Billing code 37760: Perforator ligationMedicare rate & RVUs in Guam
Open radical subfascial ligation of incompetent perforator veins in one leg, typically for advanced venous disease with ulceration or skin changes.
CMS doesn’t publish an office rate for 37760 in Guam.
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 37760 covers
This code describes an extensive open operation that reaches beneath the leg’s fascia to interrupt incompetent perforator veins connecting the superficial and deep venous systems. Vascular surgeons typically perform it for advanced chronic venous insufficiency, including disease associated with venous skin changes or ulceration. Skin grafting, when performed as part of the operation, is included.
Report the code for the radical subfascial procedure on one leg, not for limited open perforator ligation or superficial varicose-vein removal. The operative report should support the treated leg, subfascial approach, and extent of perforator-vein work. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 for bilateral surgery is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons require 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.
37760 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $503.89 |
How the 37760 rate is calculated
Each of 37760’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 · 37760
RVUs × geographic indexes × conversion factor
Work10.51
10.51 RVUs× 1.000 GPCI
Practice expense2.66
2.66 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
15.8500
Conversion factor
$33.4009
Medicare rate
$529.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37760
37760 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37760
Perforator ligation
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 37760
Perforator ligation
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
37760 without 50 · national facility
$529.40
Perforator ligation
37760-50 · Bilateral: 150%
$794.10
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).
37760 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37761Perforator ligation
- Both address perforator veins beneath the fascia, but 37760 is the radical, extensive operation; 37761 describes open perforator ligation without that radical extent.
- 37722Vein stripping
- 37722 treats the long saphenous trunk by ligation and stripping. Choose 37760 when the operation targets incompetent perforator veins beneath the fascia.
- 37765Stab phlebectomy
- 37765 is for removal of superficial varicose veins through 10–20 small incisions. It does not describe radical subfascial perforator ligation.
37760 billing questions
How does 37760 differ from 37761?
37760 is the radical, extensive subfascial operation. Use 37761 for open subfascial perforator ligation that does not meet the radical-procedure description.
Is skin grafting separately reported with 37760?
Skin grafting performed as part of this operation is included in 37760.
What documentation supports 37760?
Document the leg treated, the open subfascial approach, and the extent of perforator-vein ligation. The operative note should support why the service was the radical procedure rather than a more limited perforator ligation.
How is bilateral 37760 reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be billed?
Assistant-at-surgery services are not paid for this code. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
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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