Summary & Overview

CPT 0238T: Iliac Artery Plaque Removal and Revascularization

CPT code 0238T describes surgical restoration of blood flow in a narrowed or occluded iliac artery by removing deposited plaque via open or percutaneous techniques. Nationally, this code represents advanced vascular revascularization procedures used to treat peripheral arterial disease affecting the iliac segment, with implications for hospital resource use, surgical specialty billing, and procedural coding consistency.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical intent and sites of service for the procedure, common billing modifiers, and the typical service line context. The publication summarizes benchmark considerations and coding practice issues relevant to hospitals and vascular surgery groups, and highlights areas where policy updates or payer-specific coverage rules can affect claim processing.

This summary provides clinicians, coding professionals, and policy analysts with a concise reference for the code's clinical scope, expected care settings, and the payer landscape addressed. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 0238Tiliac arteryvascular surgeryrevascularizationendovascularpercutaneoushospital billingperipheral arterial disease

Billing Code Overview

CPT code 0238T describes a procedure to restore blood flow in a narrowed or blocked segment or branch of the iliac artery by removing deposited plaque through an open or percutaneous approach. This is a vascular surgical procedure addressing iliac artery occlusive disease.

Service type: Vascular plaque removal / iliac artery revascularization
Typical site of service: Hospital operating room or endovascular/interventional suite (inpatient or outpatient) depending on patient condition and approach

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old male with progressive left-sided claudication and diminished distal pulses. Noninvasive testing (ankle-brachial index and duplex ultrasound) demonstrates hemodynamically significant stenosis of the left common iliac artery. The vascular surgery team schedules endarterectomy or percutaneous transluminal intervention to restore blood flow. Pre-procedure workflow includes focused history and physical, review of prior imaging (CTA or MRA of the pelvis), assessment of anticoagulation and contrast allergy, and informed consent documenting risks (bleeding, infection, embolization, vessel injury). In the operating room or angiography suite, the provider performs percutaneous or open access, confirms the lesion with angiography, and proceeds with plaque removal (open endarterectomy or directional/aspiration thrombectomy and adjunctive balloon angioplasty/stent placement as indicated). Post-procedure workflow includes hemostasis management, limb perfusion assessment, monitoring for access site complications, antiplatelet/anticoagulation management, and discharge planning with follow-up vascular laboratory testing.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default billing	Used when no additional modifier applies and standard reimbursement is appropriate.

| 22 | Increased procedural services | When work or complexity substantially exceeds typical expectations (document justification and time/effort).

Taxonomy Code	Specialty	Notes
207P00000X	Vascular Surgery	Primary specialty performing open iliac endarterectomy and complex peripheral interventions.

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Common underlying etiology for iliac artery plaque causing claudication or ischemia.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0238T`	Restoration of blood supply in narrowed or blocked portion or branch of the iliac artery; removal of deposited plaque through open or percutaneous approach	Primary procedure restoring iliac artery blood flow via plaque removal.

| 37220 | Revascularization, endovascular, open or percutaneous, iliac artery, initial vessel; with transluminal angioplasty | Often performed in conjunction when angioplasty is required after plaque removal or when percutaneous approaches are used.

| 37221 | Revascularization, endovascular, open or percutaneous, iliac artery, initial vessel; with stent placement | Used when stent deployment is indicated after plaque removal to maintain vessel patency.

| 35476 | Thrombectomy of iliac artery by catheter; with distal embolic protection | May be used when catheter-based thrombectomy is performed for occlusive thrombus in the iliac segment.

| 35831 | Endarterectomy, other than carotid, including patch graft, if performed; iliac/femoral region | Used for open surgical endarterectomy with patching in the iliac/femoral territory when coded separately per payer rules.

| 76000 | Fluoroscopic guidance for vascular procedures | Imaging guidance commonly reported by facility or physician when separate reporting is allowed.

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