CPT 0236T Aortic Plaque Removal Reimbursement | OpenPayer

Summary & Overview

CPT 0236T: Aortic Plaque Removal, Open or Percutaneous

CPT code 0236T designates a vascular procedure to restore blood flow in a narrowed or blocked abdominal aorta by removing deposited plaque via open or percutaneous techniques. This code is relevant nationally for vascular surgery, interventional radiology, and hospital reimbursement because it captures a complex, potentially high-resource intervention for aorto-occlusive disease.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, site-of-service considerations, and typical use cases for the code. The publication provides benchmarks where available, summarizes policy considerations that affect coverage and payment, and outlines coding context for hospital and procedural billing workflows.

This summary is intended to clarify what the code represents, how it is used across inpatient and procedural settings, and what stakeholders should know about its clinical purpose and administrative implications. Data not available in the input is noted where relevant in detailed sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 0236Taortic plaque removalvascular surgeryendovascular procedureshospital billinginterventional radiology

Billing Code Overview

CPT code 0236T describes a vascular procedure to restore blood flow in a narrowed or blocked abdominal aorta by removing deposited plaque. The procedure can be performed via an open surgical approach or a percutaneous (catheter-based) technique.

Service type: Vascular aortic plaque removal (open or percutaneous aortic endarterectomy/thrombectomy)
Typical site of service: Hospital operating room or interventional suite; may also occur in an inpatient or outpatient hospital setting depending on clinical complexity and site capabilities.

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with progressive exertional leg pain, diminished femoral pulses, and an ankle-brachial index of 0.6 presents after noninvasive vascular testing (ABI, duplex ultrasound, and CTA) demonstrating atherosclerotic occlusive disease with a hemodynamically significant stenosis of the infrarenal abdominal aorta. The vascular surgery team evaluates the patient in the outpatient clinic and determines that revascularization is indicated to restore distal perfusion and relieve symptoms. Preoperative workup includes cardiopulmonary risk assessment, medication optimization (antiplatelet and statin therapy), and informed consent discussing open versus percutaneous options.

In the operating suite or hybrid endovascular suite, the provider performs an aortic endarterectomy or percutaneous transluminal angioplasty with mechanical plaque debulking as indicated by anatomy and surgical judgment. The primary goal is removal of atherosclerotic plaque from the narrowed or occluded abdominal aorta to restore luminal diameter and improve downstream blood flow. Typical intraoperative workflow includes vascular access (open femoral exposure or percutaneous access), arteriography for lesion localization, plaque removal or atherectomy, adjunctive balloon angioplasty, and selective stent placement if required. Post-procedure care involves hemodynamic monitoring, limb perfusion checks, anticoagulation or antiplatelet management, and outpatient follow-up with duplex surveillance.

Coding Specifications

Modifier	Description	When to Use
`22`

CPT 0238T: Iliac Artery Plaque Removal and Revascularization

CPT-0237T-BRACHIOCEPHALIC-TRUNK-PLAQUE-REMOVAL

CPT 0237T: Brachiocephalic Trunk Plaque Removal, Open or Percutaneous

CPT-0235T-VISCERAL-ARTERY-PLAQUE-REMOVAL

CPT 0235T: Visceral Artery Plaque Removal

CPT-0234T-RENAL-ARTERY-REVASCULARIZATION-PLAQUE-REMOVAL

CPT 0234T: Renal Artery Revascularization with Plaque Removal

Taxonomy Code	Specialty	Notes
207K00000X	Vascular Surgery	Primary specialty performing open and endovascular aortic procedures.
207RH0000X	Interventional Cardiology	Performs endovascular interventions when involved in complex aortic or peripheral interventions.
207RP2900X	Interventional Radiology	Performs percutaneous plaque removal, angioplasty, and stenting under imaging guidance.
2080P0001X	General Surgery	May perform open aortic endarterectomy in surgical practice settings.
2084P0800X	Thoracic and Cardiovascular Surgery	In centers where thoracic/cardiovascular teams manage complex aortic disease.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Reflects peripheral atherosclerotic disease often extending to the abdominal aorta requiring plaque removal.
`I70.0`	Atherosclerosis of aorta	Directly describes aortic atherosclerotic disease targeted by this procedure.
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Acute embolic/thrombotic events may prompt urgent plaque removal or embolectomy.
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	Included when thrombotic complications of arterial disease affect postoperative management (secondary relevance).
`I73.9`	Peripheral vascular disease, unspecified	Common presenting diagnosis leading to evaluation and revascularization including aortic interventions.
`R02`	Gangrene, not elsewhere classified	Severe ischemia or tissue loss from critical limb ischemia that may lead to revascularization efforts at the aortic level.
`E78.5`	Hyperlipidemia, unspecified	A common comorbidity contributing to atherosclerosis and treatment planning.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Common comorbidity influencing perioperative risk assessment and management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0236T`	Removal of plaque from abdominal aorta; open or percutaneous approach (restores blood supply to narrowed or blocked abdominal aorta)	Primary procedure for aortic plaque removal and revascularization.
`37220`	Revascularization, endovascular, open or percutaneous, abdominal, iliac, femoral, or popliteal; percutaneous transluminal angioplasty	Often performed adjunctively for downstream iliac or femoral lesions either before or after aortic plaque removal.
`37225`	Revascularization, endovascular, open or percutaneous, placement of stent(s), initial vessel	Stent placement may follow plaque removal/angioplasty to scaffold residual stenosis.
`34701`	Thromboendarterectomy, iliofemoral (including patch graft, when performed)	Related open procedures on distal vessels that may be combined with aortic endarterectomy for extensive disease.
`35831`	Endarterectomy, abdominal aorta, with patch graft, with or without graft; for occlusive disease	Open surgical alternative or complement to `0236T` when extensive disease requires formal aortic endarterectomy/patching.
`76000`	Fluoroscopic guidance for vascular procedures (radiological supervision and interpretation)	Imaging support commonly used intraoperatively for lesion localization and device deployment.

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