How much does Medicare pay for CPT 37246?

Medicare allowed an average of $1236.27 per service and paid $981.61 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4305.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 37246?

Balloon dilation of artery with review by radiologist, initial artery. It was billed 1,988 times to 1,355 Medicare beneficiaries by 54 providers in 2024.

Does 37246 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1205.38 in an office setting and $1266.37 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 37246 most?

Vascular Surgery, with 603 services from 12 clinicians. Next are Nephrology, Ambulatory Surgical Center, Interventional Radiology.

CPT 37246

Balloon dilation of artery with review by radiologist, initial artery

$1236.27Medicare-allowed amount per service, averaged across 1,988 services

Providers submitted

$4305.68

Asking price, not received

Medicare allowed

$1236.27

The fee schedule figure

Medicare paid

$981.61

Balance is patient coinsurance

Providers submitted an average of $4305.68 for this code and Medicare allowed $1236.27 — 3.5× 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 $981.61 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1205.38
Hospital / facility: $1266.37

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 981 services were billed in an office setting and 1,007 in a facility.

Services: 1,988
Beneficiaries: 1,355
Providers billing it: 54
Total allowed: $2,457,705

What Medicare pays for CPT 37246

Across 1,988 services billed by 54 providers to 1,355 beneficiaries, Medicare allowed an average of $1236.27 per service. That is 1.5 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 37246

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	603	353	$895.82	12
Nephrology	566	339	$908.02	13
Ambulatory Surgical Center	408	305	$2702.65	12
Interventional Radiology	147	128	$508.16	5
Diagnostic Radiology	123	109	$1308.02	7
Thoracic Surgery	53	43	$774.70	1
General Surgery	34	32	$290.00	2
Internal Medicine	29	23	$313.85	1
Interventional Cardiology	25	23	$212.40	1

37246 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	924	$1138.93	$802.96	15
Texas	184	$1386.72	$1166.12	6
Maryland	157	$1717.23	$1348.48	2
New York	117	$1839.26	$1216.38	5
Illinois	101	$1486.66	$1149.09	4
Virginia	69	$1279.97	$990.77	3
Massachusetts	68	$319.04	$239.98	2
South Carolina	58	$255.00	$211.49	3
Florida	53	$904.66	$726.83	3
District of Columbia	47	$339.37	$165.50	1
Arizona	39	$1724.44	$1382.78	2
New Mexico	36	$1431.01	$1325.58	1
Arkansas	32	$1387.65	$1195.76	2
Wisconsin	29	$2647.93	$2193.33	1
Michigan	26	$270.79	$238.18	1
North Carolina	21	$1464.94	$1255.87	1
Nevada	14	$3254.54	$2615.81	1
Tennessee	13	$246.27	$230.55	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.