No office rate
37182 is used to place a TIPS initially; 37183 is used to revise a shunt that is already in place.
On this page
CMS RVU26D · Effective 2026-10-01
37183 TIPS revision Medicare reimbursement rates in Guam
Revision of an existing transjugular intrahepatic portosystemic shunt to treat dysfunction such as stenosis or occlusion, with angioplasty or stenting when needed. Compare 37183 office and facility rates across CMS payment localities in Guam.
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 37183 in Guam?
Guam 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
$6094.26
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$315.71
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Interventional radiology
About 37183: Revision of an existing TIPS
Revision of an existing transjugular intrahepatic portosystemic shunt to treat dysfunction such as stenosis or occlusion, with angioplasty or stenting when needed.
37183 is reported when an existing transjugular intrahepatic portosystemic shunt (TIPS) is revised to address dysfunction, such as stenosis or occlusion. An interventional radiologist typically evaluates the shunt with catheter-based imaging and restores flow with balloon angioplasty, stent placement, or both, when needed. Common clinical contexts include recurrent portal-hypertension complications, such as ascites or variceal bleeding, when inadequate shunt function is implicated. The service is generally performed in a hospital interventional radiology suite.
Report the revision rather than initial TIPS placement, and document the existing shunt, its dysfunction, imaging findings, and the corrective work performed. The service includes vascular access, catheterization, imaging guidance, and radiological supervision and interpretation; do not separately report angioplasty or stenting performed as part of the revision. Same-day preoperative and postoperative care is included in the 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 is inappropriate for this anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 37183
- 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 RVU7.55 · 5%
- Practice expense (office) RVU153.40 · 95%
- Malpractice RVU0.85 · 1%
773
Medicare services in 2024 · #3186 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.
37183 compared with similar codes
Office rates for Guam, from the same CMS release.
$1,440.03
37248 describes venous balloon angioplasty outside the TIPS revision service. Angioplasty performed to revise a TIPS is included in 37183.
$3,673.18
37238 describes venous stent placement outside the TIPS revision service. Stent placement performed to revise a TIPS is included in 37183.
Compare 37183 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
Hawaii, Guam →
Office / nonfacility
$6094.26
Facility
$315.71
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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 37183 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,578
- Code
- 37183
- Physician work
- 7.55
- Practice expense
- 153.40
- Malpractice
- 0.85
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.55 | × 1.000 | 7.5500 |
| Practice expense | 153.40 | × 1.137 | 174.4158 |
| Malpractice | 0.85 | × 0.579 | 0.4921 |
| Total RVUs | 182.4580 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$6094.26
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.55 | 1 |
| Practice expense | 153.4 | 1.137 |
| Malpractice | 0.85 | 0.579 |
(7.55 × 1 + 153.4 × 1.137 + 0.85 × 0.579) × $33.4009 = $6094.26
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.55 | 1 |
| Practice expense | 1.24 | 1.137 |
| Malpractice | 0.85 | 0.579 |
(7.55 × 1 + 1.24 × 1.137 + 0.85 × 0.579) × $33.4009 = $315.71
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.
37183 billing questions
When should 37183 be chosen over 37182?
Use 37183 to revise an existing TIPS for dysfunction. Code 37182 describes initial TIPS placement.
Can angioplasty or stent placement be reported separately during the TIPS revision?
No. Angioplasty and stent placement performed as part of the TIPS revision are included in 37183.
Are imaging guidance and radiological interpretation included?
Yes. The service includes imaging guidance and radiological supervision and interpretation, along with vascular access and catheterization.
Can modifier 50 be used when the shunt is revised?
No. Report the TIPS revision as a single procedure; modifier 50 is inappropriate for this anatomy.
What documentation supports reporting 37183?
Document that a TIPS already exists, the evidence of dysfunction, relevant imaging findings, and the revision performed, such as angioplasty or stent placement.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
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.
4,57537180,,Revision of circulation,A,,35.59,13.59,NA,13.59,,9.54,58.72,58.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57637181,,Splice spleen/kidney veins,A,,39.00,14.55,NA,14.55,,10.45,64.00,64.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57737182,,Insert hepatic shunt (tips),A,,16.55,2.59,NA,2.59,,1.85,20.99,20.99,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57837183,,Revision tips,A,,7.55,153.40,,1.24,,0.85,161.80,9.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57937184,,Prim art m-thrmbc 1st vsl,A,,8.20,39.12,,1.56,,1.51,48.83,11.27,0,000,0.00,0.00,0.00,2,1,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,58037185,,Prim art m-thrmbc sbsq vsl,A,,3.20,9.95,,0.44,,0.59,13.74,4.23,0,ZZZ,0.00,0.00,0.00,0,2,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,58137186,,Sec art thrombectomy add-on,A,,4.80,28.79,,0.66,,1.06,34.65,6.52,0,ZZZ,0.00,0.00,0.00,0,2,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014