No office rate
This code is for the portacaval route. Choose 37145 when the open shunt uses the renal venous route.
On this page
CMS RVU26D · Effective 2026-10-01
37140 Portacaval shunt Medicare reimbursement rates in Michigan
Reports open creation of a connection between the portal vein and inferior vena cava to decompress portal hypertension, such as in selected patients with variceal bleeding. Compare 37140 office and facility rates across CMS payment localities in Michigan.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 37140 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2140.40–$2360.09
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular surgery
About 37140: Open portacaval shunt creation
Reports open creation of a connection between the portal vein and inferior vena cava to decompress portal hypertension, such as in selected patients with variceal bleeding.
A vascular surgeon creates an open connection between the portal venous system and the inferior vena cava, diverting portal blood to reduce portal pressure. The operation is used in selected patients with portal hypertension, including some with recurrent variceal hemorrhage when surgical shunting is chosen. It is a major abdominal procedure, generally performed in a hospital operating room; the operative report should identify the veins connected and describe construction of the shunt.
Report this code for the portacaval route, not a shunt using a different venous connection or an endovascular TIPS procedure. Documentation should establish the anatomy, operative approach, and completed anastomosis. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 37140
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU39.00 · 61%
- Practice expense (office) RVU14.55 · 23%
- Malpractice RVU10.45 · 16%
28
Medicare services in 2024 · #5706 by national volume
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.
37140 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This code describes a portacaval connection; 37160 is for an open mesenteric-to-caval shunt.
No office rate
Use 37182 for endovascular TIPS creation through a transjugular approach, not an open portacaval shunt.
Compare 37140 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$2360.09
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$2140.40
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
37140 billing questions
How is this code distinguished from other surgical shunt codes?
Use it for an open connection from the portal venous system to the inferior vena cava. A different venous route, such as a renal or mesenteric connection, belongs to its corresponding code.
Is this the code for a TIPS procedure?
No. This code describes an open abdominal portacaval shunt; TIPS is created through an endovascular, transjugular approach.
Can modifier 50 be used for a bilateral procedure?
No. Modifier 50 is inappropriate for this code’s anatomy and descriptor.
What documentation supports reporting the procedure?
The operative report should identify the portal and caval venous anatomy, confirm the open approach, and describe creation of the portacaval anastomosis.
How are assistant and co-surgeon services handled?
Medicare payment for an assistant at surgery is statutorily restricted. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,56936908,,Stent plmt ctr dialysis seg,A,,4.14,36.82,,0.61,,0.69,41.65,5.44,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57036909,,Dialysis circuit embolj,A,,4.02,49.70,,0.57,,0.67,54.39,5.26,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,5713700F,,Psych disorders assessed,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57237140,,Revision of circulation,A,,39.00,14.55,NA,14.55,,10.45,64.00,64.00,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57337145,,Revision of circulation,A,,36.08,13.70,NA,13.70,,9.67,59.45,59.45,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57437160,,Revision of circulation,A,,37.05,14.07,NA,14.07,,9.93,61.05,61.05,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57537180,,Revision of circulation,A,,35.59,13.59,NA,13.59,,9.54,58.72,58.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00