Billing code 37183: TIPS revisionMedicare rate & RVUs in Oregon
Revision of an existing transjugular intrahepatic portosystemic shunt to treat dysfunction such as stenosis or occlusion, with angioplasty or stenting when needed.
Medicare pays $5,375.34–$5,969.76 for 37183 in the office in Oregon, from Rest Of Oregon to Portland. 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 37183 covers
37183 is reported when an existing transjugular intrahepatic portosystemic shunt (TIPS) is revised to address dysfunction, such as stenosis or occlusion. An interventional radiologist typically evaluates the shunt with catheter-based imaging and restores flow with balloon angioplasty, stent placement, or both, when needed. Common clinical contexts include recurrent portal-hypertension complications, such as ascites or variceal bleeding, when inadequate shunt function is implicated. The service is generally performed in a hospital interventional radiology suite.
Report the revision rather than initial TIPS placement, and document the existing shunt, its dysfunction, imaging findings, and the corrective work performed. The service includes vascular access, catheterization, imaging guidance, and radiological supervision and interpretation; do not separately report angioplasty or stenting performed as part of the revision. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are 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.
Where 37183 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $5,969.76 | $323.35 |
| Rest Of Oregon | $5,375.34 | $313.39 |
How the 37183 rate is calculated
Each of 37183’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 · 37183
RVUs × geographic indexes × conversion factor
Work7.55
7.55 RVUs× 1.000 GPCI
Practice expense153.40
153.40 RVUs× 1.000 GPCI
Malpractice0.85
0.85 RVUs× 1.000 GPCI
Adjusted RVUs
161.8000
Conversion factor
$33.4009
Medicare rate
$5,404.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37183
The CMS indicators that decide how 37183 is paid alongside other services.
CMS payment indicators · 37183
TIPS revision
| 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) | 0 | Not paid without supporting documentation. |
| 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
37183 without 51 · national office
$5,404.27
TIPS revision
37183-51 · Second procedure: 50%
$2,702.14
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%).
37183 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37182TIPS placement
- 37182 is used to place a TIPS initially; 37183 is used to revise a shunt that is already in place.
- 37248Venous angioplasty
- 37248 describes venous balloon angioplasty outside the TIPS revision service. Angioplasty performed to revise a TIPS is included in 37183.
- 37238Venous stenting
- 37238 describes venous stent placement outside the TIPS revision service. Stent placement performed to revise a TIPS is included in 37183.
37183 billing questions
When should 37183 be chosen over 37182?
Use 37183 to revise an existing TIPS for dysfunction. Code 37182 describes initial TIPS placement.
Can angioplasty or stent placement be reported separately during the TIPS revision?
No. Angioplasty and stent placement performed as part of the TIPS revision are included in 37183.
Are imaging guidance and radiological interpretation included?
Yes. The service includes imaging guidance and radiological supervision and interpretation, along with vascular access and catheterization.
Can modifier 50 be used when the shunt is revised?
No. Report the TIPS revision as a single procedure; modifier 50 is inappropriate for this anatomy.
What documentation supports reporting 37183?
Document that a TIPS already exists, the evidence of dysfunction, relevant imaging findings, and the revision performed, such as angioplasty or stent placement.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
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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