3555F CPT: Policy & Reimbursement Benchmarks

CPT code 3555F is a Category II performance measure code used to document and report clinical quality data. Category II codes are not used for payment determination but instead capture specific clinical behaviors, outcomes, or observations to support quality measurement and improvement nationally. The presence of this code signals attention to standardized, reportable clinical elements that inform value-based programs, public reporting, and payer quality initiatives across the health system.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the clinical and reporting contexts in which it is used, and the implications for quality measurement. The publication outlines benchmarks and reporting considerations, summarizes relevant policy developments affecting Category II reporting, and provides clinical context for how the measure is captured in routine workflows. Data limitations from the source are noted where applicable.

Billing Code Overview

CPT code 3555F represents a performance measure for which no summary was provided in the source description. Based on the code format, this is a CPT Category II performance measure used for reporting quality-related clinical information. Service type: Data reporting related to a clinical quality measure. Typical site of service: Quality reporting occurs across clinical settings where performance data are collected (for example, outpatient clinics, hospital-based care, and ambulatory care settings).

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Clinical Context

A typical patient is an adult undergoing a peripheral arterial intervention for symptomatic peripheral artery disease (claudication or critical limb ischemia) in an outpatient vascular lab or hospital interventional suite. The workflow begins with vascular imaging and pre-procedure evaluation by an interventional cardiologist, vascular surgeon, or interventional radiologist. The patient receives local or conscious sedation, vascular access is obtained (commonly femoral or radial), diagnostic angiography is performed, and targeted endovascular therapy (angioplasty, stent placement, atherectomy, or thrombolysis) is delivered to restore perfusion. Post-procedure, hemostasis is achieved with manual compression or closure device, the patient is observed in recovery, and follow-up includes vascular exam and imaging as indicated. Typical sites of service include hospital outpatient departments, ambulatory surgical centers, and specialized endovascular suites.

Coding Specifications

Modifier	Description	When to Use
`24`	Unrelated E/M service by the same physician during a postoperative period	Use when an unrelated evaluation and management visit occurs during the global period.
`25`	Significant, separately identifiable E/M service on same day as procedure

Taxonomy Code	Specialty	Notes
208100000X	Cardiology	Interventional cardiologists perform peripheral interventions in some centers.
208100000X	Vascular Surgery	Vascular surgeons commonly perform endovascular peripheral arterial procedures.
208D00000X	Diagnostic Radiology	Interventional radiologists perform vascular access, angiography, and interventions.
208600000X	Anesthesiology	Provides sedation or anesthesia support for complex interventions.
363A00000X	Nurse Practitioner	May perform pre- and post-procedure assessments and assist in clinic workflows.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
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Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37184`	Transcatheter placement of intravascular stent(s), peripheral artery, open or percutaneous approach, including angioplasty when performed; peripheral artery, each vessel	Often performed during the same session when angioplasty alone is insufficient and stent placement is required.
`35476`	Thrombolysis, arterial, infusion for thrombolysis, including catheter placement, infusion, and monitoring when performed (peripheral)	May be used when acute thrombotic occlusion is present and catheter-directed thrombolysis is indicated prior to definitive endovascular therapy.
`37220`	Revascularization, endovascular, open or percutaneous, femoral/popliteal artery, including angioplasty and stent when performed; single vessel	Commonly billed for percutaneous transluminal angioplasty of femoropopliteal segments performed in the same procedural episode.
`92928`	Percutaneous transcatheter placement of intracoronary stent(s), with or without other therapeutic intervention	Included here for context when coronary and peripheral interventions are performed during the same hospitalization by interventional teams (different vascular beds).
`93925`	Duplex scan of arterial inflow and outflow, complete bilateral study	Often performed pre- and post-procedure to evaluate arterial disease extent and procedural success.

OpenPayer

Summary & Overview

CPT 3555F: Quality Performance Measure Reporting