Billing code 37160: Shunt revisionMedicare rate & RVUs in Texas
Report this code for open revision of an existing portal-systemic venous shunt, rather than creation of a new shunt or endovascular TIPS revision.
CMS doesn’t publish an office rate for 37160 in Texas.
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 37160 covers
This code describes open surgical revision of an existing portal-systemic venous shunt, a surgically created route that diverts portal blood into the systemic venous circulation. The operation addresses a problem with the existing shunt, such as impaired flow, and is distinct from creating a new shunt or revising a transjugular intrahepatic portosystemic shunt (TIPS). Vascular or transplant surgeons typically perform the operation in a hospital operating room for patients with portal hypertension or a shunt complication.
Select the code when the operative report documents revision of the existing portal-systemic shunt and identifies the anatomy and work performed. 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 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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.
Where 37160 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $2,031.05 |
| Beaumont | Unavailable | $1,973.28 |
| Brazoria | Unavailable | $1,971.83 |
| Dallas | Unavailable | $2,001.29 |
| Fort Worth | Unavailable | $2,000.90 |
| Galveston | Unavailable | $1,988.69 |
| Houston | Unavailable | $2,170.44 |
| Rest Of Texas | Unavailable | $1,982.99 |
How the 37160 rate is calculated
Each of 37160’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 · 37160
RVUs × geographic indexes × conversion factor
Work37.05
37.05 RVUs× 1.000 GPCI
Practice expense14.07
14.07 RVUs× 1.000 GPCI
Malpractice9.93
9.93 RVUs× 1.000 GPCI
Adjusted RVUs
61.0500
Conversion factor
$33.4009
Medicare rate
$2,039.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 37160
37160 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37160
Shunt revision
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 37160
Shunt revision
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 51 · payment effect
With and without the modifier
37160 without 51 · national facility
$2,039.12
Shunt revision
37160-51 · Second procedure: 50%
$1,019.56
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%).
37160 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 37140Portacaval shunt
- 37140 describes creation of an open portal-systemic venous anastomosis. Use 37160 for revision of an existing shunt.
- 37182TIPS placement
- 37182 describes endovascular TIPS placement; 37160 is for open revision of an existing portal-systemic shunt.
- 37183TIPS revision
- 37183 describes endovascular TIPS revision. Choose 37160 when the existing portal-systemic shunt is revised through open surgery.
37160 billing questions
How is this different from 37140?
37140 is for creating an open portal-systemic venous anastomosis. Use 37160 when the surgeon revises an existing portal-systemic shunt.
Is revision of a TIPS reported with this code?
No. Revision of an endovascular TIPS is reported with 37183; 37160 describes open revision of a portal-systemic shunt.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What documentation supports reporting 37160?
The operative report should establish that an existing portal-systemic shunt was revised and describe the shunt anatomy and revision performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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