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    OpenPayerBilling CodesLigation Procedures on Arteries and VeinsCPT cpt-37619-inferior-vena-cava-ligation-venous-surgical-procedure
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    CPT 37619: Inferior Vena Cava Ligation

    Medicare pays $1588 on average nationally for this procedure.

    CPT code 37619 describes surgical ligation of the inferior vena cava where the provider narrows the vessel diameter by tying it off with sutures or applying a clip; this is a vascular surgical procedure typically performed in an operating room or surgical suite as an open or exposed vascular intervention to control venous flow or treat vascular pathology.

    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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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 58-year-old with chronic venous insufficiency and recurrent, symptomatic deep venous thrombosis (DVT) of the lower extremity leading to significant venous stasis and risk of pulmonary embolism despite medical therapy. After vascular surgery evaluation, the team decides to perform inferior vena cava (IVC) narrowing (ligature or clip) to reduce caval diameter and improve venous outflow dynamics or to trap emboli when IVC filter placement is contraindicated or not feasible. The procedure is performed in an operating room or hybrid endovascular suite under general or monitored anesthesia care. The vascular surgeon exposes the infrarenal IVC via a transabdominal or retroperitoneal approach, encircles the cava, and places sutures or clips to achieve narrowing; intraoperative fluoroscopy or ultrasound may be used for localization. Typical workflow includes preoperative imaging (CT venography or duplex ultrasound), perioperative anticoagulation management, informed consent documenting risks (bleeding, infection, caval thrombosis), anesthesia induction, surgical exposure and narrowing, hemostasis, and postoperative monitoring in a recovery unit with early ambulation and anticoagulation plan.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37619Ligation or narrowing of inferior vena cava (tie off to narrow diameter with sutures or clip)Primary procedure for surgical narrowing of the IVC.
    37718Venous thrombectomy, inferior vena cava (includes control of bleeding)May be performed before or during IVC narrowing when thrombus removal is required.
    36445Venous catheterization, inferior vena cava, insertion of permanent inferior vena cava filterAlternative or adjunctive therapy to IVC narrowing for embolic protection; may be performed in hybrid workflows.
    37250Transcatheter placement of intravascular stent(s), percutaneous; venous stent placementMay be performed before or after operative narrowing if venous stenting is indicated for outflow lesions.
    32551Repair of diaphragm, transabdominal approach (if required)Occasionally performed when extended exposure is required; included when adjacent structures are addressed.
    99100Anesthesia for patient of extreme age, or under special circumstances (if applicable)Used for anesthesia complexity reporting when applicable; anesthesia billing per payer rules.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    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…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    207RG0100X
    207T00000X
    208600000X
    207L00000X
    2086S0120X
    2255R0406X
    275N00000X

    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-37607-ARTERIOVENOUS-FISTULA-LIGATION

    CPT 37607: Ligation of Artificial Arteriovenous Fistula

    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

    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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