CPT 37615 Ligation of Neck Artery — Reimbursement | OpenPayer

Summary & Overview

CPT 37615: Ligation of Ruptured Neck Artery Due to Trauma

CPT code 37615 denotes surgical ligation of a ruptured arterial vessel in the neck due to injury or trauma. It captures a time-sensitive, high-acuity vascular operation performed to control life-threatening hemorrhage and stabilize patients. Nationally, correct coding for this intervention affects hospital and surgical reporting, trauma registry records, and high-acuity reimbursement pathways.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for the procedure, typical sites of service, and the types of documentation elements that support coding and claim submission. The publication also summarizes benchmark considerations, common billing modifiers encountered in practice, and potential policy implications for payers and providers handling emergency vascular trauma care.

This analysis is intended for hospital coding managers, trauma surgeons, revenue cycle staff, and policy analysts seeking a clear, national-level briefing on CPT code 37615 — what it represents clinically, why it matters for coding and billing, and where to focus documentation and administrative attention when this emergent procedure is performed.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareCPT 37615vascular surgerytraumaemergency surgeryoperative procedurebillingcoding

Billing Code Overview

CPT code 37615 describes the surgical ligation (closure, clipping, or tying off) of a ruptured artery of the neck performed for injury or trauma. This procedure represents an emergency vascular surgical intervention to control hemorrhage from major cervical arterial injury.

Service type: Emergency vascular surgical procedure
Typical site of service: Operating room or trauma center surgical suite

Clinical & Coding Specifications

Clinical Context

A typical patient is a 28-year-old male presenting to the emergency department after a penetrating neck injury (stab wound) with active hemorrhage, expanding hematoma, or signs of vascular injury (rapid hemodynamic deterioration, pulsatile bleeding, or neurologic compromise). Initial trauma evaluation follows Advanced Trauma Life Support (ATLS) protocols: airway secured, breathing and circulation assessed, intravenous access established, and blood product resuscitation as needed. Rapid assessment includes focused physical exam of the neck, bedside ultrasound or plain radiography for foreign body localization, and urgent computed tomography angiography (CTA) of the neck when the patient is hemodynamically stable to identify the injured vessel.

If the patient is unstable with ongoing arterial hemorrhage from the neck, the surgical team (trauma/vascular surgery and sometimes otolaryngology) proceeds to the operating room or emergency surgical suite for definitive hemorrhage control. The procedure represented by 37615 is operative ligation (tying, clipping, or otherwise occluding) of a ruptured neck artery due to trauma. Intraoperative steps include exposure of the injured vessel via the appropriate cervical incision, proximal and distal vascular control, identification of adjacent neural and airway structures, hemostasis by ligation or clip application, and completion of wound irrigation and closure. Post-procedure care includes hemodynamic monitoring in a critical care setting, repeat vascular imaging only if indicated, wound care, and monitoring for ischemic or neurologic sequelae.

Typical site of service: hospital operating room or emergency department operating suite, with post-procedure care often in an intensive care unit.

Service type: emergent operative vascular procedure for traumatic arterial injury of the neck.

Coding Specifications

Modifier

CPT 37722: Great Saphenous Vein Stripping for Varicose Veins

CPT-37700-LIGATION-DIVISION-LONG-SAPHENOUS-VEIN-VARICOSE-VEINS

CPT 37700: Ligation and Division of Long Saphenous Vein for Varicose Veins

CPT-37650-FEMORAL-VEIN-LIGATION-UPPER-THIGH

CPT 37650: Femoral Vein Ligation for Varicose Vein

CPT-37766-PHLEBECTOMY-VARICOSE-VEIN-EXCISION-20-PLUS-INCISIONS

CPT 37766: Excision of Varicose Veins (20+ Small Incisions)

CPT-37785-VARICOSE-VEIN-CLUSTER-EXCISION

CPT 37785: Excision of Cluster of Varicose Veins

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

CPT 37616: Ligation of Ruptured Chest Artery (Trauma)

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

CPT 37565: Internal Jugular Vein Ligation for Venous Hum Tinnitus

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

CPT 37600: External Carotid Artery Ligation, Neck

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

CPT 37605: Ligation of Internal or Common Carotid Artery

CPT-37780-SHORT-SAPHENOUS-VEIN-EXCISION-SAPHENOPOPLITEAL-JUNCTION

CPT 37780: Short (Small) Saphenous Vein Excision at Saphenopopliteal Junction

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Taxonomy Code	Specialty	Notes
208000000X	General Surgery (Trauma)	Trauma/general surgeons commonly perform emergent neck vascular control and ligation.
2080P0002X	Vascular Surgery	Vascular surgeons perform complex arterial repair or ligation when available.
207L00000X	Otolaryngology (ENT)	ENT surgeons may be involved for exposure, airway management, or zone-specific neck injuries.
2086S0125X	Critical Care Medicine	Intensivists provide post-operative critical care but do not perform the procedure.
367A00000X	Physician Assistant	PAs often assist intraoperatively and in perioperative management.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35080`	Avulsion of external carotid artery or branch; repair	Performed when repair of an avulsed external carotid branch is feasible instead of ligation.
`35741`	Ligation, innominate artery; elective or emergency	Related higher-level thoracic/central vessel ligation when more central great vessel control is required.
`37205`	Transcatheter occlusion or embolization of vascular lesion	Endovascular embolization may be performed as an alternative or adjunct to open ligation, particularly when endovascular access is possible.
`35800`	Vascular exploration, neck, with repair or ligation	Commonly paired when exploration of neck vessels is required and multiple repairs or ligations are performed.
`36415`	Collection of venous blood by venipuncture	Performed preoperatively for labs, crossmatch, and type and screen in trauma patients.

`22`	Increased procedural services	Use when work required is substantially greater than typical for `37615` due to extensive dissection, prolonged operative time, or complex exposure.
`23`	Unusual anesthesia	Use when general anesthesia is not advisable and the procedure is performed under heavy sedation or local/regional techniques because of patient condition.
`26`	Professional component	Use when reporting only the surgeon’s professional component separate from technical facility billing — uncommon for this operative code but applicable in split-billing scenarios.
`50`	Bilateral procedure	Use if bilateral neck arterial ligations are performed and payer requires a bilateral modifier.
`51`	Multiple procedures	Use when `37615` is reported with additional significant procedures during the same operative session.
`52`	Reduced services	Use if the procedure was attempted but substantially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure was started but halted for patient safety before completion.
`59`	Distinct procedural service	Use when another distinct, separate procedure is performed at a separate anatomic site or session and needs to be distinguished from `37615`.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons due to complexity requiring concurrent skills.
`78`	Unplanned return to OR	Use when the patient returns to the operating room for a related procedure during the global period due to complications (e.g., re-bleed).
`80`	Assistant surgeon	Use when a qualified assistant surgeon is documented and billed for assistance during the procedure.
`81`	Minimum assistant surgeon	Use when minimal assistance is documented rather than full assistant service.
`82`	Assistant surgeon (when qualified resident not available)	Use when an assistant surgeon is required and a qualified resident is not available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when a PA/NP/CNS performs or assists and payer requires the AS modifier for reimbursement.

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