CPT 37259
Global ZZZ ActiveRevsc evasc ivt stent sf ea
CPT 37259 Billing & Documentation Guide
CPT code 37259 (Revsc evasc ivt stent sf ea) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4, a non-facility practice expense RVU of 31.12, and a malpractice RVU of 0.98, a total non-facility RVU of 36.1 and facility RVU of 5.43. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1249.14, though rates vary from $1043.34 to $1664.71 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 37259, 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)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 37259 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 37259
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4 | 4 |
| Practice Expense RVU | 31.12 | 0.45 |
| Malpractice RVU | 0.98 | 0.98 |
| Total RVU | 36.1 | 5.43 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 37259
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 | $1386.08 | $173.93 | $1292.64 - $1664.71 | 29 |
| Florida | $1240.22 | $212.4 | $1176.5 - $1298.44 | 3 |
| Georgia | $1164.59 | $187.31 | $1099.8 - $1229.38 | 2 |
| Illinois | $1200.98 | $211.15 | $1133.77 - $1260.04 | 4 |
| Michigan | $1155.71 | $193.79 | $1119.56 - $1191.85 | 2 |
| North Carolina | $1124.31 | $168.54 | $1124.31 - $1124.31 | 1 |
| New York | $1344.03 | $201.21 | $1144.08 - $1438.83 | 5 |
| Ohio | $1115.6 | $180.32 | $1115.6 - $1115.6 | 1 |
| Pennsylvania | $1187.93 | $184.52 | $1118.74 - $1257.11 | 2 |
| Texas | $1188.07 | $179.54 | $1109.9 - $1262.6 | 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 37259
What does CPT code 37259 mean? +
CPT code 37259 represents: Revsc evasc ivt stent sf ea. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 37259? +
The 2026 Medicare national average non-facility payment for CPT 37259 is $1249.14. Rates range from $1043.34 to $1664.71 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 37259? +
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 37259? +
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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