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CMS 2020 Final Rule Allowed Amounts Released - Vein Procedures

VEIN BILLING CMS Fee Schedules

CMS released its 2020 Physician Fee Schedule Final Rule, and it reflects the reductions in vein procedure allowed amounts that were announced in 2019, which will continue through 2022.

Below is a comparison of the 2019 to 2020 national average allowed amounts for office-based (non-facility) common vein procedures.

CMS announced in 2019 that decreases will continue through 2022 for 1st Vein procedures to adjust to the decreases in Practice Expense (PE) RVUs based on CMS research evidence of declining device prices.  However, Phlebectomy was cut not just for PE RVUs, but also Work RVUs and Malpractice RVUs, hence the much more severe impact. 

 

CMS National Average
Allowed Amount
CPT Procedure 2019 2020 % Change
36465 Varithena Single Vein $ 1,572.75 $ 1,550.05 -1.44%
36466 Varithena Multi Vein $ 1,653.11 $ 1,719.67 4.03%
36470 Sclerotherapy Single Vein $ 108.84 $ 111.88 2.79%
36471 Sclerotherapy Multi Vein $ 197.13 $ 201.74 2.34%
36473 ClariVein 1st Vein $ 1,492.02 $ 1,458.38 -2.25%
36474 ClariVein add on $ 283.63 $ 297.02 4.72%
36475 RF Ablation 1st Vein $ 1,463.19 $ 1,404.97 -3.98%
36476 RF Ablation add on $ 308.13 $ 317.95 3.19%
36478 Laser Ablation 1st Vein $ 1,156.86 $ 1,092.07 -5.60%
36479 Laser Ablation add on $ 325.43 $ 334.91 2.91%
36482 VenaSeal 1st Vein $ 2,089.91 $ 1,949.92 -6.70%
36483 VenaSeal add on $ 153.53 $ 160.60 4.61%
37765 Phlebectomy 10-20 $ 667.44 $ 457.62 -31.44%
37766 Phlebectomy > 20 $ 793.58 $ 534.85 -32.60%

If you have any questions, please contact your StreamlineMD client representative.