How much does Medicare pay for CPT 37221?

Medicare allowed an average of $1190.47 per service and paid $946.69 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7193.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37221?

Insertion of stent in groin artery, initial vessel. It was billed 3,143 times to 2,901 Medicare beneficiaries by 187 providers in 2024.

Does 37221 pay differently in an office than a hospital?

Yes. The allowed amount averaged $2040.07 in an office setting and $762.42 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 37221 most?

Vascular Surgery, with 1,854 services from 117 clinicians. Next are Cardiology, Interventional Cardiology, Interventional Radiology.

CPT 37221

Insertion of stent in groin artery, initial vessel

$1190.47Medicare-allowed amount per service, averaged across 3,143 services

Providers submitted

$7193.35

Asking price, not received

Medicare allowed

$1190.47

The fee schedule figure

Medicare paid

$946.69

Balance is patient coinsurance

Providers submitted an average of $7193.35 for this code and Medicare allowed $1190.47 — 6.0× 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 $946.69 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $2040.07
Hospital / facility: $762.42

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. 1,053 services were billed in an office setting and 2,090 in a facility.

Services: 3,143
Beneficiaries: 2,901
Providers billing it: 187
Total allowed: $3,741,647

What Medicare pays for CPT 37221

Across 3,143 services billed by 187 providers to 2,901 beneficiaries, Medicare allowed an average of $1190.47 per service. 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 37221

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	1,854	1,743	$901.83	117
Cardiology	279	249	$1340.76	15
Interventional Cardiology	228	210	$805.62	14
Interventional Radiology	221	203	$1591.05	10
Ambulatory Surgical Center	158	121	$5015.79	7
General Surgery	138	134	$641.75	9
Peripheral Vascular Disease	99	81	$1242.31	3
Diagnostic Radiology	74	70	$1166.01	5
Thoracic Surgery	52	51	$1042.88	4
Cardiac Surgery	18	17	$374.23	1
Internal Medicine	11	11	$406.61	1
General Practice	11	11	$411.65	1

37221 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
Florida	457	$1320.73	$1046.27	24
California	240	$2064.35	$1326.60	11
New York	207	$1196.33	$899.16	12
Illinois	186	$1380.76	$1066.54	10
Texas	166	$671.79	$534.70	12
Tennessee	157	$1409.99	$1242.27	10
South Dakota	152	$941.30	$776.20	7
Missouri	137	$892.19	$806.57	10
Maryland	113	$2386.31	$1761.06	6
Kansas	104	$1507.61	$1336.26	4
Arkansas	103	$539.61	$466.42	7
Nebraska	102	$1989.20	$1752.54	2
Kentucky	99	$835.19	$723.46	6
New Jersey	82	$1668.78	$1159.09	4
North Carolina	81	$398.12	$332.62	6
Oklahoma	67	$394.53	$338.03	5
Ohio	50	$451.49	$365.33	4
Montana	45	$414.25	$318.08	3
Idaho	45	$433.57	$375.16	3
Georgia	45	$957.78	$802.82	3
Washington	45	$1200.38	$898.22	3
Arizona	39	$401.67	$331.07	3
Minnesota	39	$416.54	$352.22	3
Massachusetts	38	$407.98	$319.35	3
Indiana	31	$419.17	$360.25	2
West Virginia	30	$452.44	$344.85	2
Rhode Island	28	$484.14	$351.79	2
South Carolina	27	$1328.22	$1134.34	2
Michigan	26	$1330.93	$1091.78	2
Mississippi	26	$2458.40	$2262.06	2
Oregon	25	$419.75	$338.83	2
Pennsylvania	23	$374.58	$297.42	2
Wisconsin	23	$435.78	$373.04	2
Hawaii	21	$2906.90	$2068.95	1
Wyoming	13	$406.73	$293.81	1
Iowa	12	$333.38	$278.56	1
Guam	12	$3003.06	$2144.22	1
Nevada	12	$2841.15	$2414.13	1
Delaware	12	$1623.87	$1178.13	1
New Hampshire	12	$376.56	$279.66	1
Virginia	11	$317.34	$263.11	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.