Billing code 37619: IVC ligationMedicare rate & RVUs in Washington
Reports surgical ligation of the inferior vena cava, generally to interrupt venous flow when managing serious pulmonary embolic risk.
CMS doesn’t publish an office rate for 37619 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 37619 covers
This code represents an operation that ties off the inferior vena cava, the large vein returning blood from the lower body to the heart. Vascular or general surgeons may perform it in a hospital operating room when an unusual, serious clinical circumstance calls for surgical interruption of this venous pathway. The operative report should identify the vena cava as the vessel treated and describe the ligation; do not select this code for ligation of a lower-extremity or iliac vein.
Report the service when the surgeon actually ligates the inferior vena cava, rather than placing an intravascular filter. The code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies its standard reduction to the others. Bilateral adjustment is inappropriate for this single midline vessel. An assistant at surgery may be paid; co-surgeon and team-surgery payment are 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 37619 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,551.22 |
| Seattle (King Cnty) | Unavailable | $1,661.89 |
How the 37619 rate is calculated
Each of 37619’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 · 37619
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.25Practice expense 10.30Malpractice 7.84
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 37619
37619 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 37619
IVC 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) | 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 · 37619
IVC 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
37619 without 51 · national facility
$1,582.87
IVC ligation
37619-51 · Second procedure: 50%
$791.44
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%).
37619 compared with similar codes
Compare codes
37619 vs 37650 vs 37660 vs 37191: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 37650Vein ligation
- This code applies when the femoral vein is ligated. Report 37619 only when the inferior vena cava itself is ligated.
- 37660Vein ligation
- This code identifies ligation of the common iliac vein. The vessel named in the operative report determines whether 37660 or 37619 applies.
- 37191Vena cava filter
- Use 37191 for endovascular IVC filter placement; 37619 describes surgical ligation of the vena cava, not filter insertion.
37619 billing questions
How is this different from IVC filter placement?
This code is for surgically tying off the vena cava. Filter placement is a separate endovascular service, reported with the code for that procedure.
How do I distinguish it from iliac or femoral vein ligation?
Use this code only when the operative report identifies the inferior vena cava as the vessel ligated. Ligation of the common iliac or femoral vein is represented by a different code.
Can modifier 50 be used?
No. The IVC is a single midline vessel, and CMS does not apply a bilateral adjustment to 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?
An assistant at surgery may be paid. Co-surgeon and team-surgery payment are not permitted for this code.
What happens if another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedure or procedures.
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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