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Official Description

Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 37722 involves the surgical ligation, division, and stripping of the long saphenous vein, which is a major vein running along the length of the leg. This procedure is typically performed to treat conditions related to venous insufficiency or varicose veins. The long saphenous vein is accessed through an incision made in the groin crease, allowing the surgeon to expose the vein and its tributaries. The tributaries are carefully dissected and ligated to prevent bleeding during the procedure. The saphenofemoral junction, where the long saphenous vein meets the femoral vein, is also exposed, and the long saphenous vein is ligated and divided at this junction. A second incision is made at or just below the knee to facilitate the stripping of the vein. The stripping technique involves inserting a specialized tool, known as a stripper, into the vein to remove it from the body. This procedure is essential for alleviating symptoms associated with venous disorders and improving overall venous circulation in the lower extremities.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Indications for the procedure described by CPT® Code 37722 include the following:

  • Varicose Veins - The presence of enlarged, twisted veins that can cause discomfort, pain, or cosmetic concerns.
  • Chronic Venous Insufficiency - A condition where the veins cannot pump enough blood back to the heart, leading to swelling, pain, and skin changes.
  • Venous Ulcers - Open sores that occur due to poor blood flow in the veins, often requiring surgical intervention to improve healing.
  • Superficial Thrombophlebitis - Inflammation of a vein caused by a blood clot, which may necessitate removal of the affected vein.

2. Procedure

The procedure for CPT® Code 37722 involves several detailed steps to ensure the effective removal of the long saphenous vein:

  • Step 1: Incision in the Groin - The surgeon begins by making an incision in the groin crease to access the long saphenous vein and its tributaries. This incision allows for direct visualization and manipulation of the vein.
  • Step 2: Exposure and Ligation of Tributaries - Once the vein is exposed, the surgeon carefully dissects the tributaries of the long saphenous vein. Each tributary is then suture ligated to prevent bleeding during the procedure.
  • Step 3: Ligation and Division at the Saphenofemoral Junction - The saphenofemoral junction is identified, and the long saphenous vein is ligated and divided flush with the femoral vein. This step is crucial to ensure that the vein is completely disconnected from the venous system.
  • Step 4: Second Incision Below the Knee - A second incision is made at or just below the knee to facilitate the stripping of the long saphenous vein. This incision provides access to the distal portion of the vein.
  • Step 5: Stripping of the Long Saphenous Vein - The surgeon employs a stripping technique, where a specialized tool called a stripper is inserted into the vein. The stripper is advanced to the saphenofemoral junction, and the vein is then pulled out through the calf incision, effectively removing it from the body.

3. Post-Procedure

Post-procedure care for patients undergoing the ligation, division, and stripping of the long saphenous vein includes monitoring for any signs of complications such as bleeding, infection, or deep vein thrombosis. Patients are typically advised to rest and elevate the affected leg to reduce swelling. Compression stockings may be recommended to support venous return and minimize discomfort. Follow-up appointments are essential to assess the surgical site and ensure proper healing. Patients should also be educated on signs of complications that may require immediate medical attention.

Short Descr LIG DIV&STRPG LONG SAPH VEIN
Medium Descr LIG DIV&STRPG LONG SAPH SAPHFEM JUNCT KNE/BELW
Long Descr Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 53 - Varicose vein stripping, lower limb
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2013-01-01 Changed Medium Descriptor changed.
2006-01-01 Added First appearance in code book in 2006.
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