CPT 37618 Ligation of Ruptured Limb Artery Reimbursement | OpenPayer

Summary & Overview

CPT 37618: Ligation of Ruptured Limb Artery

CPT code 37618 identifies the surgical ligation of a ruptured artery in an upper or lower limb due to injury or trauma. This is an acute vascular hemorrhage control procedure typically performed in hospital operating rooms, trauma centers, or emergency departments with operative capability. The code is clinically important because timely arterial ligation can be lifesaving, reduce blood loss, and stabilize patients for further reconstruction or definitive vascular repair.

Key payers in the national coverage landscape include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical context, common service settings, and the payer mix relevant to reimbursements and coverage considerations. The publication summarizes benchmark patterns where available, highlights common billing and coding themes associated with emergency vascular procedures, and outlines the clinical scenarios that typically justify use of this code.

This analysis is written for a national audience and focuses on operational and coding clarity rather than state-level policy. Data not available in the input is noted where applicable, including specific payer policy details, associated taxonomies, and linked ICD-10 diagnosis codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37618CPTvascular-surgerytraumaarterial-ligationemergency-surgeryhospital-proceduresoperative-care

Billing Code Overview

CPT code 37618 describes the surgical ligation of a ruptured artery of the upper or lower limb performed in response to injury or trauma. The procedure involves tying off, closing, or clamping the damaged arterial segment to stop hemorrhage and control bleeding.

Service type: Emergency/trauma vascular surgical procedure
Typical site of service: Hospital operating room, trauma center, or emergency department with operative capability

Clinical & Coding Specifications

Clinical Context

A 34-year-old male is brought to the emergency department after a motorcycle collision with an open laceration to the right forearm and brisk arterial bleeding. Primary survey and hemorrhage control are performed in triage; the patient is hemodynamically stable after pressure dressings and IV fluid bolus. Vascular surgery is consulted for persistent bleeding suspicious for a transected radial artery. In the operating room under general anesthesia, the surgeon performs exploration of the wound and ligation of the ruptured arterial segment in the upper limb to control hemorrhage. The clinical workflow includes preoperative assessment, informed consent documenting the need for arterial ligation to control hemorrhage and preserve life/limb, operative procedure 37618 (ligation of ruptured artery, upper limb), intraoperative hemostasis confirmation, wound debridement and closure or planned delayed closure, postoperative monitoring for ischemia, neurovascular checks, and discharge planning with instructions for limb elevation, wound care, and follow-up with vascular or trauma surgery.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for `37618` (e.g., extensive debridement, difficult exposure).

CPT 37765: Ambulatory Microphlebectomy for Varicose Veins

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

CPT 37619: Inferior Vena Cava Ligation to Narrow Vessel Diameter

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

CPT 37605: Ligation of Internal or Common Carotid Artery

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

CPT 37616: Ligation of Ruptured Chest Artery (Trauma)

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

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

CPT-37761-PERFORATOR-VEIN-LIGATION-EXCISION-VARICOSE-VEINS

CPT 37761: Perforator Vein Ligation and Excision for Varicose Veins

CPT-37615-NECK-ARTERY-LIGATION-TRAUMA

CPT 37615: Ligation of Ruptured Neck Artery Due to Trauma

CPT-37660-OPEN-ABDOMINAL-LIGATION-COMMON-ILIAC-VEIN

CPT 37660: Open Abdominal Ligation of Common Iliac Vein

CPT-37718-SHORT-SAPHENOUS-VEIN-STRIPPING-VARICOSE-VEINS

CPT 37718: Short Saphenous Vein Stripping for Varicose Veins

CPT-37785-VARICOSE-VEIN-CLUSTER-EXCISION

CPT 37785: Excision of Cluster of Varicose Veins

Showing 1–10 of 22

Taxonomy Code	Specialty	Notes
207RG0400X	Vascular Surgery	Vascular surgeons commonly perform arterial ligation for traumatic arterial injuries.
208D00000X	General Surgery	Trauma/general surgeons often manage limb vascular injuries in emergent settings.
2080P0207X	Emergency Medicine	Emergency physicians perform initial hemorrhage control and coordinate operative care.
207L00000X	Orthopedic Surgery	Orthopedic trauma surgeons may perform or assist when musculoskeletal injuries coexist.
363A00000X	Plastic Surgery	Plastic/reconstructive surgeons may be involved for complex soft tissue reconstruction after ligation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S45.01XA`	Injury of radial artery, right upper limb, initial encounter	Direct arterial injury to the radial artery requiring ligation to control hemorrhage.
`S45.02XA`	Injury of ulnar artery, right upper limb, initial encounter	Ulnar artery transection presenting with active bleeding or pulsatile hematoma.
`S65.021A`	Laceration of radial artery at forearm level, right arm, initial encounter	Lacerations causing arterial bleeding that may necessitate ligation.
`S75.021A`	Laceration of femoral artery, right thigh, initial encounter	Major lower limb arterial injury where ligation may be used for hemorrhage control.
`S81.011A`	Laceration of anterior tibial artery, right lower leg, initial encounter	Lower extremity arterial injuries that may require ligation in traumatic settings.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.5 cm or less	May be performed for wound closures adjacent to arterial ligation when simple closure is appropriate.
`13102`	Complex repair of wounds of extremities, 2.6 cm to 7.5 cm	Used when wound requires layered closure or debridement in conjunction with arterial ligation.
`25000`	Incision and drainage, forearm and/or wrist	May be required if infection or deep hematoma evacuation is necessary in conjunction with vascular control.
`35701`	Repair, blood vessels, with direct anastomosis, or graft, upper extremity	Related when vessel repair or reconstruction is attempted instead of ligation; documents alternative vascular procedures.
`99024`	Postoperative follow-up visit, global surgery package	Used to report routine postoperative visits during the global period following `37618`.

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