37260
Active0-day globalRevsc evasc ivt st cplx 1st
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.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 37260 | 1 | $8,433.73 | $579.84 |
| add-on37252 | 0 | $895.48/ unit | $79.16/ unit |
| add-on37253 | 0 | $169.68/ unit | $62.46/ unit |
| add-on37255 | 0 | $510.03/ unit | $135.94/ unit |
| add-on37257 | 0 | $579.51/ unit | $176.02/ unit |
| add-on37259 | 0 | $1,205.77/ unit | $181.37/ unit |
| add-on37261 | 0 | $3,361.47/ unit | $192.72/ unit |
| add-on37262 | 0 | $3,409.23/ unit | $135.94/ unit |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 37260 | 12.69 | 236.79 | 1.65 | 3.02 | 252.50 |
Payment policy for 37260
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=2Standard MPPR
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Bilateral (modifier 50)
bilt_surg=1Bilateral 150%
With modifier 50 (both sides), payment is 150% of the single-side amount.
Assistant surgeon (80/81/82)
asst_surg=0Payable with documentation
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Co-surgeons (modifier 62)
co_surg=0Not permitted
Co-surgeons (mod 62) may not be paid for this procedure.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
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.