Billing code 37761: Perforator ligationMedicare rate & RVUs in Texas
Reports open subfascial ligation of incompetent perforator veins in one leg, commonly to address venous hypertension associated with skin changes or ulceration.
CMS doesn’t publish an office rate for 37761 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 37761 covers
A surgeon exposes and ties off incompetent perforator veins beneath the fascia through an open approach in one leg. The procedure may be part of treatment for chronic venous insufficiency when perforator reflux contributes to venous hypertension, skin changes, or a lower-leg ulcer. Vascular surgeons commonly perform it in an operating-room setting.
Report the code for the open subfascial approach, not per vein treated; document the leg, operative technique, targeted perforators, and clinical indication. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. 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 37761 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 | $486.54 |
| Beaumont | Unavailable | $471.93 |
| Brazoria | Unavailable | $472.67 |
| Dallas | Unavailable | $479.33 |
| Fort Worth | Unavailable | $479.14 |
| Galveston | Unavailable | $476.46 |
| Houston | Unavailable | $517.10 |
| Rest Of Texas | Unavailable | $474.53 |
How the 37761 rate is calculated
Each of 37761’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 · 37761
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.90Practice expense 3.48Malpractice 2.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37761
37761 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37761
Perforator 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) | 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 · 37761
Perforator 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
37761 without 50 · national facility
$487.65
Perforator ligation
37761-50 · Bilateral: 150%
$731.48
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).
37761 compared with similar codes
Compare codes
37761 vs 37760 vs 37765 vs 37766: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37760Perforator ligation
- Both concern subfascial perforator veins in one leg, but 37760 specifies the radical procedure; 37761 specifies the open procedure.
- 37765Stab phlebectomy
- Use 37765 for stab phlebectomy of 10–20 superficial leg veins, not open subfascial ligation of perforators.
- 37766Stab phlebectomy
- Use 37766 for stab phlebectomy of more than 20 superficial leg veins; 37761 treats perforator veins beneath the fascia.
37761 billing questions
How does this differ from 37760?
Both address perforator veins beneath the fascia in one leg. Code 37761 describes the open procedure; 37760 identifies the radical procedure.
Is the code reported per perforator vein?
No. It describes treatment in one leg, not a separate unit for each vein ligated. Document the treated leg and operative findings.
How is bilateral treatment reported?
For both legs, report bilateral treatment with modifier 50. CMS lists payment at 150% for the bilateral procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Routine follow-up related to the operation falls within that period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Can superficial varicose vein removal be reported with this code?
A separate phlebectomy code may describe treatment of superficial tributary varicosities when that work is performed. Document the distinct veins and work rather than counting those veins as perforators.
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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