How much does Medicare pay for CPT 37231?

Medicare allowed an average of $10,753 per service and paid $8553.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $25,248, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37231?

Removal of plaque and insertion of stents in artery of leg, initial vessel. It was billed 1,629 times to 1,328 Medicare beneficiaries by 48 providers in 2024.

Does 37231 pay differently in an office than a hospital?

Yes. The allowed amount averaged $11,224 in an office setting and $3140.64 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 37231 most?

Cardiology, with 439 services from 15 clinicians. Next are Interventional Radiology, Vascular Surgery, Interventional Cardiology.

CPT 37231

Removal of plaque and insertion of stents in artery of leg, initial vessel

$10,753Medicare-allowed amount per service, averaged across 1,629 services

Providers submitted

$25,248

Asking price, not received

Medicare allowed

$10,753

The fee schedule figure

Medicare paid

$8553.27

Balance is patient coinsurance

Providers submitted an average of $25,248 for this code and Medicare allowed $10,753 — 2.3× 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 $8553.27 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $11,224
Hospital / facility: $3140.64

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. 1,534 services were billed in an office setting and 95 in a facility.

Services: 1,629
Beneficiaries: 1,328
Providers billing it: 48
Total allowed: $17,516,425

What Medicare pays for CPT 37231

Across 1,629 services billed by 48 providers to 1,328 beneficiaries, Medicare allowed an average of $10,753 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 37231

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	439	362	$10,983	15
Interventional Radiology	393	266	$10,946	5
Vascular Surgery	227	204	$9795.92	10
Interventional Cardiology	139	125	$9749.26	5
General Surgery	123	122	$10,341	2
Peripheral Vascular Disease	110	82	$11,700	2
Internal Medicine	69	50	$11,181	1
Diagnostic Radiology	63	58	$11,775	4
General Practice	27	22	$11,894	1
Ambulatory Surgical Center	24	23	$10,486	2
Clinical Cardiac Electrophysiology	15	14	$11,284	1

37231 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	554	$11,060	$8987.10	15
Illinois	312	$10,890	$8985.02	1
Utah	109	$10,453	$8886.31	1
New Jersey	92	$13,022	$8993.40	4
California	84	$13,489	$8969.01	4
Tennessee	80	$7283.03	$6965.33	4
Michigan	69	$11,181	$9074.83	1
Pennsylvania	56	$11,330	$8971.38	2
New York	49	$13,416	$8980.59	2
Texas	35	$11,026	$8990.18	2
Nebraska	35	$7069.47	$5951.60	2
Maryland	29	$10,896	$7712.91	2
Iowa	28	$5492.17	$4774.65	2
Kansas	24	$10,249	$9001.51	1
Louisiana	24	$5543.25	$4970.93	2
North Carolina	20	$10,455	$8973.64	1
Massachusetts	16	$10,908	$8912.64	1
Missouri	13	$693.84	$557.18	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.