How much does Medicare pay for CPT 37220?

Medicare allowed an average of $1227.40 per service and paid $975.22 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7428.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37220?

Balloon dilation of groin artery, initial vessel. It was billed 1,132 times to 954 Medicare beneficiaries by 47 providers in 2024.

Does 37220 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1501.72 in an office setting and $499.99 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 37220 most?

Vascular Surgery, with 523 services from 25 clinicians. Next are Interventional Radiology, Cardiology, Interventional Cardiology.

CPT 37220

Balloon dilation of groin artery, initial vessel

$1227.40Medicare-allowed amount per service, averaged across 1,132 services

Providers submitted

$7428.68

Asking price, not received

Medicare allowed

$1227.40

The fee schedule figure

Medicare paid

$975.22

Balance is patient coinsurance

Providers submitted an average of $7428.68 for this code and Medicare allowed $1227.40 — 6.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $975.22 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1501.72
Hospital / facility: $499.99

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 822 services were billed in an office setting and 310 in a facility.

Services: 1,132
Beneficiaries: 954
Providers billing it: 47
Total allowed: $1,389,417

What Medicare pays for CPT 37220

Across 1,132 services billed by 47 providers to 954 beneficiaries, Medicare allowed an average of $1227.40 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 37220

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	523	442	$1118.35	25
Interventional Radiology	157	134	$1496.62	4
Cardiology	139	112	$1278.11	6
Interventional Cardiology	133	115	$710.40	5
Diagnostic Radiology	67	60	$1431.19	2
General Surgery	62	50	$1256.03	3
Ambulatory Surgical Center	33	29	$2451.43	1
Undefined Physician type	18	12	$2374.60	1

37220 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	346	$1420.02	$931.88	13
Florida	124	$1488.72	$1200.51	4
New York	120	$1207.80	$847.94	5
Illinois	110	$1146.78	$961.37	2
New Jersey	102	$940.33	$648.73	4
Oklahoma	44	$301.31	$256.38	2
Washington	43	$865.89	$628.19	3
Massachusetts	31	$992.94	$717.24	2
Michigan	27	$1102.73	$946.91	2
South Dakota	27	$1270.17	$1070.76	1
Nevada	24	$1201.74	$978.12	1
North Carolina	23	$1214.01	$1042.55	1
Texas	21	$1421.44	$1118.97	1
Louisiana	20	$1186.87	$1050.87	1
Kansas	16	$1087.85	$955.16	1
Arizona	16	$1320.41	$1153.06	1
Maryland	14	$1912.48	$1299.22	1
Missouri	12	$1780.14	$1480.29	1
Colorado	12	$344.06	$269.98	1

Related codes

37253Ultrasound evaluation of blood vessel$158.74
37252Ultrasound evaluation of blood vessel$758.72
37229Removal of plaque in artery of leg$7260.85
37225Removal of plaque in arteries of leg$5516.77
37243Occlusion of growths or obstructed vessels$4293.10
37227Removal of plaque and insertion of stents in arteries of leg$9119.72
37228Balloon dilation of artery of leg$1158.26
37224Balloon dilation of artery of leg$562.15
37242Occlusion of artery$4565.89
37215Insertion of stent and blood clot protection device in neck artery$885.92
37248Balloon dilation of vein$1242.61
37238Insertion of stent in vein$2975.98

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.