Billing code 37618: Arterial ligationMedicare rate & RVUs in Washington
Reports surgical ligation of a major artery in an extremity, such as when a traumatic arterial injury requires the vessel to be tied off.
CMS doesn’t publish an office rate for 37618 in Washington.
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 37618 covers
A surgeon ties off a major artery in an arm or leg, stopping blood flow through that vessel. The procedure may be used to control bleeding from a traumatic arterial injury or rupture when ligation, rather than arterial repair, is performed. Vascular, trauma, and other surgeons typically perform it in an operating room, generally in a facility setting.
Choose this code based on the artery’s location in an extremity and the procedure actually performed; document the vessel, side and site, indication, and ligation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment does not apply, and modifier 50 is inappropriate. 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 37618 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $367.29 |
| Seattle (King Cnty) | Unavailable | $399.06 |
How the 37618 rate is calculated
Each of 37618’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 · 37618
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.88Practice expense 3.76Malpractice 1.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37618
37618 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37618
Arterial 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) | 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 · 37618
Arterial 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 51 · payment effect
With and without the modifier
37618 without 51 · national facility
$369.41
Arterial ligation
37618-51 · Second procedure: 50%
$184.71
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%).
37618 compared with similar codes
Compare codes
37618 vs 37615 vs 37616 vs 37617 vs 37607: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37615Arterial ligation
- Use 37615 for ligation of a major artery in the neck; 37618 is for an extremity artery.
- 37616Arterial ligation
- Use 37616 when the major artery being ligated is in the chest, not an arm or leg.
- 37617Arterial ligation
- Use 37617 for a major artery in the abdomen; 37618 applies to a major artery in an extremity.
- 37607Access fistula procedure
- 37607 describes ligation or banding of an angioaccess arteriovenous fistula. 37618 is for ligation of a major artery in an extremity.
37618 billing questions
How is 37618 distinguished from the other major-artery ligation codes?
Use 37618 when the ligated major artery is in an extremity. Codes 37615, 37616, and 37617 are for major arteries in the neck, chest, and abdomen, respectively.
Can 37618 be used for ligation of a dialysis access fistula?
A procedure directed at ligating or banding an angioaccess arteriovenous fistula is represented by 37607. Use 37618 for ligation of a major extremity artery, not simply because an access is located in an arm.
Are routine postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does the multiple-procedure rule affect 37618?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard multiple-procedure reduction.
Should modifier 50 be used for ligation on both sides?
No. CMS facts specify that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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