2025 CPT code 37229
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Revascularization of the tibial or peroneal artery with atherectomy, including angioplasty within the same vessel, when performed, on the initial vessel.
Modifiers may be applicable to this code. For example, modifier 50 would be used for a bilateral procedure and modifier 78 could be used for the unplanned return to the operating room by the same physician following the initial procedure for a related procedure during the postoperative period. Consult modifier guidelines for appropriate usage.
Medical necessity for this procedure must be established by documenting the patient's symptoms, such as claudication (leg pain with exertion), rest pain, or tissue loss. Diagnostic studies showing significant blockage in the tibial or peroneal artery, such as angiography or duplex ultrasound, are also required.
The physician restores blood supply to a blocked tibial or peroneal artery in the leg. This can be done through a small incision (percutaneous), a larger incision (open), or from inside the blood vessel (endovascular).The procedure includes removing the blockage (atherectomy) and may also involve widening the artery with a balloon (angioplasty).
In simple words: This procedure restores blood flow in a leg artery (tibial or peroneal) using a minimally invasive or open technique. It involves removing plaque buildup from the artery and may also include widening the artery with a balloon.
Endovascular, open or percutaneous revascularization of the tibial or peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed.
Example 1: A patient presents with severe leg pain due to a blocked tibial artery. The physician performs an atherectomy to remove the blockage and then performs angioplasty to widen the artery, restoring blood flow., A patient with peripheral artery disease has a blockage in the peroneal artery. The physician performs an open atherectomy to remove the plaque, restoring blood flow to the lower leg., A patient has a blockage in both the tibial and peroneal arteries of one leg. The physician performs an endovascular atherectomy on the initial vessel and uses other codes such as +37233 to denote the work in additional vessels.
Documentation should include details of the procedure, including the approach used (endovascular, open, or percutaneous), the specific artery treated (tibial or peroneal), the methods used (atherectomy, angioplasty), and the location of the blockage. Pre- and post-procedure angiograms are crucial, and the medical necessity for the procedure should be clearly documented.
- Revenue Code: P2F - MAJOR PROCEDURE, CARDIOVASCULAR - OTHER
- Payment Status: Active
- Specialties:Vascular Surgery, Interventional Radiology, Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center