How can I find the cost of a medical procedure?

To find the cost of a medical procedure, you'll typically need to know the specific CPT (Current Procedural Terminology) code for the service and your geographic location. Many payers have different fee schedules based on location and provider contracts. For a reliable estimate, you can use tools like Payerprice, which offers a fee schedule lookup tool where you can search with a CPT code and specific location.

What is a CPT code and why is it important for pricing?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. CPT codes are crucial for pricing because they standardize the reporting of services, allowing insurance companies and patients to understand exactly what procedure or service was rendered. Fee schedules, which determine how much providers are paid, are typically organized by CPT code.

Where can I look up fee schedules or pricing for specific CPT codes?

For specific fee schedules and pricing associated with CPT codes, you can use specialized lookup tools. Payerprice provides a fee schedule lookup tool that allows users to search using a CPT code and specific location, offering insights into expected costs for various medical services. This is a more direct and user-friendly approach compared to navigating complex government or payer-specific documentation.

Is there a way to compare prices for healthcare services?

Yes, comparing prices for healthcare services is becoming increasingly possible. Tools designed for price transparency allow you to input a CPT code and location to see estimated costs. Payerprice, for instance, offers a lookup tool that helps you understand the fee schedules for specific services based on CPT codes and your location, aiding in price comparison. Always verify specific out-of-pocket costs with your insurance provider and healthcare facility.

What information do I need to search for a specific service's price?

To accurately search for a specific service's price, you typically need two key pieces of information: the CPT (Current Procedural Terminology) code for the service and the specific geographic location where the service will be performed. Having the CPT code ensures you are looking up the correct procedure, and the location is important because prices can vary significantly by region. Tools like Payerprice's fee schedule lookup can then use this information to provide relevant pricing data.

CPT 37242 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Vasc Embolize Occlude Artery, Vascular Embolization Or Occlusion Inclusive Of All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention Arterial Other Than Hemorrhage Or Tumor Eg Congenital Or Acquired Arterial Malformations Arteriovenous Malformations Arteriovenous Fistulas Aneurysms Pseudoaneurysms

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Cardiovascular System
Common Place of Service	11 - Office 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital
Common Modifiers	None XS - Separate Structure 59 - Distinct Procedural Service
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 37242
Medicaid Fee Schedule	View Medicaid rates for 37242

National average reimbursement for CPT 37242 by major payers:

$7,580.37

$10,315.16

$11,073.21

$1,564.91

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 37242.

CPT 37242

5 of 25 sample ratesHigher to lower in this preview

Christopher Raio
Mercy Medical Center
NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-1635088
$21,952.43Published rate
Chandrashekar Kumbar
Deaconess Hospital Inc
INClinical Cardiac Electrophysiology PhysicianNPI 1568425692Tax ID 35-0593390
$12,963.69Published rate
John Buttari
Town Center Orthopaedic Associates, P.C.
VAPhysical TherapistNPI 1386721033Tax ID 54-1383504
$11,203.40Published rate
Charles Bailey
Heart Endovascular And Rhythm Of Texas PA
TXInterventional Cardiology PhysicianNPI 1437145174Tax ID 47-5121509
$7,181.00Published rate
Kristin Whitley
Town Center Orthopaedic Associates, P.C.
VAAdult Health Nurse PractitionerNPI 1801543756Tax ID 54-1383504
$648.58Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 37242 vs. Other Surgical Procedures on the Cardiovascular System Codes

The CPT 37242 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 37242 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
37241-CPT	High	Vasc Embolize Occlude Venous, Vascular Embolization Or Occlusion Inclusive Of All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention Venous Other Than Hemorrhage Eg Congenital Or Acquired Venous Malformations Venous And Capillary Hemangiomas Varices Varicoceles
37242-CPT	High	Vasc Embolize Occlude Artery, Vascular Embolization Or Occlusion Inclusive Of All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention Arterial Other Than Hemorrhage Or Tumor Eg Congenital Or Acquired Arterial Malformations Arteriovenous Malformations Arteriovenous Fistulas Aneurysms Pseudoaneurysms
37243-CPT	High	Vasc Embolize Occlude Organ, Vascular Embolization Or Occlusion Inclusive Of All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention For Tumors Organ Ischemia Or Infarction
37244-CPT	High	Vasc Embolize Occlude Bleed, Vascular Embolization Or Occlusion Inclusive Of All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention For Arterial Or Venous Hemorrhage Or Lymphatic Extravasation

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 37242. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 37242 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 37242 Fee Schedule

Christopher Raio

Chandrashekar Kumbar

John Buttari

Charles Bailey

Kristin Whitley