Billing code 37145: Surgical shuntMedicare rate & RVUs in Utah
Open portal-to-hepatic vein shunt or bypass surgery redirects portal blood flow, typically as a surgical treatment for portal hypertension.
CMS doesn’t publish an office rate for 37145 in Utah.
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 37145 covers
This code represents an open surgical shunt connecting the portal vein with a hepatic vein to redirect blood flow. A vascular or transplant surgeon performs the operation in a hospital operating room, generally to address portal hypertension when a surgically constructed bypass is selected. It is distinct from an endovascular TIPS procedure, which creates an intrahepatic channel using a catheter-based approach.
Report the code for the documented portal-to-hepatic vein surgical configuration, not for a different shunt anatomy or a TIPS revision. The operative report should identify the vessels joined and the bypass performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this code.
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.
37145 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,925.28 |
How the 37145 rate is calculated
Each of 37145’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 · 37145
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 36.08Practice expense 13.70Malpractice 9.67
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37145
37145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37145
Surgical shunt
| 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) | 0 | Not permitted. |
| 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 · 37145
Surgical shunt
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
37145 without 51 · national facility
$1,985.68
Surgical shunt
37145-51 · Second procedure: 50%
$992.84
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%).
37145 compared with similar codes
Compare codes
37145 vs 37140 vs 37180 vs 37181 vs 37182: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37140Portacaval shunt
- Use 37145 for the portal-to-hepatic vein configuration. 37140 describes other surgical shunts or bypasses, such as mesocaval or mesoatrial procedures.
- 37180Shunt revision
- 37180 is for a splenorenal shunt configuration, not a portal-to-hepatic vein bypass.
- 37181Splenorenal shunt
- 37181 describes a splenic-to-renal vein shunt configuration; 37145 is selected for the portal-to-hepatic vein configuration.
- 37182TIPS placement
- 37182 describes endovascular TIPS creation. 37145 is for the specified open surgical shunt.
37145 billing questions
How is this code different from 37140?
37145 identifies a portal-to-hepatic vein shunt configuration. 37140 covers other surgical shunt or bypass configurations, such as mesocaval or mesoatrial.
Can this code be reported for a TIPS procedure?
No. TIPS is an endovascular procedure; 37182 describes TIPS creation. Report 37145 for the specified open surgical shunt configuration.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
What documentation supports choosing 37145?
The operative report should identify the portal vein and hepatic vein as the vessels connected and describe the surgical bypass performed.
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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