How much does Medicare pay for CPT 37228?

Medicare allowed an average of $1158.26 per service and paid $922.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7253.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37228?

Balloon dilation of artery of leg, initial vessel. It was billed 8,293 times to 7,125 Medicare beneficiaries by 433 providers in 2024.

Does 37228 pay differently in an office than a hospital?

Yes. The allowed amount averaged $2960.32 in an office setting and $610.92 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 37228 most?

Vascular Surgery, with 4,902 services from 270 clinicians. Next are Cardiology, Interventional Cardiology, Interventional Radiology.

CPT 37228

Balloon dilation of artery of leg, initial vessel

$1158.26Medicare-allowed amount per service, averaged across 8,293 services

Providers submitted

$7253.68

Asking price, not received

Medicare allowed

$1158.26

The fee schedule figure

Medicare paid

$922.25

Balance is patient coinsurance

Providers submitted an average of $7253.68 for this code and Medicare allowed $1158.26 — 6.3× 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 $922.25 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $2960.32
Hospital / facility: $610.92

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. 1,932 services were billed in an office setting and 6,361 in a facility.

Services: 8,293
Beneficiaries: 7,125
Providers billing it: 433
Total allowed: $9,605,450

What Medicare pays for CPT 37228

Across 8,293 services billed by 433 providers to 7,125 beneficiaries, Medicare allowed an average of $1158.26 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 37228

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	4,902	4,262	$850.98	270
Cardiology	1,172	998	$1626.28	52
Interventional Cardiology	546	463	$894.99	30
Interventional Radiology	497	426	$1844.60	26
Diagnostic Radiology	415	309	$2052.36	14
General Surgery	304	267	$522.10	17
Ambulatory Surgical Center	227	190	$4031.30	10
Internal Medicine	62	57	$590.13	4
Thoracic Surgery	58	52	$1265.81	3
Peripheral Vascular Disease	42	36	$463.97	2
Cardiac Surgery	32	29	$1707.16	2
Physician Assistant	23	23	$301.47	2
Urology	13	13	$453.26	1

37228 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	1,296	$1604.99	$1148.44	54
Texas	763	$1287.01	$1056.56	43
New York	659	$1431.22	$1013.98	30
Florida	592	$1033.77	$801.05	31
Illinois	373	$658.45	$492.64	21
Maryland	371	$1626.28	$1206.25	20
North Carolina	278	$917.33	$790.02	15
New Jersey	269	$815.76	$583.85	16
South Dakota	245	$1231.96	$1008.59	11
Pennsylvania	219	$517.26	$382.44	11
Massachusetts	219	$797.94	$614.87	12
Tennessee	218	$1188.10	$1073.45	13
Arkansas	203	$934.45	$808.12	11
Kansas	193	$1075.08	$953.12	8
Ohio	192	$677.37	$574.38	10
Missouri	172	$482.63	$388.00	9
Kentucky	139	$617.47	$518.03	9
Oregon	125	$956.56	$780.75	6
Michigan	125	$2112.33	$1783.78	8
South Carolina	119	$473.84	$393.52	6
Indiana	119	$435.81	$376.36	7
Wisconsin	118	$439.15	$383.60	7
Oklahoma	116	$1240.35	$1047.93	7
Virginia	114	$1067.15	$877.68	7
Washington	113	$1162.99	$870.67	6
Arizona	99	$2220.25	$1815.68	8
District of Columbia	81	$1329.60	$1003.02	3
Mississippi	78	$1562.52	$1418.54	4
Minnesota	71	$431.37	$386.42	4
Georgia	62	$1141.83	$848.50	4
Connecticut	62	$1914.10	$1359.74	4
Colorado	50	$476.56	$385.63	3
New Mexico	45	$467.24	$363.47	1
West Virginia	45	$451.18	$347.63	2
North Dakota	42	$454.46	$371.77	3
Delaware	42	$2983.20	$2217.25	3
Louisiana	41	$2320.41	$2058.10	3
Idaho	30	$464.37	$409.62	1
Hawaii	26	$463.24	$387.30	1
New Hampshire	26	$499.12	$394.35	2
Nebraska	23	$453.07	$399.71	1
Utah	20	$482.51	$399.24	1
Nevada	16	$3611.90	$3060.33	1
Guam	16	$3470.05	$2473.75	1
Wyoming	16	$466.62	$379.45	1
Montana	15	$517.94	$410.51	1
Alabama	14	$419.66	$365.81	1
Iowa	12	$385.69	$323.03	1
Alaska	11	$636.79	$391.24	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
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
37233Removal of plaque in artery of leg$1004.57

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.