2025 CPT code 37233
(Active) Effective Date: N/A Surgery - Cardiovascular System Surgery Feed
Revascularization of each additional unilateral tibial or peroneal artery with atherectomy, including angioplasty when performed within the same vessel during the procedure. This is an add-on code to be used in conjunction with primary procedure codes.
Modifiers may be applicable to indicate laterality, anatomical distinctions, or specific circumstances of the procedure. Refer to current CPT coding guidelines for modifier usage.
Medical necessity must be supported by documentation of inadequate blood flow to the limb due to arterial stenosis or occlusion, resulting in claudication, rest pain, or tissue loss. Diagnostic studies, such as angiography or Doppler ultrasound, should confirm the diagnosis and location of the blockage.The additional intervention must be justified by the presence of significant disease in another vessel that warrants intervention during the same session.
The physician performs the revascularization procedure, including atherectomy and possible angioplasty, on the additional tibial or peroneal artery.This may involve open or percutaneous access, use of catheters, guidewires, balloons, and atherectomy devices under radiological guidance. The physician is responsible for ensuring vessel patency and controlling bleeding.
In simple words: This additional procedure restores blood flow in leg arteries (tibial or peroneal) using a minimally invasive technique or open surgery.It involves removing blockage and may include widening the artery with a balloon. It is always performed after a similar procedure on another artery in the same leg.
This add-on procedure describes restoring blood supply in each additional unilateral tibial or peroneal artery through endovascular, open, or percutaneous approach, after performing the same procedure in an initial vessel.Atherectomy is used to remove plaque from the blood vessel.Angioplasty is included if performed within the same vessel during the procedure.
Example 1: A patient presents with severe peripheral artery disease affecting multiple vessels in the leg. The physician performs revascularization with atherectomy on the anterior tibial artery (37229) and then performs the same procedure on the posterior tibial artery (37233)., A patient undergoes revascularization with stent placement in the peroneal artery (37230). An additional atherectomy is required in the anterior tibial artery during the same session. 37233 is used in addition to 37230 to report the additional atherectomy., During an open bypass procedure, the surgeon performs revascularization with stent placement and atherectomy on the posterior tibial artery (37231).An additional atherectomy is needed on the peroneal artery.37233 is reported in addition to 37231 for this additional procedure.
Documentation should include details of the primary procedure, the reason for the additional revascularization, the specific vessel(s) treated, the method of access (open or percutaneous), devices used, and the outcome of the procedure. Operative reports, angiographic findings, and pre- and post-procedure notes are essential.
- Revenue Code: P2F - Major Procedure, Cardiovascular - Other
- Specialties:Interventional Radiology, Vascular Surgery, Cardiology
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient