9.56,188.81,,1.34,,1.48,199.85,12.38,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60537243,,Vasc embolize/occlude organ,A,,11.45,226.62,,1.69,,1.30,239.37,14.44,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60637244,,Vasc embolize/occlude bleed,A,,13.41,167.90,,2.01,,1.53,182.84,16.95,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60737246,,Trluml balo angiop 1st art,A,,6.83,44.12,,1.06,,1.34,52.29,9.23,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00