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See a sample rate comparisonCPT 37242 Fee Schedule
Medicare rates as of October 2026
CPT 37242 is classified under Surgery, in the Surgical Procedures on the Cardiovascular System subgroup.
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 | XS - Separate Structure 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $6,675.17 national non-facility rate (2026) · View Medicare rates for 37242 |
| Medicaid Fee Schedule | $5,282.525 median of the 8 states in the free preview · View Medicaid rates for 37242 |
National average reimbursement for CPT 37242 by major payers:
$7,580.37
BCBS / Anthem
$10,315.16
UnitedHealthcare
$11,073.21
Aetna
$1,564.91
Cigna
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
$21,952.43Published rateChandrashekar Kumbar
Deaconess Hospital Inc
$12,963.69Published rateJohn Buttari
Town Center Orthopaedic Associates, P.C.
$11,203.40Published rateCharles Bailey
Heart Endovascular And Rhythm Of Texas PA
$7,181.00Published rateKristin Whitley
Town Center Orthopaedic Associates, P.C.
$648.58Published rate
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See a sample payer proposalCPT 37242 vs. Other Surgical Procedures on the Cardiovascular System Codes
The table lists codes related to 37242. Select one to see its fee schedule.
| 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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Frequently Asked Questions
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.
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.
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.
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.
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.