CPT 37258
Global 000 ActiveRevsc evasc ivt stent sf 1st
CPT 37258 Billing & Documentation Guide
CPT code 37258 (Revsc evasc ivt stent sf 1st) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.75, a non-facility practice expense RVU of 95.81, and a malpractice RVU of 2.09, a total non-facility RVU of 106.65 and facility RVU of 12.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $3697.76, though rates vary from $3077.13 to $4976.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 37258, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify current NCCI edits before bundling with related codes.
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 37258 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 37258
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.75 | 8.75 |
| Practice Expense RVU | 95.81 | 1.17 |
| Malpractice RVU | 2.09 | 2.09 |
| Total RVU | 106.65 | 12.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 37258
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $4127.24 | $386.83 | $3842 - $4976.43 | 29 |
| Florida | $3638.96 | $467.36 | $3456.51 - $3800.15 | 3 |
| Georgia | $3429.15 | $413.51 | $3229.99 - $3628.32 | 2 |
| Illinois | $3518.82 | $464.45 | $3323.1 - $3704.55 | 4 |
| Michigan | $3395.45 | $427.21 | $3292.8 - $3498.09 | 2 |
| North Carolina | $3322.6 | $373.33 | $3322.6 - $3322.6 | 1 |
| New York | $3971.1 | $444.62 | $3381.47 - $4245.56 | 5 |
| Ohio | $3284.35 | $398.3 | $3284.35 - $3284.35 | 1 |
| Pennsylvania | $3504.06 | $407.79 | $3295.96 - $3712.15 | 2 |
| Texas | $3509.25 | $397.18 | $3269.24 - $3740.44 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
Frequently Asked Questions, CPT 37258
What does CPT code 37258 mean? +
CPT code 37258 represents: Revsc evasc ivt stent sf 1st. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 37258? +
The 2026 Medicare national average non-facility payment for CPT 37258 is $3697.76. Rates range from $3077.13 to $4976.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 37258? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 37258? +
No NCCI PTP edits currently on file for this code.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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