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37215

Restricted coverage90-day global

Transcath stent cca w/eps

Restricted coverage: Covered only in unusual circumstances; special instructions apply.

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.

Show values as
Modifiers
LineQtyNon-facility (office)Facility (hospital/ASC)
372151$889.47$889.47
add-on0984T
0
$0.00/ unit$0.00/ unit
add-on37252
0
$895.48/ unit$79.16/ unit
add-on37253
0
$169.68/ unit$62.46/ unit
Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF

RowWork RVUPE RVU (office)PE RVU (facility)MP RVUTotal (office)
3721517.314.704.704.6226.63

Payment policy for 37215

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=2

Standard MPPR

When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.

Bilateral (modifier 50)

bilt_surg=1

Bilateral 150%

With modifier 50 (both sides), payment is 150% of the single-side amount.

Assistant surgeon (80/81/82)

asst_surg=0

Payable with documentation

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Co-surgeons (modifier 62)

co_surg=1

Payable with documentation

Co-surgeons paid (62.5% each) if medical necessity is documented.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 9% is attributed to pre-operative care, 84% to the procedure itself, and 7% to post-operative visits.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.

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