Billing code 37243: EmbolizationMedicare rate & RVUs in Kansas
Reports catheter-directed embolization to treat a tumor or cause organ ischemia or infarction, including uterine fibroid and prostate artery embolization.
Medicare pays $7,246.98 for 37243 in the office in Kansas (Kansas). 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 37243 covers
An interventional radiologist or other qualified physician delivers embolic material through a catheter to reduce or stop blood flow to a tumor or targeted organ. Common settings include hospital interventional radiology suites, where procedures may address liver tumors, uterine fibroids, or benign prostatic hyperplasia. The embolic agent and catheter approach depend on the target vessels and treatment plan.
Choose this code when the embolization is performed for a tumor or to produce organ ischemia or infarction; embolization for bleeding or other arterial and venous indications belongs to different codes in the family. The report should identify the clinical indication, target organ or tumor, vessels treated, embolic technique, and imaging guidance. The code includes same-day preoperative and postoperative care under its 0-day global period. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and reduces the others by 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery 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.
37243 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | $7,246.98 | $455.35 |
How the 37243 rate is calculated
Each of 37243’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 · 37243
RVUs × geographic indexes × conversion factor
Work11.45
11.45 RVUs× 1.000 GPCI
Practice expense226.62
226.62 RVUs× 1.000 GPCI
Malpractice1.30
1.30 RVUs× 1.000 GPCI
Adjusted RVUs
239.3700
Conversion factor
$33.4009
Medicare rate
$7,995.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37243
The CMS indicators that decide how 37243 is paid alongside other services.
CMS payment indicators · 37243
Embolization
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 51 · payment effect
With and without the modifier
37243 without 51 · national office
$7,995.17
Embolization
37243-51 · Second procedure: 50%
$3,997.59
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
37243 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37242Arterial embolization
- Use 37243 for tumor treatment or intended organ ischemia or infarction. Use 37242 for arterial embolization for another indication, such as an aneurysm or vascular malformation.
- 37244Vascular embolization
- Choose 37244 when the target is to control hemorrhage; choose 37243 when treating a tumor or producing organ ischemia or infarction.
- 37241Venous embolization
- 37241 is for venous embolization for indications other than hemorrhage or tumor. This code covers embolization for tumors or organ ischemia or infarction.
37243 billing questions
When should this code be chosen instead of arterial embolization code 37242?
Use 37243 when the purpose is tumor treatment or organ ischemia or infarction. Code 37242 describes an arterial embolization for another indication, such as a vascular malformation or aneurysm.
How does this code differ from embolization for bleeding?
Use 37244 when the embolization treats hemorrhage. The indication for 37243 is a tumor or intended organ ischemia or infarction.
Can the imaging used to guide embolization be separately reported?
The code includes the imaging guidance, intraprocedural roadmapping, and radiological supervision and interpretation necessary to complete the intervention. Do not separately report those included services as though they were separate guidance for the same embolization.
Should modifier 50 be appended for embolization on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What happens when other procedures are performed in the same session?
CMS pays the highest-valued procedure in full and reduces the other procedures by 50% under the standard multiple procedure rule.
Does Medicare pay an assistant or co-surgeon for this procedure?
CMS lists a statutory restriction on assistant-at-surgery payment and does not permit co-surgeon or team-surgery payment for this code.
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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