No office rate
Use 37615 for ligation of a major artery in the neck; 37618 is for an extremity artery.
On this page
CMS RVU26D · Effective 2026-10-01
37618 Arterial ligation Medicare reimbursement rates in Missouri
Reports surgical ligation of a major artery in an extremity, such as when a traumatic arterial injury requires the vessel to be tied off. Compare 37618 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 37618 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
$350.85–$363.48
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 37618 pays more and less in Missouri
Vascular surgery
About 37618: Major artery ligation, extremity
Reports surgical ligation of a major artery in an extremity, such as when a traumatic arterial injury requires the vessel to be tied off.
A surgeon ties off a major artery in an arm or leg, stopping blood flow through that vessel. The procedure may be used to control bleeding from a traumatic arterial injury or rupture when ligation, rather than arterial repair, is performed. Vascular, trauma, and other surgeons typically perform it in an operating room, generally in a facility setting.
Choose this code based on the artery’s location in an extremity and the procedure actually performed; document the vessel, side and site, indication, and ligation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment does not apply, and modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 37618
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.88 · 53%
- Practice expense (office) RVU3.76 · 34%
- Malpractice RVU1.42 · 13%
628
Medicare services in 2024 · #3354 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.
37618 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 37616 when the major artery being ligated is in the chest, not an arm or leg.
No office rate
Use 37617 for a major artery in the abdomen; 37618 applies to a major artery in an extremity.
No office rate
37607 describes ligation or banding of an angioaccess arteriovenous fistula. 37618 is for ligation of a major artery in an extremity.
Compare 37618 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
$360.66
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$363.48
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$350.85
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37618 billing questions
How is 37618 distinguished from the other major-artery ligation codes?
Use 37618 when the ligated major artery is in an extremity. Codes 37615, 37616, and 37617 are for major arteries in the neck, chest, and abdomen, respectively.
Can 37618 be used for ligation of a dialysis access fistula?
A procedure directed at ligating or banding an angioaccess arteriovenous fistula is represented by 37607. Use 37618 for ligation of a major extremity artery, not simply because an access is located in an arm.
Are routine postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does the multiple-procedure rule affect 37618?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard multiple-procedure reduction.
Should modifier 50 be used for ligation on both sides?
No. CMS facts specify that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 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.
4,67837615,,Ligation major artery neck,A,,7.61,4.81,NA,4.81,,1.43,13.85,13.85,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,67937616,,Ligation major artery chest,A,,18.50,9.00,NA,9.00,,4.56,32.06,32.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,68037617,,Ligation major artery abd,A,,23.20,7.37,NA,7.37,,5.49,36.06,36.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,68137618,,Ligation major artery xtr,A,,5.88,3.76,NA,3.76,,1.42,11.06,11.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,68237619,,Ligation of inf vena cava,A,,29.25,10.30,NA,10.30,,7.84,47.39,47.39,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,6833761F,,Pt w/o 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
4,6843762F,,Patient is dysarthric,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