Billing code 37186: Arterial thrombectomyMedicare rate & RVUs in Guam
Reports secondary percutaneous removal of thrombus from a noncoronary artery or arterial bypass graft during another intervention in the same vascular territory.
Medicare pays $1,274.18 for 37186 in the office in Guam (Hawaii, Guam). 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 37186 covers
This add-on describes secondary percutaneous thrombectomy in a noncoronary, nonintracranial artery or arterial bypass graft during another intervention in the same vascular territory. For example, an interventional radiologist or vascular surgeon may use aspiration or a snare to remove thrombus encountered during peripheral angioplasty or stenting. Fluoroscopic guidance and intraprocedural thrombolytic injections are included when performed.
Choose this code when thrombectomy is performed as a secondary technique alongside a different percutaneous intervention, rather than as the primary mechanical thrombectomy service. The operative report should identify the treated artery or graft, thrombus removal technique, and the accompanying intervention in that territory. Report it only with a qualifying primary procedure; it is paid within that procedure’s global period. CMS prices the code as bilateral, so modifier 50 does not increase payment.
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.
37186 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $1,274.18 | $205.89 |
How the 37186 rate is calculated
Each of 37186’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 · 37186
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.80Practice expense 28.79Malpractice 1.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37186
The CMS indicators that decide how 37186 is paid alongside other services.
CMS payment indicators · 37186
Arterial thrombectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
37186 compared with similar codes
Compare codes
37186 vs 37184 vs 37185 vs 37187: national Medicare rates
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How to choose
- 37184Arterial thrombectomy
- 37184 is for primary mechanical thrombectomy of the initial arterial vessel. Choose 37186 when thrombectomy is secondary to another percutaneous intervention in the same territory.
- 37185Arterial thrombectomy
- 37185 covers primary mechanical thrombectomy in an additional vessel. It is not the secondary thrombectomy add-on for thrombectomy performed with angioplasty or stenting.
- 37187Venous thrombectomy
- 37187 describes mechanical thrombectomy in a vein. Use 37186 for secondary thrombectomy involving a noncoronary artery or arterial bypass graft.
37186 billing questions
When is 37186 used instead of 37184 or 37185?
Use 37186 for secondary thrombectomy performed with another percutaneous intervention, such as angioplasty or stenting. Codes 37184 and 37185 describe primary mechanical thrombectomy of the initial or an additional vessel.
Can 37186 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary percutaneous intervention in the same vascular territory.
Are fluoroscopy and thrombolytic injections separately reported?
Fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections are included in the thrombectomy service when performed.
Should modifier 50 be appended for bilateral treatment?
CMS prices 37186 as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting 37186?
Document the artery or arterial graft treated, the secondary thrombectomy technique, the thrombus removed, and the other percutaneous intervention performed in that vascular territory.
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
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