Billing code 37261: Iliac stentingMedicare rate & RVUs in Illinois
Reports complex endovascular stent revascularization of each additional iliac vessel treated after the primary complex iliac stent procedure.
Medicare pays $3,103.95–$3,475.27 for 37261 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 37261 covers
This add-on code represents complex endovascular stent revascularization in an additional vessel of the iliac vascular territory. It is used during treatment of iliac arterial disease, such as flow-limiting disease associated with claudication or limb ischemia. Vascular surgeons and interventional radiologists commonly perform these procedures in an angiography suite or operating room, using catheter-based imaging and tools to place the stent.
Report it for each additional treated vessel that meets the complex stent service criteria, alongside the primary complex iliac stent code 37260. Documentation should identify the vessels treated, the stent work performed in each, and the findings supporting the complex classification. This add-on is paid within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% under the stated bilateral rule.
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.
Where 37261 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$3103.95 to $3475.27
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $3,423.37 | $238.78 |
| East St. Louis | $3,141.91 | $226.66 |
| Rest Of Illinois | $3,103.95 | $210.89 |
| Suburban Chicago | $3,475.27 | $220.97 |
How the 37261 rate is calculated
Each of 37261’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 · 37261
RVUs × geographic indexes × conversion factor
Work4.25
4.25 RVUs× 1.000 GPCI
Practice expense95.35
95.35 RVUs× 1.000 GPCI
Malpractice1.04
1.04 RVUs× 1.000 GPCI
Adjusted RVUs
100.6400
Conversion factor
$33.4009
Medicare rate
$3,361.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37261
The CMS indicators that decide how 37261 is paid alongside other services.
CMS payment indicators · 37261
Iliac stenting
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not 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
37261 without 50 · national office
$3,361.47
Iliac stenting
37261-50 · Bilateral: 150%
$5,042.20
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).
37261 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37260Arterial stenting
- 37260 reports the primary complex iliac stent vessel. Use 37261 only for each additional vessel treated in the same procedure.
- 37259Iliac stenting
- 37259 represents each additional iliac vessel treated with a simple stent service; 37261 is for an additional vessel meeting complex stent criteria.
- 37257Iliac angioplasty
- 37257 covers complex angioplasty in each additional iliac vessel. Choose 37261 when complex stent revascularization is performed instead.
37261 billing questions
What code is reported for the first complex iliac vessel?
Report 37260 for the primary complex iliac stent vessel. Code 37261 represents each additional vessel and is not reported alone.
Is 37261 counted by vessel or by lesion?
It is reported for each additional treated vessel, not for every lesion within a vessel. Document the vessels treated and the work performed in each.
How should the complex service be distinguished from simple iliac stenting?
Use 37261 only for an additional vessel meeting the complex stent service criteria. A simple additional iliac stent vessel is represented by 37259.
How is a bilateral procedure handled?
CMS specifies modifier 50 for a bilateral procedure and pays 150% under that rule. The documentation should support treatment on both sides.
Is 37261 paid outside the primary procedure's global period?
No. CMS identifies it as an add-on code paid within the primary procedure’s 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 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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