Summary & Overview
CPT 37650: Femoral Vein Ligation for Varicose Vein
CPT code 37650 identifies femoral vein ligation via an incision in the upper thigh, typically performed to address varicose veins and abnormal venous reflux. Nationally, this code represents a focused surgical intervention within venous disease care pathways and has implications for outpatient surgical utilization, resource allocation, and clinical coding consistency.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements for venous procedures can vary across these payers, affecting access and site-of-service decisions.
Readers will find: a concise clinical context for the procedure; payer coverage landscape and common billing considerations; and benchmarks where available. The publication also outlines typical settings for service delivery (outpatient surgical suite or hospital operating room) and highlights coding clarity to support accurate claims submission. Data not provided in the input (such as associated taxonomies, specific ICD-10 pairings, and payer-specific reimbursement rates) are noted as unavailable.
Billing Code Overview
CPT code 37650 describes a surgical procedure in which a provider makes an incision in the upper leg to access the femoral vein and ligates it with a suture or clip. This procedure is most commonly performed to treat a varicose vein by interrupting blood flow in a pathologic superficial or perforator vein that communicates with the femoral vein.
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Service type: Surgical venous ligation/venous procedure
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Typical site of service: Outpatient surgical suite or hospital operating room for a procedure on the upper thigh/femoral region
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Clinical & Coding Specifications
Clinical Context
A 58-year-old ambulatory female with symptomatic varicose veins of the right thigh presents to the vascular surgery clinic after conservative measures (compression therapy and leg elevation) failed to control aching, swelling, and recurrent superficial thrombophlebitis. Duplex ultrasound demonstrates reflux in the great saphenous vein with tributary varicosities and an incompetent saphenofemoral junction. The surgeon schedules an outpatient open ligation of the femoral/saphenous junction under regional or general anesthesia.
Preoperative workflow includes history and physical, focused venous duplex imaging, pre-op labs as indicated, informed consent documenting risks (bleeding, infection, nerve injury), and marking of the operative site. In the operating room, the patient is positioned supine; the groin/upper thigh is prepped and draped. A transverse incision is made to expose the femoral vein and saphenous junction; the incompetent saphenous vein is ligated at the junction using suture or clips. Hemostasis is achieved, wound closed in layers, and a dressing and compression applied. Postoperative workflow includes recovery room monitoring, discharge with instructions for compression stockings, activity restrictions, and wound care, with follow-up venous care arranged.
Typical site of service: Outpatient ambulatory surgery center or hospital outpatient department. Service type: Surgical procedure — open femoral/saphenous vein ligation (varicose vein surgery).
Coding Specifications
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