Summary & Overview
CPT 37700: Ligation and Division of Long Saphenous Vein for Varicose Veins
CPT code 37700 represents an open surgical procedure to ligate and divide the long (great) saphenous vein at its junction with the femoral vein, commonly used to treat varicose veins and symptomatic venous reflux. This procedure remains a relevant treatment option in vascular and general surgery, particularly for patients with extensive superficial venous disease or anatomical considerations that favor an open approach. Nationally, understanding coding and coverage for 37700 is important for surgical billing, payer policy alignment, and tracking utilization of operative venous interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and typical settings for 37700, common billing considerations, and how payers commonly handle surgical venous procedures. The publication summarizes benchmarks where available and highlights recent policy and coding clarifications relevant to operative management of varicose veins. Clinicians, billing professionals, and policy analysts will gain clarity on the procedure’s clinical context, typical site-of-service patterns, and payer coverage landscape at a national level. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 37700 describes surgical ligation and division of the long saphenous (great saphenous) vein at its junction with the femoral vein, with multiple incisions over the affected thigh and along the vein as needed. The procedure is most commonly performed to treat varicose veins by interrupting reflux in the long saphenous system.
Service type: Open surgical venous procedure for treatment of venous insufficiency/varicosities.
Typical site of service: Operating room or ambulatory surgery center, frequently performed under regional or general anesthesia with multiple thigh incisions.
Clinical & Coding Specifications
Clinical Context
A 52-year-old ambulatory female presents with symptomatic varicose veins of the right lower extremity with pain, swelling, and cosmetic concern. After duplex ultrasound mapping demonstrating reflux of the great saphenous (long saphenous) vein with incompetent saphenofemoral junction and tributary varices, the vascular surgeon schedules an inpatient/ambulatory surgical procedure: high ligation and stripping of the great saphenous vein. The typical clinical workflow includes preoperative evaluation (history, physical exam, medication reconciliation), informed consent, preoperative marking of the vein distribution, duplex confirmation in the holding area, administration of regional or general anesthesia in the operating room, multiple small incisions over the thigh and along the long saphenous vein, ligation and division of the saphenous vein at the saphenofemoral junction and along the upper leg as needed, removal (stripping) of the diseased segment, hemostasis, wound closure, and postoperative recovery with instructions for compression therapy and activity modification. Typical site of service is the hospital outpatient surgery department or ambulatory surgical center; some cases occur in an inpatient setting for complex disease or comorbid patients. The service type is surgical — open vascular procedure for varicose veins (37700).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |