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    v1.0.30
    OpenPayerBilling CodesLigation Procedures on Arteries and VeinsCPT cpt-37607-arteriovenous-fistula-ligation
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    CPT 37607: Ligation of Artificial Arteriovenous Fistula

    Medicare pays $349 on average nationally for this procedure.

    CPT code 37607 describes a surgical procedure to locate and ligate an artificially created arteriovenous fistula by making an incision and using sutures or clamps to control or stop blood flow; this is a minor operative vascular service typically performed in an outpatient surgical suite or hospital operating room for patients with vascular access complications or when fistula closure is required.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with an established hemodialysis arteriovenous fistula (AVF) who presents with persistent bleeding, high-output heart failure, recalcitrant infection localized to the fistula, or severe steal syndrome unresponsive to conservative measures. The patient is evaluated in the outpatient vascular surgery clinic or in the hospital by a vascular surgeon or interventionalist. Preoperative assessment includes review of dialysis access history, physical exam of the AVF (bruit, thrill, erythema, drainage), duplex ultrasound to localize the fistula and assess flow, and relevant labs (complete blood count, coagulation profile). After informed consent, the patient is taken to an operating room, ambulatory surgery center, or bedside in select inpatient settings. Under regional or general anesthesia, a targeted incision is made to expose the surgically created AVF; the fistula inflow and outflow are controlled and the fistula is ligated with sutures or clamps to stop flow. Postoperative care includes hemostasis confirmation, wound closure, monitoring for limb ischemia, pain control, and coordination with the patient’s dialysis provider to arrange alternative access or catheter placement as needed. Typical sites of service are the hospital operating room, ambulatory surgery center, or inpatient bedside procedure. The service type is a surgical vascular procedure for termination (ligation) of an arteriovenous fistula used for hemodialysis.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36830Thrombectomy, open, for dialysis circuit, arterial and/or venous; each vesselPerformed if thrombosis is present prior to or instead of definitive ligation of the AVF.
    36831Thrombectomy, open, for dialysis circuit, with revision; each vesselPerformed when salvage or revision of the access is attempted rather than ligation.
    36832Revision, dialysis access, with thrombectomy and creation of new anastomosisAlternative when reconstruction of access is undertaken instead of ligation.
    36620Arteriovenous fistula creation, by direct arteriovenous anastomosis, upper arm (e.g., brachiocephalic)Related prior procedure describing creation of the AVF that may now require ligation.
    36445Cannulation of vascular access device, complicated; requiring fluoroscopic guidance or cutdownUsed when alternate access placement or catheter insertion for dialysis is required after ligation.

    Related Modifiers

    7 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…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207L00000X
    207K00000X
    2085R0001X
    261QP0905X
    207YP0228X
    2080P0208X
    163WC0200X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    D69.6Thrombocytopenia, unspecified
    I65.29Occlusion and stenosis of unspecified carotid artery
    I66.9Occlusion and stenosis of unspecified cerebral artery
    I71.9Aortic aneurysm of unspecified site, without rupture
    I72.3Aneurysm of iliac artery
    I72.9Aneurysm of unspecified site
    I73.9Peripheral vascular disease, unspecified
    I74.3Embolism and thrombosis of arteries of the lower extremities
    I74.4Embolism and thrombosis of arteries of extremities, unspecified
    I77.6Arteritis, unspecified

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-37565-INTERNAL-JUGULAR-VEIN-LIGATION-NECK-INCISION

    CPT 37565: Internal Jugular Vein Ligation via Neck Incision

    CPT-37600-EXTERNAL-CAROTID-ARTERY-LIGATION-NECK-SURGERY

    CPT 37600: External Carotid Artery Ligation, Neck Incision

    CPT-37605-CAROTID-ARTERY-LIGATION-OPEN-VASCULAR-SURGERY

    CPT 37605: Ligation of Internal or Common Carotid Artery

    CPT-37606-CAROTID-ARTERY-LIGATION-NECK

    CPT 37606: Ligation of Internal or Common Carotid Artery

    CPT-37609-TEMPORAL-ARTERY-LIGATION-ANEURYSM-TREATMENT

    CPT 37609: Temporal Artery Ligation for Aneurysm

    CPT-37615-NECK-ARTERY-LIGATION-TRAUMA

    CPT 37615: Ligation of Ruptured Neck Artery (Traumatic)

    CPT-37616-THORACIC-ARTERY-LIGATION-RUPTURE-TRAUMA

    CPT 37616: Ligation of Ruptured Chest Artery (Trauma)

    CPT-37617-ABDOMINAL-ARTERY-LIGATION-TRAUMA

    CPT 37617: Ligation of Ruptured Abdominal Artery

    CPT-37618-LIGATION-RUPTURED-LIMB-ARTERY-TRAUMA

    CPT 37618: Ligation of Ruptured Limb Artery

    CPT-37619-INFERIOR-VENA-CAVA-LIGATION-VENOUS-SURGICAL-PROCEDURE

    CPT 37619: Inferior Vena Cava Ligation

    Showing 1–10 of 22

    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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