Summary & Overview
CPT 37722: Great Saphenous Vein Stripping for Varicose Veins
CPT code 37722 represents open surgical removal (stripping) of the long saphenous vein, a procedure primarily used to treat symptomatic varicose veins. This code is clinically significant because it captures a traditional operative approach to venous insufficiency; although endovenous and minimally invasive techniques have grown, open stripping remains relevant for select patients and affects surgical billing patterns nationally. Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service captured by 37722, common settings where the procedure is performed, and the payer landscape addressed in the publication. The report outlines benchmarks for utilization and reimbursement trends where available, summarizes recent policy developments that affect coverage and coding decisions, and provides clinical context to help coding, billing, and administrative teams align documentation with the code definition. Data not available in the input is indicated where applicable, and the publication does not provide clinical recommendations for patient care.
Billing Code Overview
CPT code 37722 describes a surgical procedure for removal of the long saphenous (great saphenous) vein using incisions and a stripping device, most commonly performed to treat varicose veins. The procedure involves making surgical incisions to access the vein and extracting it with instrumentation to reduce venous reflux and symptom burden.
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Service type: Surgical venous procedure (open vein stripping)
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Typical site of service: Outpatient surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 52-year-old ambulatory female presents to a vascular surgery clinic with progressive symptomatic varicose veins of the right lower extremity characterized by aching, swelling, and cosmetic bulging despite conservative measures (compression stockings and leg elevation). Duplex ultrasound confirms reflux of the great (long) saphenous vein from the saphenofemoral junction to the mid-thigh, with incompetent perforators. After informed consent, the patient is scheduled for surgical removal of the long saphenous vein via open stripping under general or regional anesthesia. The clinical workflow includes preoperative evaluation (history, focused vascular exam, duplex ultrasound), perioperative marking of venous segments, induction of anesthesia, groin incision(s) to access the saphenous vein, insertion of a stripping device and traction to remove the vein, hemostasis, layered wound closure, and application of compression dressing and stockings. Postoperative care includes recovery monitoring, pain control, instructions for ambulation, and follow-up for wound check and duplex surveillance as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no modifier applies and the service is furnished under ordinary circumstances |
11 | Primary procedure | Use when this stripping is the primary service during the encounter |
22 | Increased procedural services | Use when work or resources substantially exceed typical expectations for 37722 |
50 | Bilateral procedure | Use when both lower extremities undergo separate vein stripping during the same operative session |
51 | Multiple procedures | Use when 37722 is performed in addition to other distinct procedures during the same operative session |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned |
53 | Discontinued procedure | Use when the procedure is terminated after anesthesia begins due to extenuating circumstances |
59 | Distinct procedural service | Use when an unrelated procedure is performed in a separate anatomic site or session and needs distinction from 37722 |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the stripping procedure |
76 | Repeat procedure by same physician (note: not in provided list) | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207K00000X | Vascular Surgery | Primary specialty performing open saphenous vein stripping |
| 207L00000X | General Surgery | General surgeons with vascular interest may perform this procedure |
| 207XS0125X | Interventional Cardiology (Peripheral Vascular) | Some peripheral vascular specialists perform venous surgery in specialized centers |
| 208600000X | Thoracic and Cardiovascular Surgery | Cardio‑vascular surgeons in some centers perform venous procedures |
| 2084P0800X | Phlebology | Physicians specializing in venous disease who may perform vein stripping when indicated |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I83.111 | Varicose veins of right lower extremity with pain | Represents symptomatic great saphenous vein reflux commonly treated with stripping |
I83.119 | Varicose veins of right lower extremity without ulcer or inflammation | Typical indication for elective stripping for symptomatic or cosmetic reasons |
I83.211 | Varicose veins of left lower extremity with inflammation | Varicosities complicated by phlebitis that may prompt definitive surgical management |
I83.90 | Varicose veins of unspecified lower extremity without complication | General coding when laterality or complication not specified; may be used in documentation |
I87.2 | Venous insufficiency (chronic) (peripheral) | Chronic venous insufficiency with reflux is the underlying pathophysiology addressed by vein stripping |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36478 | Endovenous thermal ablation of incompetent vein, radiofrequency or laser, percutaneous, including ultrasound guidance; each vein | Alternative less-invasive treatment often used instead of open stripping; may be performed in a separate session |
36482 | Endovenous chemical ablation (sclerotherapy), percutaneous, including ultrasound guidance; for truncal vein(s) | Adjunct or alternative to stripping for treatment of saphenous reflux in select patients |
36465 | Injection procedure for non–saphenous varicose veins (sclerotherapy) | Performed before or after stripping for residual tributary varicosities |
37197 | Endovascular mechanical thrombectomy, venous, with thrombolytic infusion (separate context) | May be performed in cases with acute venous thrombosis complicating varicose disease; not routine with elective stripping |
12001 | Simple repair of superficial wound, small area (example) | Minor skin repairs or incision closures performed if needed at access/incision sites |