How much does Medicare pay for CPT 37226?

Medicare allowed an average of $1527.88 per service and paid $1214.00 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $9441.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37226?

Insertion of stent in arteries of leg. It was billed 3,104 times to 2,786 Medicare beneficiaries by 171 providers in 2024.

Does 37226 pay differently in an office than a hospital?

Yes. The allowed amount averaged $7415.82 in an office setting and $413.46 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 37226 most?

Vascular Surgery, with 2,023 services from 116 clinicians. Next are Cardiology, General Surgery, Interventional Cardiology.

CPT 37226

Insertion of stent in arteries of leg

$1527.88Medicare-allowed amount per service, averaged across 3,104 services

Providers submitted

$9441.54

Asking price, not received

Medicare allowed

$1527.88

The fee schedule figure

Medicare paid

$1214.00

Balance is patient coinsurance

Providers submitted an average of $9441.54 for this code and Medicare allowed $1527.88 — 6.2× 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 $1214.00 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $7415.82
Hospital / facility: $413.46

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. 494 services were billed in an office setting and 2,610 in a facility.

Services: 3,104
Beneficiaries: 2,786
Providers billing it: 171
Total allowed: $4,742,540

What Medicare pays for CPT 37226

Across 3,104 services billed by 171 providers to 2,786 beneficiaries, Medicare allowed an average of $1527.88 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 37226

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	2,023	1,824	$1449.58	116
Cardiology	380	337	$3602.06	15
General Surgery	223	203	$427.62	13
Interventional Cardiology	218	192	$810.14	14
Peripheral Vascular Disease	79	68	$1287.12	3
Interventional Radiology	55	48	$337.72	2
Diagnostic Radiology	52	45	$421.96	3
Thoracic Surgery	48	46	$391.38	3
Cardiac Surgery	26	23	$319.54	2

37226 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	353	$3414.63	$2396.87	13
New York	347	$1408.50	$965.20	20
Florida	278	$2145.97	$1669.10	15
Pennsylvania	227	$456.24	$344.34	14
Massachusetts	142	$443.52	$329.59	6
Maryland	139	$3916.26	$2818.50	7
Tennessee	125	$1572.41	$1420.59	7
Texas	114	$426.33	$334.90	8
Arkansas	107	$382.89	$329.71	7
Kentucky	87	$428.29	$343.30	6
Washington	86	$420.84	$328.09	5
Illinois	85	$453.16	$327.25	5
North Carolina	80	$1581.04	$1393.07	4
Kansas	71	$1394.35	$1221.25	4
South Dakota	67	$377.53	$325.87	3
Missouri	66	$369.79	$292.13	2
New Jersey	64	$1237.30	$834.66	5
Indiana	59	$390.81	$339.36	4
Minnesota	56	$356.72	$309.58	3
Delaware	55	$5905.72	$4878.66	2
Ohio	51	$411.55	$323.20	4
Michigan	46	$6269.51	$5433.56	2
South Carolina	38	$369.32	$295.79	3
Arizona	36	$429.11	$348.98	2
Georgia	35	$468.62	$359.23	2
Wisconsin	30	$321.46	$312.55	2
Oregon	29	$378.58	$318.79	2
Rhode Island	28	$413.54	$323.14	2
District of Columbia	28	$493.98	$294.10	2
West Virginia	24	$402.30	$327.64	1
Alabama	23	$435.06	$397.53	1
Oklahoma	20	$371.44	$306.38	1
Hawaii	19	$8366.66	$6250.53	1
Wyoming	18	$336.18	$256.99	1
Virginia	17	$400.37	$322.23	1
New Hampshire	15	$425.69	$327.32	1
Iowa	15	$384.35	$312.33	1
Nebraska	13	$296.37	$286.80	1
Colorado	11	$401.60	$304.31	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.