Summary & Overview

CPT 0505T: Femoral–Popliteal Endovascular Stent Placement via Transvenous Access

CPT code 0505T represents an endovascular femoral–popliteal stent placement performed via a catheter introduced through a venous access site, with comprehensive intraprocedural imaging, mapping and radiological supervision and interpretation. The code captures a specialized technique used to treat peripheral arterial disease, severe limb ischemia, or disabling claudication in the lower extremity by restoring arterial blood flow through the femoral–popliteal segment. This procedure is clinically significant given the burden of peripheral arterial disease nationally and the importance of minimally invasive options that can reduce recovery time and limb loss risk.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of the clinical intent and procedural components represented by the code, the typical sites of service where the procedure is performed, and the common billing modifiers associated with this service. The publication also outlines the payer landscape relevant to reimbursement and coverage considerations and provides context for related service lines in vascular interventional care. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0505TCPTperipheral-arterial-diseaseendovascularfemoral-poplitealvascular-interventionstent-placementradiological-supervision

Billing Code Overview

CPT code 0505T describes an endovascular procedure that restores blood flow to the femoral–popliteal arterial system by inserting a stent via a catheter introduced through a venous access site. The procedure includes vascular access (via a small puncture over a groin vein or open ipsilateral vascular access), intraprocedural imaging and mapping with arteriography, ultrasound guidance, closure by any method, and radiological supervision and interpretation (RS&I).

Service type: Endovascular peripheral arterial stent placement (femoral–popliteal) performed via transvenous catheter access with imaging and RS&I
Typical site of service: Hospital outpatient department or ambulatory surgical center where vascular interventional procedures and intraprocedural imaging are available

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old male with symptomatic peripheral arterial disease presenting with lifestyle-limiting claudication in the left calf and/or rest pain and nonhealing ischemic ulceration. Noninvasive testing (ankle-brachial index and duplex ultrasound) demonstrates significant femoropopliteal artery stenosis or occlusion. After diagnostic angiography confirms a flow-limiting lesion within the femoral–popliteal arterial segment, the vascular interventionalist elects to perform a percutaneous transvenous femoral–popliteal stent placement (CPT 0505T) to restore inline flow to the lower extremity.

The typical clinical workflow includes pre-procedure evaluation and optimization (cardiac risk assessment, antiplatelet/anticoagulation review, renal function assessment for contrast), informed consent, sterile preparation in an endovascular suite or hybrid operating room, ultrasound-guided venous access (commonly contralateral or ipsilateral groin), catheter-based arteriography and lesion mapping, crossing the lesion, stent deployment within the femoral–popliteal system, intraprocedural imaging and hemodynamic assessment, and vascular access closure. Post-procedure monitoring includes limb perfusion checks, access-site surveillance, discharge planning with antiplatelet therapy and wound care if applicable, and arranged follow-up duplex surveillance and vascular clinic visits.

Coding Specifications

Modifier	Description	When to Use
`22`

Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Primary specialty performing endovascular femoropopliteal interventions.
`208800000X`	Interventional Cardiology	Performs peripheral endovascular interventions in some centers.
`207RR0500X`	Interventional Radiology	Commonly performs catheter-based arterial interventions and arteriography.
`207L00000X`	General Surgery	Vascular-trained general surgeons may perform procedure in certain settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of extremities, unspecified extremity with intermittent claudication	Common indication for femoral–popliteal stent placement to relieve claudication.
`I70.231`	Atherosclerosis of native arteries of right leg with rest pain	Indicates critical limb ischemia in the right lower extremity that may require revascularization with `0505T`.
`I70.232`	Atherosclerosis of native arteries of left leg with rest pain	Indicates critical limb ischemia in the left lower extremity and is directly relevant to planning endovascular stent placement.
`I70.243`	Atherosclerosis of nonautologous biological bypass graft(s) of the leg with rest pain	Relevant when femoropopliteal disease involves bypass grafts and endovascular stenting is considered.
`I70.261`	Atherosclerosis of native arteries of extremities with ulceration of thigh	Indicates tissue loss from poor perfusion; revascularization via femoral–popliteal stent may be used to promote healing.
`I73.9`	Peripheral vascular disease, unspecified	General diagnosis that commonly appears on claims for peripheral arterial interventions.
`L97.421`	Non-pressure chronic ulcer of left calf with fat layer exposed	Ulceration related to ischemia prompting revascularization with this procedure.
`R02`	Gangrene, not elsewhere classified	Severe ischemic limb threat where femoropopliteal revascularization may be performed to salvage limb.

CPT Code	Description	Relationship to This Procedure
`36200`	Introduction of catheter, aorta; diagnostic, arterial catheterization (e.g., for selective arterial study)	May be used if diagnostic aortography or selective arteriography is performed prior to `0505T` for lesion mapping.
`36901`	Introduction of a needle and catheter for thigh–leg infusion or embolectomy (or similar peripheral arterial catheter procedures)	Represents peripheral arterial catheter-based interventions that can be performed in the same session for thrombotic complications or adjunctive therapy.
`36011`	Introduction of needle and/or catheter, central venous access (non-tunneled)	Used when central venous access is required for monitored anesthesia care or medication administration during the procedure.
`75962`	Angiography, extremity, bilateral (radiological supervision and interpretation)	Provides radiologic imaging and interpretation codes commonly billed alongside peripheral arterial interventions when arteriography is performed.
`93925`	Duplex scan of arterial inflow and outflow, unilateral or bilateral study	Often performed pre- and post-procedure for surveillance of flow restoration and stent patency.

OpenPayer