CPT 37269
Global 000 ActiveRevsc evasc fpvt st cplx 1st
CPT 37269 Billing & Documentation Guide
CPT code 37269 (Revsc evasc fpvt st cplx 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 14.75, a non-facility practice expense RVU of 327.62, and a malpractice RVU of 3.53, a total non-facility RVU of 345.9 and facility RVU of 20.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $12023.92, though rates vary from $9953.25 to $16389.58 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 37269, 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 37269 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 37269
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 14.75 | 14.75 |
| Practice Expense RVU | 327.62 | 1.92 |
| Malpractice RVU | 3.53 | 3.53 |
| Total RVU | 345.9 | 20.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 37269
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 | $13522.62 | $650.14 | $12557.55 - $16389.58 | 29 |
| Florida | $11701.46 | $786.53 | $11131.19 - $12182.3 | 3 |
| Georgia | $11073.91 | $695.66 | $10394.19 - $11753.63 | 2 |
| Illinois | $11293.19 | $781.67 | $10667.73 - $11943.3 | 4 |
| Michigan | $10933.91 | $718.84 | $10616.56 - $11251.26 | 2 |
| North Carolina | $10777.64 | $627.84 | $10777.64 - $10777.64 | 1 |
| New York | $12884.11 | $747.86 | $10971.21 - $13754.14 | 5 |
| Ohio | $10602.29 | $670.06 | $10602.29 - $10602.29 | 1 |
| Pennsylvania | $11341.62 | $685.95 | $10649.58 - $12033.65 | 2 |
| Texas | $11378.08 | $668.03 | $10560.15 - $12175.6 | 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 37269
What does CPT code 37269 mean? +
CPT code 37269 represents: Revsc evasc fpvt st cplx 1st. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 37269? +
The 2026 Medicare national average non-facility payment for CPT 37269 is $12023.92. Rates range from $9953.25 to $16389.58 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 37269? +
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 37269? +
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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