2017 Vein Care (Phlebology) Payment Information

The following chart provides payment information that is based on the national unadjusted Medicare physician fee schedule for the ultrasound services discussed. Payment will vary by geographic region.

The information provided below is intended to assist providers in determining appropriate codes and the other information for reimbursement purposes. It represents the information available to United Medical Instruments as of January 2017. Subsequent guidance might alter the information provided. United Medical Instruments disclaims any responsibility to update the information provided. It is the provider’s responsibility to determine and submit appropriate codes, modifiers, and claims for the services rendered. Before filing any claims, providers should verify current requirements and policies with the applicable payer.

Phlebology Ultrasound and Procedural CPT Codes and Descriptions

Medicare Physician Fee Schedule – National Average*
CPT Code Description Private Office Hospital Professional Component Technical 2  Component
93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study $200.26 $200.26 $35.53 $164.73
93971 Duplex scan of extremity veins including responses to compression maneuvers; unilateral or limited study $122.02 $122.02 $22.61 $99.41
93975 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and or retroperitoneal organs; complete study $286.39 $286.39 $59.22 $227.18
93976 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and or retroperitoneal organs; limited study $166.16 $166.16 $40.91 $125.25
76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation $61.37 $61.37 $33.02 $28.35
76970 Ultrasound study, follow up $94.03 $94.03 $19.74 $74.29
Procedures
36011 Selective catheter placement, venous system, first order branch $841.95 $164.01 n/a n/a
36475 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated $1,545.73 $292.85 n/a n/a
36476 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites (listed separately in addition to code for primary procedure) $301.11 $142.48 n/a n/a
36478 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous laser; first vein treated $1,223.80 $291.06 n/a n/a
36479 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure) $316.18 $143.20 n/a n/a
Sclerotherapy
36470 Injection of sclerosing solution; single level $150.37 $86.13 n/a n/a
36471 Injection of sclerosing solution; multiple veins, same leg $178.37 $104.08 n/a n/a
Ligation
37700 Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions $259.48 $259.48 n/a n/a
37785 Ligation, division, and/or excision of varicose vein cluster (s), one leg $366.06 $273.83 n/a n/a
Ambulatory Phlebectomy
37765 Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions $670.40 $469.78 n/a n/a
37766 Stab phlebectomy of varicose veins, one extremity; more than 20 stab incisions $796.01 $573.50 n/a n/a

1Professional Payment: use to estimate the reimbursement to the physician.
2Technical Payment: use to estimate the reimbursement to the technologist.

CPT™ five digit codes, nomenclature and other data are Copyright 2015 American Medical Association. All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. 

Deficit Reduction Act of 2005 Adjustment has not been figured into the above global fees.