2025 CPT code 37226

Revascularization of a unilateral femoral or popliteal artery using an endovascular, open, or percutaneous approach with transluminal stent placement; includes angioplasty if performed.

Follow current CPT coding guidelines for vascular procedures.Ensure that all components of the procedure are accurately coded.If other procedures such as intravascular ultrasound (IVUS) are done, they should be coded appropriately (C7535).

Modifiers may be applied (e.g., 59 for distinct procedural service, 51 for multiple procedures performed on the same day, -22 for increased procedural services if significant additional work is performed) depending on the circumstances.

Medical necessity is established by the presence of clinically significant symptoms related to arterial stenosis or occlusion, such as claudication, rest pain, or critical limb ischemia.Appropriate documentation supporting the need for revascularization is required, including imaging evidence of the disease and its impact on the patient’s quality of life.

The physician is responsible for accessing the artery (open or percutaneous approach), advancing the catheter and stent system, deploying the stent, confirming placement (potentially using an angioscope), achieving hemostasis (controlling bleeding), and monitoring the patient's condition.

IMPORTANT 37224 (angioplasty only), 37225 (atherectomy + angioplasty), 37227 (stent placement + atherectomy + angioplasty).HCPCS code C7535 may be used if intravascular ultrasound is also performed.

In simple words: This procedure fixes a blocked or narrowed artery in one leg. A tiny tube with a stent (a small mesh tube) is inserted to open the artery and restore blood flow.If a balloon is used to widen the artery (angioplasty), that's included in this code.

This code encompasses the revascularization of a single femoral or popliteal artery in one leg.The procedure involves restoring blood flow to a narrowed or blocked artery using an endovascular, open, or percutaneous approach. This includes transluminal stent placement to widen the artery.Angioplasty is included in the code if performed within the same vessel.

Example 1: A 70-year-old male presents with critical limb ischemia due to severe stenosis of the left superficial femoral artery.The physician performs an open surgical approach, inserts a stent to revascularize the artery, and performs angioplasty as needed.Code 37226 is used., A 65-year-old female with intermittent claudication due to stenosis in the right popliteal artery undergoes a percutaneous transluminal intervention with stent placement.Angioplasty is not necessary. Code 37226 is appropriate., A 55-year-old male with acute limb ischemia caused by total occlusion of the left common femoral artery and superficial femoral artery receives a stent placement with angioplasty.Only one code 37226 is billed because the two arteries are part of the same vascular family.Use of code 36218 or 36248 is not required in this case.

Detailed history and physical exam, including documentation of symptoms (e.g., claudication, rest pain, ulceration), non-invasive vascular studies (e.g., ABI, segmental pressures, duplex ultrasound), angiographic images demonstrating the stenosis or occlusion, and a description of the stent type and placement.Surgical notes and operative report with details of the approach (open or percutaneous), and any associated angioplasty should be available. Post-operative notes showing patient status should also be recorded.

** This code is for unilateral procedures only.For bilateral procedures, the code should be billed once per side.Remember to consult with your payer's specific guidelines for pre-authorization, medical necessity, and coding requirements.

  • Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
  • RVU: The RVUs vary based on the year and place of service (facility vs. office).Refer to the AMA CPT codebook or other payer-specific fee schedules for the most up-to-date information. Data from 2021 suggests RVUs between 10.24-15.13 (work RVU) andtotal RVUs around 15.13.
  • Global Days : Global period information is not explicitly provided for this code, but it's likely subject to the usual post-operative global surgical period guidelines which vary depending on payer.
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Fee Schedule : Fee schedules vary significantly by payer and year. Data from 2021 estimates around $9,969 (national average payment). Refer to historical CPT manuals or payer-specific fee schedules.
  • Specialties:Vascular Surgery, Interventional Cardiology, Radiology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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