Summary & Overview
CPT 37217: Transcatheter Stent Placement, Intrathoracic Carotid/Innominate
CPT code 37217 represents a specialized vascular procedure: transcatheter stent placement in the intrathoracic common carotid artery or the innominate artery performed via a retrograde lesion treatment through an open cervical carotid artery approach. This hybrid open and endovascular service includes angioplasty when needed and all radiological guidance, supervision, and interpretation. The code captures complex carotid/innominate interventions that combine surgical exposure with catheter-based stenting and imaging support.
Nationally, CPT code 37217 is relevant to hospitals, vascular surgeons, interventional radiologists, and health plans because it denotes a high-acuity procedure with resource-intense operating room and imaging requirements. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for use of CPT code 37217, the typical site of service and service type, and how the code is positioned relative to related carotid and thoracic stenting services. The publication also provides benchmarks and policy-relevant context for coverage and billing practice where available, and highlights areas where input data was not provided. Data not available in the input.
Billing Code Overview
CPT code 37217 describes transcatheter stent placement in the intrathoracic common carotid artery or innominate artery performed via a retrograde treatment of a lesion through an open cervical carotid artery approach. The service includes any required angioplasty, radiological guidance, and radiological supervision and interpretation.
Service type: Endovascular stent placement with open cervical carotid artery access (retrograde approach)
Typical site of service: Operating room or hybrid operating room with interventional radiology capability, often in a hospital inpatient or outpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with symptomatic high-grade atherosclerotic stenosis of the intrathoracic common carotid artery presents with recurrent transient ischemic attacks despite optimal medical therapy. Diagnostic cerebrovascular angiography demonstrates a focal proximal common carotid lesion inaccessible via a transfemoral endovascular approach. The vascular surgery and interventional radiology teams plan a hybrid retrograde open cervical carotid approach for transcatheter stent placement using 37217. The workflow includes preoperative imaging (CTA/MRA), perioperative antiplatelet loading, an open cervical exposure of the common carotid artery, retrograde arterial access through an arteriotomy, delivery and deployment of a self-expanding carotid stent across the lesion, completion angioplasty as indicated, and intraoperative radiological supervision and interpretation. Postprocedure care includes neurovascular monitoring, duplex ultrasound surveillance prior to discharge, antiplatelet management, and outpatient follow-up for wound and stent surveillance. Typical site of service is an operating room or hybrid angiography suite within an acute-care hospital; the service is performed by vascular surgeons or interventional radiologists with support from anesthesia and surgical nursing teams.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two qualified surgeons work together as primary surgeons, each performs distinct portions of a complex retrograde carotid stent procedure. |