$4,924.86
37182 creates a new TIPS; 37183 revises a TIPS that is already in place.
On this page
CMS RVU26D · Effective 2026-10-01
37182 TIPS placement Medicare reimbursement rates in Tennessee
Reports creation of a transjugular intrahepatic portosystemic shunt to decompress portal hypertension, commonly for complications such as recurrent variceal bleeding. Compare 37182 office and facility rates across CMS payment localities in Tennessee.
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 37182 in Tennessee?
Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$664.60
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
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.
Vascular intervention
About 37182: Transjugular intrahepatic portosystemic shunt placement
Reports creation of a transjugular intrahepatic portosystemic shunt to decompress portal hypertension, commonly for complications such as recurrent variceal bleeding.
A TIPS procedure creates a channel through the liver between the portal venous system and a hepatic vein, then keeps that channel open with a stent. Interventional radiologists and other qualified endovascular physicians perform it in a hospital setting, commonly for portal hypertension complications such as recurrent variceal bleeding or refractory ascites. The service involves vascular access and catheter work, imaging guidance, and the steps needed to establish the shunt.
Report 37182 for initial TIPS creation, not for revising an existing shunt. The record should support the clinical indication and document creation of the intrahepatic connection and its stent placement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 37182
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.55 · 79%
- Practice expense (office) RVU2.59 · 12%
- Malpractice RVU1.85 · 9%
1.3K
Medicare services in 2024 · #2769 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.
37182 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
37181 concerns portal-vein stenting; 37182 creates a channel through the liver between the portal and hepatic venous systems.
No office rate
37140 is a surgical portosystemic shunt. Use 37182 for transjugular, endovascular creation of an intrahepatic shunt.
Compare 37182 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.
1 of 1 payment localities
Tennessee →
Office / nonfacility
Unavailable
Facility
$664.60
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 37182 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
4,577
- Code
- 37182
- Physician work
- 16.55
- Practice expense
- 2.59
- Malpractice
- 1.85
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.55 | × 1.000 | 16.5500 |
| Practice expense | 2.59 | × 0.909 | 2.3543 |
| Malpractice | 1.85 | × 0.537 | 0.9935 |
| Total RVUs | 19.8978 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$664.60
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.55 | 1 |
| Practice expense | 2.59 | 0.909 |
| Malpractice | 1.85 | 0.537 |
(16.55 × 1 + 2.59 × 0.909 + 1.85 × 0.537) × $33.4009 = $664.60
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
37182 billing questions
How is initial TIPS placement different from code 37183?
Use 37182 to create a new intrahepatic shunt. Code 37183 is for revision of an existing TIPS.
Does 37182 include imaging guidance and catheter access?
Yes. The TIPS placement service includes the access, catheter work, imaging guidance, and related steps needed to create the shunt.
Can modifier 50 be reported for TIPS placement?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
When is an assistant at surgery payable?
CMS allows assistant-at-surgery payment only when documentation establishes medical necessity.
How does the multiple-procedure reduction affect 37182?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50% under the standard reduction.
Can co-surgeons or a surgical team report this procedure?
CMS does not permit co-surgeons or team surgery for 37182.
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.
4,57437160,,Revision of circulation,A,,37.05,14.07,NA,14.07,,9.93,61.05,61.05,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57537180,,Revision of circulation,A,,35.59,13.59,NA,13.59,,9.54,58.72,58.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57637181,,Splice spleen/kidney veins,A,,39.00,14.55,NA,14.55,,10.45,64.00,64.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57737182,,Insert hepatic shunt (tips),A,,16.55,2.59,NA,2.59,,1.85,20.99,20.99,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57837183,,Revision tips,A,,7.55,153.40,,1.24,,0.85,161.80,9.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,57937184,,Prim art m-thrmbc 1st vsl,A,,8.20,39.12,,1.56,,1.51,48.83,11.27,0,000,0.00,0.00,0.00,2,1,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,58037185,,Prim art m-thrmbc sbsq vsl,A,,3.20,9.95,,0.44,,0.59,13.74,4.23,0,ZZZ,0.00,0.00,0.00,0,2,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780