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    OpenPayerBilling CodesPortal Decompression Procedures on Arteries and VeinsCPT cpt-37183-tips-shunt-revision-stent-placement
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    CPT 37183: Transjugular Intrahepatic Portosystemic Shunt (TIPS) Revision with Stent Placement

    Medicare pays $5657 on average nationally for this procedure.

    CPT code 37183 describes removal of a previously placed transjugular intrahepatic portosystemic shunt (TIPS) and placement of a new stent within the created intrahepatic channel to restore flow, typically performed for shunt thrombosis or stenosis; service type: endovascular shunt revision with stent placement; typical site of service: hospital interventional radiology suite or tertiary care vascular suite.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 58-year-old with cirrhosis and portal hypertension who previously underwent transjugular intrahepatic portosystemic shunt (TIPS) placement. Over weeks to months the patient develops recurrent ascites and signs of portal hypertension or acute decompensation due to TIPS dysfunction from stenosis or thrombosis. The clinical workflow begins with cross-sectional imaging (Doppler ultrasound, CT or MR venography) demonstrating reduced or absent flow through the TIPS or imaging evidence of stenosis or occlusion. The interventional radiology team evaluates the patient, reviews coagulation status and anticoagulation management, and obtains informed consent for TIPS revision. In the angiography suite under moderate sedation or general anesthesia, venous access is obtained (commonly via the right internal jugular vein), hepatic venography and portal pressure measurements are performed, the failed shunt is recanalized or the old stent removed as indicated, and a new stent is placed to re-establish flow between the portal vein and a hepatic vein. Hemostasis is secured and the patient is observed post-procedure for access-site complications, bleeding, encephalopathy, or hemodynamic changes. Typical sites of service are the hospital-based interventional radiology suite, an ambulatory surgery center (if available and appropriate), or an inpatient angiography suite when performed for urgent complications. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37184Transcatheter placement of intravascular stent(s), central venous system (e.g., superior vena cava, inferior vena cava, innominate vein); each additional stent (List separately in addition to code for primary procedure)May be used when additional stents are required during the TIPS revision procedure as adjunctive devices.
    75894Transcatheter therapy, embolization, any method, radiologic supervision and interpretationPerformed when concomitant embolization of varices or collateral vessels is required during the same session.
    36245Selective catheter placement, venous system, superior or inferior vena cava including all associated radiological supervision and interpretationMay be performed for venous access or diagnostic venography as part of the TIPS revision workflow.
    43286Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement, biliary or pancreaticData not specific to TIPS but occasionally part of multidisciplinary care for hepatobiliary disease; used when combined endoscopic procedures are clinically necessary.
    36415Collection of venous blood by venipuncturePerformed pre- and post-procedure for laboratory monitoring including coagulation testing and liver panels.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0002X
    207L00000X
    2086S0122X
    172V00000X
    101YM0800X
    224P00000X
    332G00000X
    261QB0400X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-37140-PORTOCAVAL-SHUNT-PORTAL-HYPERTENSION-SURGERY

    CPT 37140: Portocaval Shunt Creation for Portal Hypertension

    CPT-37145-RENOPORTAL-VENOUS-ANASTOMOSIS-RENAL-TO-PORTAL-VEIN

    CPT 37145: Renoportal Venous Anastomosis for Portal Flow Restoration

    CPT-37160-CAVAL-MESENTERIC-VENOUS-ANASTOMOSIS-PORTAL-HYPERTENSION

    CPT 37160: Caval–Mesenteric Venous Anastomosis

    CPT-37180-PROXIMAL-SPLENORENAL-VENOUS-ANASTOMOSIS

    CPT 37180: Proximal Splenorenal Venous Anastomosis

    CPT-37181-SPLENORENAL-SHUNT-OPEN-SURGICAL-VENOUS-BYPASS

    CPT 37181: Splenic-to-Renal (Splenorenal) Vein Shunt, Open

    CPT-37182-TIPS-SHUNT-CREATION-STENT-PLACEMENT-PORTAL-HYPERTENSION

    CPT 37182: Transjugular Intrahepatic Portosystemic Shunt (TIPS) with Stent

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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