No office rate
Both address stenting in the intrathoracic common carotid or innominate artery. The approach is antegrade for 37218 and retrograde for 37217.
On this page
CMS RVU26D · Effective 2026-10-01
37218 Carotid stenting Medicare reimbursement rates in Wyoming
Reports antegrade stent placement in the intrathoracic common carotid or innominate artery, including angioplasty when performed during treatment. Compare 37218 office and facility rates across CMS payment localities in Wyoming.
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 37218 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$710.74
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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 intervention
About 37218: Antegrade intrathoracic carotid stenting
Reports antegrade stent placement in the intrathoracic common carotid or innominate artery, including angioplasty when performed during treatment.
This service treats a lesion in the intrathoracic common carotid or innominate artery by placing an intravascular stent in an antegrade direction. Angioplasty of the treated vessel is included when performed. Vascular surgeons and interventional specialists typically perform the procedure in a hospital setting, using catheter-based imaging to guide treatment of a proximal supra-aortic vessel lesion.
Select this code when the treated vessel and antegrade approach meet its scope; distinguish it from retrograde treatment and stenting of the cervical carotid artery. The operative report should identify the target vessel, approach, lesion, stent placement, and any angioplasty performed. The service has 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 37218
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.38 · 65%
- Practice expense (office) RVU4.25 · 19%
- Malpractice RVU3.58 · 16%
169
Medicare services in 2024 · #4479 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.
37218 compared with similar codes
Office rates for Wyoming, from the same CMS release.
37215
No office rateTranscath stent cca w/eps
37215 is for cervical carotid stenting with distal embolic protection; 37218 is for antegrade stenting in the intrathoracic common carotid or innominate artery.
37216
No office rateTranscath stent cca w/o eps
37216 is for cervical carotid stenting without distal embolic protection. Choose 37218 for the specified intrathoracic vessel and antegrade approach.
Compare 37218 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$710.74
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 37218 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,598
- Code
- 37218
- Physician work
- 14.38
- Practice expense
- 4.25
- Malpractice
- 3.58
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.38 | × 1.000 | 14.3800 |
| Practice expense | 4.25 | × 1.000 | 4.2500 |
| Malpractice | 3.58 | × 0.740 | 2.6492 |
| Total RVUs | 21.2792 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$710.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.38 | 1 |
| Practice expense | 4.25 | 1 |
| Malpractice | 3.58 | 0.74 |
(14.38 × 1 + 4.25 × 1 + 3.58 × 0.74) × $33.4009 = $710.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
37218 billing questions
How does 37218 differ from 37217?
The distinction is the direction of treatment: 37218 is for an antegrade approach, while 37217 is for a retrograde approach to the specified proximal vessel.
Is angioplasty of the treated vessel reported separately?
Angioplasty performed as part of the stent treatment is included in 37218.
When should 37215 or 37216 be considered instead?
Those codes describe stenting in the cervical carotid artery. Use 37218 for antegrade treatment of the intrathoracic common carotid or innominate artery.
What documentation supports reporting 37218?
Document the treated vessel and lesion, the antegrade approach, and the stent placement; also describe angioplasty if performed.
Can an assistant-at-surgery be paid for this procedure?
CMS assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are 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 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.
4,59537215,,Transcath stent cca w/eps,R,,17.31,4.70,NA,4.70,,4.62,26.63,26.63,0,090,0.09,0.84,0.07,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,59637216,,Transcath stent cca w/o eps,N,+,17.53,6.34,NA,6.34,,1.87,25.74,25.74,9,090,0.09,0.84,0.07,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,59737217,,Stent placemt retro carotid,A,,19.87,4.43,NA,4.43,,5.02,29.32,29.32,0,090,0.09,0.84,0.07,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,59837218,,Stent placemt ante carotid,A,,14.38,4.25,NA,4.25,,3.58,22.21,22.21,0,090,0.09,0.84,0.07,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,59937236,,Open/perq place stent 1st,A,,8.53,67.32,,1.18,,1.97,77.82,11.68,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60037237,,Open/perq place stent ea add,A,,4.14,31.27,,0.48,,1.00,36.41,5.62,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,60137238,,Open/perq place stent same,A,,5.89,90.91,,0.98,,1.24,98.04,8.11,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,