Billing code 37650: Vein ligationMedicare rate & RVUs in Nevada
Surgical ligation interrupts flow through the femoral vein and is reported when the deep vein itself is intentionally occluded.
CMS doesn’t publish an office rate for 37650 in Nevada.
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 37650 covers
This operation ties off the femoral vein, interrupting blood flow through a major deep vein in the thigh. It is an uncommon procedure, generally performed by a vascular or other surgeon in a hospital operating room when the femoral vein must be intentionally occluded. The operative report should identify the vein and side, describe the ligation, and explain the clinical reason for occluding the vessel.
Report the service for ligation of the femoral vein, not for treatment directed at a different vein or an artery. The code has 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 multiple-procedure reduction. For bilateral service, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
37650 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $411.83 |
How the 37650 rate is calculated
Each of 37650’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 · 37650
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.28Practice expense 2.29Malpractice 2.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37650
37650 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37650
Vein ligation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 37650
Vein ligation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
37650 without 50 · national facility
$423.52
Vein ligation
37650-50 · Bilateral: 150%
$635.28
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).
37650 compared with similar codes
Compare codes
37650 vs 37660 vs 37619 vs 37607: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37660Vein ligation
- Choose 37650 for ligation of the femoral vein; 37660 identifies ligation of the common iliac vein.
- 37619IVC ligation
- Code 37619 is for ligation of the inferior vena cava, a different and more central vein.
- 37607Access fistula procedure
- Code 37607 addresses ligation or banding of an arteriovenous access fistula; 37650 is for the femoral vein itself.
37650 billing questions
How is femoral vein ligation distinguished from iliac vein ligation?
Use this code when the femoral vein is ligated. Ligation of the common iliac vein is reported with 37660.
Is this code for ligation of a dialysis access fistula?
No. Code 37650 describes ligation of the femoral vein; 37607 describes ligation or banding of an arteriovenous access fistula.
What should the operative report document?
Document the femoral vein and side, the surgical ligation performed, and the reason the vein was occluded.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global service.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are payable only when supporting documentation is provided.
How is bilateral ligation handled?
For bilateral service, report modifier 50; CMS pays the bilateral procedure at 150%.
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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