Varicose Vein Procedures in Medicare: New York vs the US, 2019 to 2024

We counted procedures that close a faulty (refluxing) vein from the inside: radiofrequency or laser ablation, medical adhesive closure, mechanochemical ablation, and injected foam. Wellpoint Federal, Medicare’s contractor for New York, lists all of these billing codes in its varicose vein billing article (A52870). Spider vein injections are not included.

How many procedures, and how fast they grew

New York’s count rose from 15,100 in 2019 to 19,131 in 2024. Over the same years, the number of New Yorkers in Original Medicare Part B fell from 1,767,193 to 1,534,407 (person-years), while enrollment in Medicare Advantage and other plans grew from 1,511,057 to 2,041,281. Measured per enrollee, the rate rose 46.0% in New York and 31.9% nationally. Both dipped in 2020, the first year of the COVID-19 pandemic.

Vein closure procedures paid by Original Medicare (first vein or foam session), by where the clinician practices. Per 10,000 Original Medicare Part B enrollees (person-years).

Among the 50 states, New York had the 10th highest rate in 2024. The highest was Arizona, at 260.4 per 10,000.

Where: almost all in the office

In 2024, 97.3% of New York’s procedures were billed as office (non-facility) services, up from 94.9% in 2019. Nationally the office share was 95.0%. The rest were billed from a facility, such as a hospital outpatient department or a surgery center; the facility’s own payment is separate and is not in this data.

Which methods: foam up, laser down

Foam injections in New York rose from 3,425 in 2019 to 10,177 in 2024, and now make up 53.2% of the state’s procedures (41.6% nationally). Laser ablation fell 60.4% in New York and 45.8% nationally. Radiofrequency ablation grew in New York, from 3,866 to 4,759, while it fell nationally, from 104,778 to 86,009.

Procedures by method (share of all procedures in that place and year).

What Medicare pays

In 2024, Original Medicare paid New York clinicians $20.8 million for these procedures, including the extra-vein add-on codes, in all settings ($280.3 million nationally). For radiofrequency ablation of the first vein in the office, the average Medicare payment was $918.68 in New York and $823.52 nationally. These amounts are what Medicare paid after the patient’s deductible and coinsurance.

Office (non-facility) services by billing code, 2024. Clinicians: New York clinicians who billed the code in the office. Avg payment: average Medicare payment per service in the office.

Who is in this data

These figures cover Original Medicare (fee-for-service) only. In 2024, 52.1% of New York’s Medicare enrollees were in Medicare Advantage or other health plans, and their procedures are not in this data, nor are procedures paid by private insurance or Medicaid.

What this means if you have varicose veins

• Medicare’s New York policy (LCD L33575) treats these procedures as medically necessary when a patient “remains symptomatic after a six-week trial of conservative therapy and has reflux in a saphenous vein.” Conservative therapy includes graduated compression stockings, leg elevation, exercise and weight reduction.
• The policy describes spider veins as “most often treated for cosmetic purposes”; their treatment is not counted here.
• Most of these procedures in New York are billed as office procedures. If you are offered one, you can ask where it will be done and what your plan will pay.
• These numbers show how often each method is billed. They do not show which method suits a given patient; that is a decision for you and your doctor.
• Our guide Is varicose vein treatment covered by insurance? explains coverage requirements, and varicose vein treatment at Fox Vein Care describes what we offer.

How we built this study

• Procedures: services billed under the first-vein or per-session codes for radiofrequency ablation (36475), laser ablation (36478), medical adhesive closure (36482), mechanochemical ablation (36473) and foam injection (36465 and 36466). Add-on codes for extra veins in the same session (36474, 36476, 36479, 36483) appear in the payment table but are not counted as procedures.
• Counts, providers and payments: CMS Medicare Physician & Other Practitioners by Geography and Service, data years 2019 to 2024, by the state where the clinician practices, with office (non-facility) and facility settings.
• Rates: procedures per 10,000 Original Medicare Part B enrollees in the same state and year, from CMS Medicare Monthly Enrollment (person-year counts). The state ranking covers the 50 states; the District of Columbia and territories are left out.
• CMS leaves out any row based on 10 or fewer patients. 45 of the 240 rows we used are missing for that reason, all small; we count them as zero, so totals are minimums.
• An independent check downloads CMS’s full bulk files for every year (not the API used to build the page) and recomputes every figure here. Every figure matched.

Limits

• Original Medicare only: Medicare Advantage, private insurance and Medicaid patients are not included.
• Place is where the clinician practices, not where the patient lives; clinicians in New York may treat patients who live in other states, and the reverse.
• The billing codes cover veins in an arm or a leg; the data does not separate them.
• Counts are services billed and paid, not patients, and they say nothing about results.
• Payments are the clinician’s Medicare payment only; facility fees and the patient’s share are not included.

Sources

• CMS, Medicare Physician & Other Practitioners by Geography and Service, data years 2019 to 2024.
• CMS, Medicare Monthly Enrollment, annual person-year counts, 2019 to 2024.
• CMS Medicare Coverage Database, LCD L33575: Varicose Veins of the Lower Extremity, Treatment of (Wellpoint Federal), and billing article A52870.
• Federal Register, CY 2027 Physician Fee Schedule final rule, published November 9, 2026.

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