No office rate
This code targets the vena cava through an abdominal incision; 34401 is for iliac-vein thrombectomy.
On this page
CMS RVU26D · Effective 2026-10-01
34421 Venous thrombectomy Medicare reimbursement rates in Washington
Reports open removal of thrombus from the vena cava through an abdominal incision, using direct extraction or catheter-assisted removal. Compare 34421 office and facility rates across CMS payment localities in Washington.
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 34421 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$619.15–$656.94
2 of 2 localities have a supported rate.
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 surgery
About 34421: Open vena cava thrombectomy
Reports open removal of thrombus from the vena cava through an abdominal incision, using direct extraction or catheter-assisted removal.
This operation removes clot from the vena cava through an abdominal incision, either by direct extraction or with catheter assistance. It is generally performed by a vascular surgeon or another surgeon experienced in major venous procedures in a hospital operating room. The service is distinct from clot removal in the iliac or leg veins because the target is the vena cava and access is abdominal.
Report the code when the operative record supports vena cava thrombectomy by this approach; document the treated vessel, incision, and method of clot removal. It has a 90-day global period, including the day-before preoperative visit and 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 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 34421
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.04 · 69%
- Practice expense (office) RVU2.66 · 14%
- Malpractice RVU3.32 · 17%
60
Medicare services in 2024 · #5237 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.
34421 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
This code treats the vena cava through an abdominal approach; 34451 addresses femoral-vein thrombectomy through a leg approach.
No office rate
This code treats the vena cava through an abdominal approach; 34471 addresses popliteal-vein thrombectomy through a leg approach.
Compare 34421 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$619.15
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$656.94
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34421 billing questions
How is this distinguished from iliac vein thrombectomy?
Use this code when the vena cava is the vessel treated through an abdominal incision. Iliac-vein thrombectomy is a different anatomic service.
What operative details support reporting?
The record should identify the vena cava as the treated vessel and describe the abdominal approach and direct or catheter-assisted clot removal.
Does the code include postoperative care?
Its 90-day global period includes the day-before preoperative visit and related postoperative care during the global period.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be available for this procedure. Co-surgeon payment requires supporting documentation.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.
How is bilateral performance handled?
When the procedure is bilateral, modifier 50 is paid at 150% under the CMS rule for this code.
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.
4,18634201,,Removal of artery clot,A,,18.99,3.93,NA,3.93,,4.84,27.76,27.76,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18734203,,Removal of leg artery clot,A,,17.41,3.97,NA,3.97,,4.44,25.82,25.82,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18834401,,Removal of vein clot,A,,25.86,4.03,NA,4.03,,6.60,36.49,36.49,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,18934421,,Removal of vein clot,A,,13.04,2.66,NA,2.66,,3.32,19.02,19.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19034451,,Removal of vein clot,A,,27.81,4.19,NA,4.19,,7.11,39.11,39.11,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19134471,,Removal of vein clot,A,,20.58,3.62,NA,3.62,,5.25,29.45,29.45,0,090,0.09,0.84,0.07,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,19234490,,Removal of vein clot,A,,10.64,2.44,NA,2.44,,2.72,15.80,15.80,0,090,0.09,0.84,0.07,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00