CPT 37243 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Cardiovascular System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • GC - Service performed by resident under supervision • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 37243 by major payers:
$9,837.15
$13,022.71
$13,362.57
$14,107.46
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 37243 | ||||||
United | 37243 | $12416.70 | 1548286958 - RHODA LEICHTER | 866007596 - (AZ) YUMA REGIONAL MEDICAL CENTER | CA | Vascular Surgery Physician (2086S0129X) |
United | 37243 | $29870.07 | 1780181552 - ALISON DUMITRIU | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Surgery Physician (208600000X) |
United | 37243 | $24208.18 | 1396069837 - ALEXIS PLASENCIA | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Surgery Physician (208600000X) |
United | 37243 | $41293.42 | 1235471608 - RYAN CHAO | 260089066 | CA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 37243 | $11089.84 | 1275581886 - JOHN ZOPFI | 680249001 | CA | Surgery Physician (208600000X) |
United | 37243 | $19467.18 | 1649461120 - AMY BREMNER | 271504911 - (CA) MEMORIALCARE MEDICAL FOUNDATION | CA | Surgery Physician (208600000X) |
United | 37243 | $10852.21 | 1710980677 - TODD HARRIS | 205281584 - (CA) ORANGE COUNTY VASCULAR ACCESS A MEDICAL CORPORATION | CA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 37243 | $7933.85 | 1114183993 - ALI GOLSHAN | 453545753 - (CA) COMPREHENSIVE DERMATOLOGY OF LONG BEACH PC | CA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 37243 | $8207.34 | 1003402884 - ROBERT AZIZI, MD INC. | 832865979 - (CA) VASCULAR INTERVENTIONS INC | CA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 37243 | $63792.32 | 1609009125 - JOHN MORIARTY | 954377219 | CA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 37243 | $16791.90 | 1629097639 - DEACONESS HOSPITAL, INC., <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 37243 | $40967.92 | 1881957694 - ANDERS DAVIDSON | 680334324 | CA | Vascular Surgery Physician (2086S0129X) |
United | 37243 | $7386.68 | 1861525511 - FARZAD ALEMI | 841816223 - (CA) FARZAD ALEMI MD INC | CA | Surgery Physician (208600000X) |
United | 37243 | $8754.54 | 1285013490 - TROY LAMAR MD, INC. | 680540954 - (CA) TROY M. LAMAR, M.D., INC. | CA | Surgery Physician (208600000X) |
United | 37243 | $8871.87 | 1760747398 - NADIR ADAM | 364690686 - (CA) DIGNITY HEALTH MEDICAL FOUNDATION | CA | Surgery Physician (208600000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 37243 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 37243 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 37243 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 |
|---|---|---|
| 37238-CPT | High | Transcatheter Placement Of An Intravascular Stent(S), Open Or Percutaneous, Including Radiological Supervision And Interpretation And Including Angioplasty Within The Same Vessel, When Performed; Initial Vein |
| 37239-CPT | High | Transcatheter Placement Of An Intravascular Stent(S) Open Or Percutaneous Including Radiological Supervision And Interpretation And Including Angioplasty Within The Same Vessel Whenperformed; Each Additional Vein (List Separately In Addition To Code For Primary Procedure). |
| 37241-CPT | High | 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) |
| 37243-CPT | High | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 37243. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 37243 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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