Billing code 37188: Venous thrombectomyMedicare rate & RVUs in Guam
Reports repeat catheter-based mechanical removal of venous thrombus during the same session as primary venous thrombectomy when further treatment is performed.
Medicare pays $1,522.06 for 37188 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 37188 covers
This code describes repeat catheter-based mechanical removal of thrombus from a vein during the same session as the primary venous thrombectomy. It is used in endovascular treatment of venous clot, such as deep vein thrombosis, when the physician performs repeat thrombectomy after the primary treatment. Interventional radiologists, vascular surgeons, and other physicians with appropriate endovascular training commonly perform the service in a hospital or other procedural facility. Fluoroscopic guidance and intraprocedural thrombolytic injections are part of the service.
Report 37188 as an add-on to 37187, not as the primary venous thrombectomy code. The procedure report should identify the treated vein or veins, the primary thrombectomy, and the repeat treatment performed during that same session. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery is not paid; co-surgeons are permitted, while 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.
37188 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $1,522.06 | $240.73 |
How the 37188 rate is calculated
Each of 37188’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 · 37188
RVUs × geographic indexes × conversion factor
Work5.32
5.32 RVUs× 1.000 GPCI
Practice expense34.86
34.86 RVUs× 1.000 GPCI
Malpractice1.06
1.06 RVUs× 1.000 GPCI
Adjusted RVUs
41.2400
Conversion factor
$33.4009
Medicare rate
$1,377.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37188
The CMS indicators that decide how 37188 is paid alongside other services.
CMS payment indicators · 37188
Venous thrombectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
37188 without 50 · national office
$1,377.45
Venous thrombectomy
37188-50 · Bilateral: 150%
$2,066.18
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).
37188 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37187Venous thrombectomy
- 37187 reports the primary venous mechanical thrombectomy. Use 37188 only for repeat thrombectomy during that same session, in addition to the primary service.
- 37184Arterial thrombectomy
- 37184 is for primary mechanical thrombectomy in an artery or arterial bypass graft; 37188 concerns repeat treatment of venous thrombus.
- 37186Arterial thrombectomy
- 37186 describes secondary mechanical thrombectomy in arterial treatment performed with another percutaneous intervention. It is not the repeat venous thrombectomy add-on.
37188 billing questions
When should 37188 be reported instead of 37187?
Use 37187 for the primary venous mechanical thrombectomy. Report 37188 as the add-on when repeat venous mechanical thrombectomy is performed during that same session.
Can 37188 be billed by itself?
No. It is reported with the primary venous thrombectomy code 37187.
Are fluoroscopy and thrombolytic injections separately reported?
Fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections are included in the thrombectomy service.
How is bilateral treatment reported?
Use modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
What documentation supports 37188?
Document the treated vein or veins, the primary thrombectomy, and the repeat mechanical treatment performed during the same session.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's payment.
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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