No office rate
Choose 37606 when the common or internal carotid is occluded by the ligation or banding; 37605 is for the related service without occlusion.
On this page
CMS RVU26D · Effective 2026-10-01
37606 Carotid ligation Medicare reimbursement rates in Missouri
Reports surgical ligation or banding that occludes the common or internal carotid artery, such as for selected bleeding control or planned vessel sacrifice. Compare 37606 office and facility rates across CMS payment localities in Missouri.
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 37606 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$707.82–$742.88
3 of 3 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.
Where 37606 pays more and less in Missouri
Vascular surgery
About 37606: Common or internal carotid ligation with occlusion
Reports surgical ligation or banding that occludes the common or internal carotid artery, such as for selected bleeding control or planned vessel sacrifice.
Code 37606 describes open surgical ligation or banding of the common or internal carotid artery when the operation closes the vessel. Vascular or head-and-neck surgeons may perform it in an operating room to control difficult carotid bleeding or injury, or as planned vessel sacrifice in selected tumor-related care. It is distinct from procedures on the external carotid artery and from ligation or banding that does not occlude the vessel.
Choose the code from the operative report: it should identify the common or internal carotid artery and document ligation or banding with occlusion. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Do not append modifier 50; a bilateral adjustment is not used. CMS allows payment for an assistant at surgery, but does not permit co-surgeons or team surgery.
CMS billing rules for 37606
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.59 · 38%
- Practice expense (office) RVU10.54 · 46%
- Malpractice RVU3.61 · 16%
12
Medicare services in 2024 · #6147 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.
37606 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
37600 concerns the external carotid artery. This code is for the common or internal carotid artery with occlusion.
No office rate
37615 covers ligation of a major artery in the neck; 37606 specifically identifies occluding the common or internal carotid artery.
Compare 37606 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$735.29
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$742.88
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$707.82
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37606 billing questions
How is 37606 different from 37605?
Use 37606 when the documented ligation or banding occludes the common or internal carotid artery. Code 37605 describes the related service without occlusion.
What operative documentation supports 37606?
The report should identify the common or internal carotid artery and describe the ligation or banding and resulting occlusion. It should also explain the clinical reason for the procedure.
Should modifier 50 be used for bilateral work?
No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.
Can an assistant surgeon be paid for this procedure?
CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,6713759F,,Pt scrn dysphag/wt loss/nutr,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
4,67237600,,Ligation xtrnl carotid art,A,,12.11,5.59,NA,5.59,,2.13,19.83,19.83,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,67337605,,Ligation int/com carotid art,A,,13.92,2.74,NA,2.74,,3.56,20.22,20.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,67437606,,Lig int/com carotid art occl,A,,8.59,10.54,NA,10.54,,3.61,22.74,22.74,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,67537607,,Lig/banding angioacs av fstl,A,,6.09,2.79,NA,2.79,,1.48,10.36,10.36,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,67637609,,Ligation/bx temporal artery,A,,2.97,5.83,,2.01,,0.65,9.45,5.63,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,6773760F,,Pt w/dysphag/wt loss/nutr,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