Billing code 37254: Iliac angioplastyMedicare rate & RVUs in Oregon
Reports endovascular angioplasty for a simple lesion in the first treated iliac artery during revascularization for iliac arterial disease.
Medicare pays $2,048.48–$2,258.45 for 37254 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 37254 covers
This service treats an iliac artery narrowing or blockage by advancing an endovascular device to the affected site and expanding a balloon to improve blood flow. Vascular surgeons, interventional radiologists, and other physicians with appropriate endovascular training commonly perform it in an angiography suite or hospital procedure room. The code identifies treatment in the iliac territory and the simple category, not angioplasty elsewhere in the leg.
Select it when the documented intervention meets the billing code criteria for simple treatment and is the first treated artery in the iliac territory. The procedure report should identify the treated artery, lesion, approach, and intervention. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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 37254 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $2,258.45 | $328.81 |
| Rest Of Oregon | $2,048.48 | $318.58 |
How the 37254 rate is calculated
Each of 37254’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 · 37254
RVUs × geographic indexes × conversion factor
Work7.30
7.30 RVUs× 1.000 GPCI
Practice expense53.04
53.04 RVUs× 1.000 GPCI
Malpractice1.71
1.71 RVUs× 1.000 GPCI
Adjusted RVUs
62.0500
Conversion factor
$33.4009
Medicare rate
$2,072.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37254
The CMS indicators that decide how 37254 is paid alongside other services.
CMS payment indicators · 37254
Iliac angioplasty
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
37254 without 50 · national office
$2,072.53
Iliac angioplasty
37254-50 · Bilateral: 150%
$3,108.80
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).
37254 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37256Iliac angioplasty
- Both are iliac-territory angioplasty codes. Choose 37254 for treatment meeting the simple-category criteria and 37256 for treatment meeting the complex-category criteria.
- 37258Arterial stenting
- This code represents simple-category iliac angioplasty; 37258 is the related simple-category code when the iliac intervention involves stent placement.
- 37263Leg angioplasty
- Both cover simple-category angioplasty, but 37254 is for the iliac territory and 37263 is for the femoropopliteal territory.
37254 billing questions
How is this code distinguished from 37256?
Both describe iliac-territory angioplasty, but 37254 is for treatment meeting the simple-category criteria. Use 37256 when the documented treatment meets the complex-category criteria.
When is 37255 relevant?
37255 is the related simple-category code for an additional treated iliac artery. Identify the arteries treated and their order in the procedure documentation.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How does CMS handle bilateral reporting and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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 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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