Billing code 37253: IVUSMedicare rate & RVUs in Guam
Reports intravascular ultrasound of each additional noncoronary vessel evaluated during a vascular procedure, after the initial vessel is coded.
Medicare pays $181.30 for 37253 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 37253 covers
A vascular specialist advances an ultrasound catheter through the vessel to examine the lumen and wall from inside. Intravascular ultrasound can help assess plaque, narrowing, thrombus, or the result of an intervention in noncoronary vessels such as the aorta, iliac vessels, and peripheral arteries or veins. Vascular surgeons, interventional radiologists, and other physicians performing endovascular procedures commonly use it in an angiography suite or operating room. The service includes image interpretation.
Report 37253 for each additional noncoronary vessel examined after the initial vessel, which is reported with 37252. Count vessels, not ultrasound passes, images, or separate findings within one vessel. The record should identify each vessel evaluated and support the physician’s interpretation and clinical use of the images. This is an add-on code: submit it with an eligible primary procedure, not by itself. Its payment is within that primary procedure’s global period; it does not establish a separate global period.
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.
37253 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $181.30 | $59.39 |
How the 37253 rate is calculated
Each of 37253’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 · 37253
RVUs × geographic indexes × conversion factor
Work1.40
1.40 RVUs× 1.000 GPCI
Practice expense3.40
3.40 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
5.0800
Conversion factor
$33.4009
Medicare rate
$169.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37253
The CMS indicators that decide how 37253 is paid alongside other services.
CMS payment indicators · 37253
IVUS
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
37253 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 37252Intravascular ultrasound
- Use 37252 for the initial noncoronary vessel examined with IVUS; 37253 identifies each additional vessel.
- 92979Endoluminl ivus oct c ea
- 92979 is for an additional coronary vessel. Use 37253 for an additional noncoronary vessel.
- 37246Arterial angioplasty
- 37246 reports balloon angioplasty in an artery, not ultrasound imaging. It may be reported with IVUS when both services are performed.
- 37248Venous angioplasty
- 37248 reports balloon angioplasty in a vein, not ultrasound imaging. It may be reported with IVUS when both services are performed.
37253 billing questions
How does 37253 differ from 37252?
37252 represents intravascular ultrasound of the initial noncoronary vessel. Use 37253 for each additional noncoronary vessel evaluated.
Can 37253 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary procedure; the initial-vessel IVUS code is 37252.
Are units based on ultrasound passes or vessels?
Units correspond to additional vessels, not repeated catheter passes or imaging runs in the same vessel.
What documentation supports an additional unit?
Document the additional vessel examined and the findings and interpretation for that vessel. The record should distinguish it from the initial vessel.
Is 37253 for coronary IVUS?
No. It applies to additional noncoronary vessels. Coronary intravascular ultrasound uses the coronary-specific code family, including 92979 for an additional vessel.
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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