Billing code 34451: Venous thrombectomyMedicare rate & RVUs in Georgia
Open thrombectomy of the popliteal vein removes venous clot directly or with catheter assistance when treatment targets this specific vein.
CMS doesn’t publish an office rate for 34451 in Georgia.
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 34451 covers
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.
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.
Where 34451 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $1,359.07 |
| Rest Of Georgia | Unavailable | $1,336.79 |
How the 34451 rate is calculated
Each of 34451’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 · 34451
RVUs × geographic indexes × conversion factor
Work27.81
27.81 RVUs× 1.000 GPCI
Practice expense4.19
4.19 RVUs× 1.000 GPCI
Malpractice7.11
7.11 RVUs× 1.000 GPCI
Adjusted RVUs
39.1100
Conversion factor
$33.4009
Medicare rate
$1,306.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 34451
34451 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 34451
Venous 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 34451
Venous 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
34451 without 50 · national facility
$1,306.31
Venous thrombectomy
34451-50 · Bilateral: 150%
$1,959.47
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).
34451 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 34421Venous thrombectomy
- 34421 applies when the treated vein is the femoral vein; 34451 applies to the popliteal vein. Follow the documented operative site.
- 34401Vein thrombectomy
- 34401 targets the iliac vein, whereas 34451 targets the popliteal vein.
- 37187Venous thrombectomy
- 37187 describes endovascular mechanical thrombectomy. Use 34451 for open surgical clot removal from the popliteal vein.
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 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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