2025 CPT code 36227
(Active) Effective Date: N/A Surgical Procedures on the Cardiovascular System - Cardiovascular System Surgery Feed
Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation. (List separately in addition to code for primary procedure)
Modifiers such as 50 (Bilateral Procedure), 52 (Reduced Services), 53 (Discontinued Procedure), 76, 77, etc may be used when applicable.
Medical necessity for this procedure must be established by documenting the clinical indication for the angiography of the external carotid circulation in addition to the primary procedure. This may include but is not limited to, evaluation of vascular abnormalities, tumors, or traumatic injuries in the head and neck region.
The physician performing the procedure is responsible for the appropriate patient preparation, including anesthesia, gaining arterial access for catheter insertion and advancement, performing the angiography under imaging guidance, managing any complications, and ensuring proper post-procedural care, including pressure application for hemostasis. The physician also provides the radiological supervision and interpretation associated with this procedure.
In simple words: This procedure involves placing a thin tube (catheter) into an artery in your neck that supplies blood to your face and neck (external carotid artery). A special dye is then injected, and X-ray images are taken to visualize the blood vessels in this area. This procedure is performed in addition to another imaging procedure of the blood vessels in your head and neck.
This add-on code describes a selective catheter placement in the external carotid artery, along with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation. It is used in addition to the primary procedure code, such as 36222, 36223, or 36224, when performed during the same session.
Example 1: A patient presents with symptoms suggesting a blockage in the external carotid artery. A diagnostic angiogram of the head and neck is performed (36223), and a selective catheterization and angiography of the external carotid artery (36227) are performed during the same session to further evaluate the suspected blockage., A patient is undergoing treatment for a tumor in the head and neck. During a common carotid artery angiography (36222), the physician also performs a selective catheterization and angiography of the external carotid artery (36227) to assess blood supply to the tumor before embolization., A patient with a head injury requires a diagnostic angiogram of the intracranial carotid circulation (36224). To obtain a comprehensive view of the head and neck vessels, a selective catheterization and angiography of the external carotid artery (36227) are also performed during the same session.
Documentation should include details of the primary procedure, the reason for the selective catheterization of the external carotid artery, the method of angiography used, the findings of the imaging, and any associated complications.
** This code specifically addresses selective catheter placement and angiography of the external carotid artery and should not be used for other branches of the carotid system. Ensure proper documentation of the primary procedure and the specific need for the external carotid angiography to support medical necessity.
- Revenue Code: P2F
- Payment Status: Active
- Modifier TC rule: Modifier TC is applicable when only the technical component of the procedure was performed.
- Specialties:Interventional Radiology, Neurosurgery, Vascular Surgery, Diagnostic Radiology, Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center